reason #5 bajillion that we need universal health care

[Soylent Brice]

got home last night. was chit-chatting with my beautiful wife. she was telling me about her sister's predicament. her sister had an appointment with her doctor the week before last due to her scoliosis. just a regular checkup. of course she had to take off a half day from work for this. she's a bartender at a chain restaurant. work was slow that week also so she only worked maybe 30 hrs.

so a few days later her sister discovers 4 lumps on her breast. so she schedules an appointment with her gyno. they get her to come in on last thursday, i believe. she goes in and they tell her they can't help her. she's confused, insists she has an appointment, etc. the lady tells her, we know you have an appointment, but your insurance is no longer valid.

uh, what?

the lady would not tell her anything further. there she is, standing at the doctor's office, 4 lumps on her breast, several women in her family who have been diagnosed with, and died from, breast cancer, and she's told that the insurance she just used the week before is now somehow no longer valid.

after harassing the insurance company for a few days she finally discovers the problem. she had n ot worked the minimum 35 hrs that week to maintain her insurance. at that point she had only worked maybe 25-30 hrs that week thus far also, so she was still no longer technically valid.

so, here we have a single mother, who bartends for a living to support her and her daughter, GED is highest education, she busts her ass standing on her feet all day with scoliosis, finds 4 lumps on her breasts with having a family history of deaths resulting from breast cancer, and the answer she gets is - well, you haven't worked enough to earn it, sorry.

un
fucking
believable
.

[JHB]

1. And remember, when the Company Talking Point Brigade disputes the "50 million without insurance"

...figure, your wife's sister is one of the people who they say "doesn't count".

[ejpoeta]

2. so see, she CHOOSES to not be insured.... she chose to miss work to go to the doctor

thus putting her under the requirement and so she chose to not be insured. please tell me i don't need the sarcasm tag for this.... and i wonder when these people who are out there spouting the talking points ad nauseum without even thinking of what they are saying will do when they need their insurance that they have been paying for and it isn't there for them. will they THEN get it???

[Soylent Brice]

3. my wife's family are all fundie RWers, and this situation just finally

made them realize how stupid they've been. watching them come to the realization that shit is fucked up with insurance cos was bitter-sweet for me. sweet because they finally see now, but bitter because my SIL is still in this situation.

i just wish people would wake up sooner. why do things like this have to happen to people before they'll realize something is wrong with the way things are?

to answer your question, i don't think these morons spouting these talking points think about what they're saying first. they don't need to. greed is all-consuming.

[surrealAmerican]

4. I blame it on a lack of empathy or imagination.

The insurance-industry-supported talking points have convinced these people that those who are suffering are somehow deserving to suffer, so their empathy doesn't kick in, and they just can't imagine it could happen to them.

[Festivito]

5. And we spend EXTRA money just to have that denial.

:banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead:

[Soylent Brice]

6. i'd stop banging your head against that wall unless you know your carrier will cover the ER visit.

[dysfunctional press]

7. relay that info to your rep while he's home on recess...

we need to inundate our reps- the other side most certainly will.

[Soylent Brice]

8. primed and ready, believe me.

i have my own personal health care fiascos going on as well. this is just fuel for the fire.

[downeyr]

9. If she works a full week...

can she get her insurance back in working order or how is that going to work? This is fucking horrible!

[JHB]

10. I suspect that now that she's been dropped...

...if she were to somehow get it back, they would call the lumps a pre-existing condition and refuse to cover treatment.

[Soylent Brice]

15. that's what she's freaking out about. she won't be able to find out until next week when

she tries to go back to the doctor.

[Lars39]

11. Her lumps would then become a pre-existing condition...probably not covered.

[downeyr]

13. Fuck. You're right. n/t

[Soylent Brice]

14. what they told her is that she must resume a 35 hr work week to regain eligibility.

apparently that's how the policy is written.

edit: welcome to DU

:hi:

[unblock]

12. i don't understand what the coverage is meant to be

is the idea that she's covered once she racks up 35 hours in a week but until then she's not covered?
so she can't ever get sick on a monday or tuesday but by friday or saturday she might be covered?

that makes no sense, something doesn't add up.

[Soylent Brice]

16. as stated upthread, that's how her policy is written apparently.

either the person she spoke with is fucking stupid and explained it wrong, or she is, which she's not. she was paying attention very carefully due to the fact she was freaked out and scared about not being able to see a doctor for this.

this isn't the first time i've heard something like this.

[unblock]

18. i can't imagine a policy actually being written that way, something got lost in translation

i can imagine that each month, the employer has to list full-time and part-time employees and if she was downgraded to part-time employee (which legally constitutes a firing) then that might do it. but i can't imagine a policy that's actually directly tied to hours worked as you work them each week.

alternatively, the employer might have screwed up and neglected to pay the premiums or properly fill out some other bits of routine paperwork. crap like that happens all the time, yet another reason to get employers out of the health care business.

[Soylent Brice]

19. all good points i can ask her to find out, although, keep in mind this is what

the carrier told her, not her employer.

she's going off of what the insurance co explained.
and we know they're chock full of shit, period.

[daa]

17. My story isn't that bad but

my lovely wife had to make an appointment for a routine bone screening. The first words out of the clerks mouth were "what insurance do you have?" Not, hello, how are you , thank you for calling our practice, just what fuc***g insurance do you have. And now we have a super dem majority trying to sell us insurance reform for health reform. Throw the Rascals Out.