27 April 2004
Our single-payer future
Health-insurance operations, I am convinced, rely on the unwillingness of most of their customers to read the thousands of words that constitute the average group policy.
Unfortunately, I read the damned things, and today someone is going to have to come up with an acceptable explanation for refusing to cover to any extent a standard name-brand drug that is listed on the copy of the formulary that was provided, a drug prescribed according to their rules and requested through a participating pharmacy as defined in said rules.
In a more rational world, I'd pay the entire tab for the drug and confine my insurance claims to seeking partial reimbursement for really expensive treatments which, of course, would cut my insurance premiums substantially. But this is the world we have, and this is the policy I have, and if they're not going to honor its provisions, they're damned well going to explain why.
Oh, no, don't worry, we're not about to enact Hillary® brand Hyperexpensive National Health Care. At least, not yet. But it's difficult for me to support the private sector when the private sector is busy looking for ways to stick it to me.
(Update, 1:30 pm: After spending entirely too much time with an annoying automated voice-responder system I have no objections to disembodied voices per se, and actually came this close to developing an insane crush on one many years ago, but "Margaret," as she was identified, seems to be one part Stepford, two parts Windows, and I kept hoping for a BSoD I got to the heart of the matter, which is this: before they can fill this prescription which, incidentally, is a condition either not specified in the contract or mentioned at a point far removed from any conceivable context they wish to speak to the prescribing physician, presumably so they can talk him into a cheaper drug. After six years with the doctor in question, I think it's a safe bet he'll tell them to jump a stump and fill as prescribed, you farging busybodies.)Posted at 7:42 AM to Dyssynergy
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» Insurance Blues from Dan and Angi Have Something to Say
I withhold all of the good, warm fuzzies I feel for the free enterprise system when it comes to HMOs, especially Aetna®, which is Satan's insurance company. Their motto (and it's not exclusive to them) is "We'll pay for what......[read more]