This is not something I would normally post to my blog since it has nothing to do with film or video production. However, I spend most of my life in a profession and craft that I love and I share that with members of my personal life. It only seems fitting that I share some personal stuff with my professional life.
I don’t like the idea of having to ask an insurance company what’s the best treatment for my son. That’s what I’m dealing with right now. The healthcare professionals in charge of my son’s treatment are as frustrated as I am and I don’t fault them for the situation.
How did I get to this point? I grew up with a family doctor who actually made house calls. I went to my annual check ups and dreaded getting my finger pricked for a blood sample. The nurse was an old woman who had patience with us kids and our fear of needles and pain, but at the time I thought she was a heartless old witch. As I got older the checkups became less intimidating and when I went off to college, they stopped altogether. Young adulthood was disease free and for the most part I was healthy.
Fast forward to parenthood. I had health insurance through my employer. I paid a little from my paycheck and they pid some. Seemed fair enough.
Fast forward to divorce-hood. I lost my insurance and was uninsured for 8 years. Three years into divorce-hood my boys came to live with me and they too, had lost their insurance. Being a single dad on the salary I was making at the time allowed me to qualify for medicaid for the boys. It worked out nicely for them. I was still uninsured but became resourceful at finding free clinics and programs to get my healthcare needs met. By now we’re talking about a thoroughly middle aged man who’s starting to feel the progress of time on his body, mind, and spirit. The coverage I received for my boys through Virginia Premier was great and relieved a lot of emotional burden from me, knowing that they were covered. However, my goal was to get off the “dole”, so to speak, and be self supporting, you know, private health insurance.
Believe it or not, it wasn’t until I quit my job and started my own company that I was able to reach that goal. The first two years of the new business I still used medicaid but when I filed for renewal at the end of 2014, my income put me out of eligibility. Hooray! I finally had made it! I was successful enough to get private insurance! I started looking around in the newly formed Healthcare Market Place and was pleasantly surprised at how easy it was to find and apply for coverage. No more dealing with insurance agents, self service! I enrolled in the plan that I now haven and started monthly premium payments that were more than I really wanted to spend but also had been reduced because of my income level. Regardless, my son was covered (the oldest one moved out so my tax credits changed). Plus I was covered as well. I’m a success story!
That brings us to where I am now, a father looking for the best care for his son. Thank God I have insurance. Right? Well, yes, and no. Without getting into personal details, my son was admitted to a short term acute care facility. He needs the kind of help that works best when the person is willing. He is willing and I was referred to a few options to consider by a community resource professional. I checked them out and picked one and got the process started. Through a simple miscommunication that is really no fault of anyone, the process was started to move him from the acute care facility but without checking to see if the long term healthcare provider was in the insurance provider’s network. Come to find out it’s not, so we have to start over again. The staff at the facility he is in is working with my insurance company to get a “single case agreement” for him to go to the place that’s out of network but it’s unlikely it will be granted. The staff member I spoke with at the current facility is frustrated with the process as well. She doesn’t like the idea of knowing what is best for the patient but not being able to initiate it because the insurance companies won’t cover it. She says it happens all the time.They can order longer stays for the patient but then that leaves the patient with medical bills to pay that aren’t covered by insurance. When I got my private insurance, I went to the administrator of a counseling program that works within the school system, to update my info. I was told that they don’t take private insurance and that my son could no longer get the service he had received the year before, services that actually helped and made a difference. I also know a Registered Nurse who recently graduated from Nursing School. She tells me that 90% of her time is spent on paper work.
Every doctor, counselor, therapist, physician’s assistant, or nurse I’ve ever met has had a deep desire to help people and has spent long hours and lots of money educating themselves. They feel they can do some good but are faced with limitations and obstacles that they have little to no control over. It comes down to the personal, one-to-one interaction they have with their patients in situations like this.
I’m a success. I’ve got one more kid to nurture and take care of who is a growing you adult and will be on his own soon. I started a successful business in a field that I love. It’s allowed me to improve the standard of living for me and my family by getting out of debt, making home improvements and getting “real” health insurance…that’s expensive and doesn’t provide as good of coverage as the Virginia Premier government-funded policy did. So, I’m stuck in the middle making enough money to live a good life. But in order for my son to get the best healthcare, I need to make shit loads more money to bypass the insurance-managed healthcare system and pay out of pocket, or close my business and take a low paying job to be eligible for medicaid.
Don’t get me wrong, I’m moving forward with my life, raising my son, growing a business that will provide opportunities for others, prevailing against stacked odds, because that’s what I do. For the first time in a long time, however, I’m really rethinking some things. Please don’t call me a republican, democrat, conservative, liberal, libertarian, independent, socialist, or commie. I’m none of that because those labels and affiliations can’t contain me or help me. I know where my strength lies.
Thanks for listening.