Sunday, April 12, 2015
The Great Obamacare Circle Jerk
Let's go back to 2013. After 24 years, the company I worked for decided to lay off its senior legal department personnel, along with some of the senior clerical staff. Well, I was "the" senior legal manager for the company. I oversaw a multi-million dollar receivables portfolio; was involved in training; the company's overall top fee earner; and held an assistant vice president level position as a special projects coordinator for the company's president. Basically, I was in charge of improving efficiency, moral, and productivity. I worked with all the department heads, as well as with the head of the North America division and with senior individuals in the home office in Paris, France (we had been bought out about six years earlier by a French commercial insurance company).
Nevertheless, come February 2014, some six months after originally applying, my wife and I finally received coverage. Because we were already in the system, we were given our choice of start dates---January, February, or March. We though the easiest avenue (to avoid further confusion) would be March. So when the documentation was submitted by Kynect to the insurance company, someone at Kynect though we really meant to say was April, not March, and so they changed the start date without alerting us. Well, that delayed things yet again, but at this point we were used to it. After that, everything seemed to settle down. We were happy with our coverage since we could keep all of our doctors and had no problems getting any prescriptions filled. Well, you know what they say about getting to comfortable right? That's usually when the rug gets pulled out from under you.
Well, the individual I spoke with at Community Based Services was polite enough, but, alas, said I couldn't do anything. I had to take what they offered or get coverage on the open market. Some choice. However, on the upside (from their perspective), I was eligible to pick between three different but essentially same type of policies. It was suggested that I make a list of all our doctors and prescriptions and call back to go over which of the policies includes our doctors. Sounded fair enough, so I make a list of all our doctors along with any prescriptions and called back. Although I had to speak with a different individual, the notes were clear enough for them.
We determined that most of our doctors were supposedly available under one particular policy, although my primary doctor was still a
Fast forward to mid-March this year and my first visit since our policy change (for my annual physical and update on prescriptions). As it turned out, my primary doctor doesn't participate with this insurer. So, I offered to pay cash for the visit. It turns out that I'm not allowed to pay by cash or credit card or anything else under this policy type (it would be considered "fraud"). So, I left without seeing my primary doctor of 33 years. Frustrated, I called Kynect as soon as I got home. Once again, there was nothing they could do, and so I was transferred to another department where I was told unsympathetically to simply "switch doctors". I explained that my primary doctor was a specialist; the only type of his kind in the area, and besides, I had a 33 year relationship with the guy! They offered to find me a substitute, but they'll likely want to do their own testing despite any medical summary they receive. This will only further delay my medical care. That's not going to work I said.
So, I was again transferred to yet another department where I explained the whole situation once more. This time I was told that I
I'm remind of an old saying which says that if you can't be a good example, at least be a good object lesson. So, if you anyone tells you that Obama's Affordable Care Act---Obamacare---allows you to keep your own doctors, or go to whatever clinic or hospital you want, or that you can get your prescriptions filled without any problems, just remember my story.