Tuesday, September 15, 2009

How health insurance is disturbing my inner peace

So I have to make this relate to spirituality, this hours-long fight I had today with my insurance companies (at least 3 of them) to cover the cost of my mammogram.

This is how it feels to fight with your insurance company, I mean companies, to cover a basic preventive procedure: tightness in the chest, difficulty breathing, and achiness in the back. (So my back always feels that way? Today, it's THEIR fault.)

I discovered our new PRIVATE health insurance has a smorgasbord of companies and phone numbers on the back of the card. About seven numbers, to be exact. So I can't really explain who my insurance is with. Guardian? HealthLink? PHCS? I'm terribly confused. One company pays the claims. Another decides what is in-network. Yet another, what is in-network for the extended PPO plan. Another does lab procedures. They don't talk back and forth. You can only ask one sort of question at each number, and then decide on your own what number you need to call to actually get assistance. I learned more than I ever wanted to know about the convoluted way my insurance plan works, or doesn't, today.

We also have four insurance cards: one each for medical, dental, labwork, and pharmacy.

So I finally figured out the correct phone number to call, and the magic words to use, to have them re-evaluate the claim. The magic words, for me, were "PHCS Extended PPO." All of a sudden, they agreed to re-process the claim, just like that. It was as miraculous as clicking my heels three times and chanting, "There's no place like home ..." and being back in Kansas again. Next time, I'll start by saying those three little words and see what happens.

So forgive me if I don't exactly understand why a government health plan is the new bogeyman. How could it possibly be any worse or more convoluted than the private coverage my family has?

And death panels? Oh, that woman, the damage she did with her wicked tongue before she resigned as Alaska governor. Don't get me started!

I watched my mother die in the ICU in a hospital, and my mother-in-law die here in our home. For myself, I would greatly prefer the latter option if it were possible, even if my life were shortened by a few days or weeks. It's about quality as much as anything else when the end is inevitable. The cost difference is at least tens of thousands of dollars, for one person.

For everyone who is terrified of consulting anybody, much less a professional, about end-of-life care: You're still not getting out of here alive, whether you want to make a will and a medical directive or not. You will probably live longer than generations before you did, and you may not want expensive, heroic measures to prolong your life. You may wish to die at home, without tubes sticking out of every orifice, being force-fed with a stomach tube, or with a machine breathing for you.

Or, you may wish to be hospitalized and have every possible procedure performed. But do you really want medical professionals to make this decision, instead of you and your loved ones? The medical professionals will always choose the heroic, expensive measures. They will work to keep you alive, even if you have dementia or your body is riddled with cancer, if your family does not stop them.

But people are so terrified of the mere thought of dying that they don't want to confront any of those issues.

End-of-life care can be extremely expensive and not at all helpful for the patient. Do you really think CPR is appropriate on a 90-something person with heart failure? Maybe you do, but shouldn't you have the right to decide for yourself and/or your immediate family?

Attitude toward the end of life is a spiritual issue. If you know that you have an eternal spirit; if your religious tradition tells you that life hereafter is a precious treasure that is too beautiful to even conceive of; if you have made peace with your loved ones, you should not be terrified of death. Some fear of the unknown is only human, but this complete avoidance of the issue of human mortality is just silly.

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