Sunday, October 6, 2013

Repost: Dear President Obama

First published July 29, 2010, then again on November 7, 2012, and now brought out again and brushed off on October 6, 2013.

Sometimes it is good to look back, to see how things were, how impossible the situation seemed, and, having come out the other side with only minor wounds, to be grateful.

So let this be a companion piece to today's bookend of rejoicing: Dear President Obama: My Experience at the Marketplace.

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Dear President Obama,

This is a follow-up letter to the one I wrote you exactly one year ago.  I thought you might like an update.

It's been a long time since I cried tears of happiness, and I would like to thank you for creating the opportunity for me to sit here like a complete nitwit, boohooing my teeny-tiny brains out.

Truth be told, the occasional blissful moment in an excellent movie can provoke a brief weep -- but tonight, we're talking floodgates, and bitter saline drawn for release from the Secret Inner Pool.

On September 30, 2009, I became one of the many uninsured.  That's no great story, no Big Whoop, as the kids used to say, and I still do.

One of the many things I admire about you and your administration is your willingness to hear individual stories, and to believe in the integrity of the storytellers.  You don't ridicule instances, you don't seem to fear being overwhelmed by them.

Already permanently disabled by a severe case of one of the most severe of pain syndromes, CRPS/RSD [Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy], lupus [SLE], avascular necrosis/osteonecrosis [AVN/ON], and Some Other Annoying Crap [SOAC] -- it was a real blow to my quality, and even hope of, life to come down with osteomyelitis in my prosthetic shoulders and in the long arm bones themselves.

A complicated but not unmanageable situation, given enough Local Talent, and I am blessed with Local Talent Galore.  There are three excellent medical schools within spitting distance of Marlinspike Hall.

The Author of My Story decided to spice things up with plot twists:  Make the offending bacteria be so obscure, nasty, and recalcitrant that it could not be identified by the wily microbiologist's eye and proved resistant to any antibiotic made by mortal man;  Create such a snarl of confusion that even the we-have-seen-everything, ennui-stricken researchers at the CDC threw their hands in the air, preferring an honest Ebola virus to my obscure domestic germs;  Dictate that the conditions under which these bacterial cultures could be successfully grown existed only in the warm, moist, rum-soaked environment of my shoulders.

Each shoulder having previously been replaced, the prostheses had to be removed.  Surgical concrete laced with all sorts of charms and amulets took their place for periods of up to 3 months, and then, most often, had to be replaced with new ones, as surgical concrete, like all other things in my life at this point, tends toward entropy.  Seven surgeries, President Obama, in the space of 18 months.  Five stays in ICU, three stints on a ventilator, and two resuscitations.  A partridge in a pear tree. 

It was not easy.

Lest you think that the drama lessened between sessions in the operating room, I also single-handedly supported a cottage industry of infectious disease warriors, and co-opted all the free time of Marlinspike Hall's Manor Denizens.  Back and forth we went, inserting and tending PICC lines, infusing intravenous antibiotics several times a day, making blood offerings to appease the demanding serum levels of Haute Society Pestilence, and so on, and so forth.

None of this would have been possible, of course, without excellent insurance coverage.  It was thanks to the reluctant involvement of the Grand PooPah of Tête de Hergé's Insurance Commission that I had any coverage at all once our version of COBRA ran out (here, it's THE ASP).  I was already in a high risk pool, but it was an unregulated pool over which the Grand PooPah could only utter tsk:tsk:tsk

BCBS of Tête de Herge is a wily enterprise, and my insurance premiums began to rise, rise, and then rise a lot more.  Finally, it was decreed that as of October 1, 2009, I was to pay, in U. S. Dollars, $1513 a month, in addition to the annual $5000 deductible/out-of-pocket expenses.  The cost of being insured would now amount to 96.6% of my private disability income of $1996.20/month, an amount never adjusted for inflation, despite the spiraling costs of Everything, Everywhere.

Of course, we all know that if they would just accept Lumps of Pure Gold Studded With Blue Topaz, there'd be no problem.  It's this Social Contract involving Oblong Green Rags of Value that is screwing everything up.  Some proprietary blend of cotton, silk, and linen is worth more than my Studded Lumps?  I don't think so.

Anyway, a 41% hike in the space of 9 months finally forced me into the scary position of being in the middle of a health crisis without benefit of insurance.

If you read my blog, and we all know you don't, you would read account after account of daily fever, pain, sweats, fatigue, and the certainty that I would need to cheer up to be suicidal.  It's nothing but a broken record, and to make matters worse?  I now write like H. P. Lovecraft.

I almost went permanently insane during the Great Health Care Debate, especially when it looked like the Tea Baggers might succeed in excluding Aliens from Tête de Hergé (très décédé, d'ailleurs).  ArseHoles!

You about lost me as a supporter when you stopped fighting for the Public Option, and at several other murky junctures.  I lost a lot of my natural optimism, my well known spunk. When the package was passed, it was not clear to me what was actually about to happen, if anything.  Everyone said it would be years before the real impact of reform would be felt.

But whispers in the dark persisted, and the word on our unpaved back-country roads was that some sort of High Risk Pool for people labelled uninsurable was going to be available... in July 2010!

Tall tales went the rounds about some website somewhere, rumored to be, that explained the possibilities in accessible language and without endless complication.

I went, myself, to the fabled site -- I saw it with my own eyes -- It is real, it is real!

There was one hoop through which I had to leap, and leap I did.  The application for coverage by the Pre-Existing Condition Insurance Plan required that a rejection letter based on pre-existing conditions be attached for eligibility.  The letter must date from within 6 months of the time of application.

Last weekend, I spent four hours filling out an insurance application from InHumana, detailing every instance of hospitalization, complication, treatment, diagnostic procedure, and ingrown toenail, and sent it off to Underwriter Land with fervent hopes for swift and complete rejection.

My rejection letter, which Fred is having framed, arrived today.  It is riotously funny, a moment of hilarity in the midst of my Personal Health Tragedy Epic Saga -- every Long Boring Story needs comic relief.

Sincere in my intent to make application to the PCIP, I poured myself a stiff one this evening, downloaded the .pdf file, printed it out, and girded my loins.

Five minutes later, I was done.

My vision blurred as I read about provisions for those who qualify within Tête de Hergé's territory.  I finally made out that my monthly premium would be $495. 

My hands began to shake when I stumbled on this:

In addition to your monthly premium, you will pay other costs. Covered in-network services are subject to a $2,500 annual deductible (except for preventive services) before the plan starts to pay benefits. Once you’ve met the deductible, you will pay a $25 copayment for doctor visits, $4 to $30 for most drugs at a retail pharmacy for the first two prescriptions and 50% of the cost of the prescriptions after that. If you use mail order, you will pay $10 for generic drugs or $75 for brand drugs on the plan formulary for a 90 day supply. You will pay 20% of the cost of any other covered benefits received from a network provider. Your out-of-pocket costs cannot be more than $5,950 per year.
And it was not long before I was weeping.  Fred, too.  La Bonne et Belle Bianca Castafiore even joined in, though she is well-insured by her operatic company.  Unfortunately, she pays more than your average soprano due to a, uhhh, errr... Cyst Situation.  But we won't talk about that...

I would love to shake your hand and give you a hug, maybe even a kiss on the cheek.  Michelle, too.  The girls and the darned dog, as well.  I don't think the Secret Service would much like that, so please accept the enclosed 2010 ManorFest TeeShirts for you and your whole family, instead.

I hope we guessed right on sizes, as they tend to run small.


The Retired Educator
Your Greatest Fan

If you have serious medical conditions and cannot get insurance because of them -- this is a good place for helpful information and suggestions: Foundation for Health Coverage Education/Coverage for All.
photo credit: Steve Hopson


  1. OMG! Really?
    This isn't Lovecraftian [1] fantasy?

    [1] I am supposed to write like David Foster Wallace, so let me insert a footnote here. Did you know Lovecraft suffered from terrible health and died at forty-six, in 1937?

    I don't know the quality of his health care, but I suspect not great, as, according to Wikipedia:

    "Despite his best writing efforts, he grew ever poorer. He was forced to move to smaller and meaner lodgings with his surviving aunt."

  2. it's true, it's true! my docs are all rubbing their hands together, licking their lips, dreaming up wish lists of things to order, stat...

    one of the best provisions is unfortunately only usable "for a child under age 19 or for a person who lives in massachusetts"[homage to Teddy?]:

    if you can show that you have a pre-existing condition but you were offered individual coverage within the past 6 months at a premium "that is at least twice as much as the Pre-Existing Condition Insurance Plan premium" for your state -- then you qualify.

    i really, really wanted to wax poetic and longwinded on that issue, but -- alas -- i am neither under 19 nor hanging out in Boston.

    poor h.p....

    hope you are well! i'm gonna go hang at your place some time this weekend. fred is busy putting up a new booth for Finale Week at ManorFest -- a fortune-telling thingy.

    he calls it "ManorFest Destiny."

    [i'm sorry.]

  3. Owwooo, omg I feel cruddy complaining about our health care sysytem here when I read your post!!

    Yes we have a effluent garbage system here when it comes to having to tolerate bad practice, service and absolutely no fair justice system when the Docs make life threatening mistakes, however your situation has just recruited all my complete empathy.

    Yes we share our lot when it comes to dealing with disintegrating bodies, but Im greatful that this financial side is covered.

    I hope you have some resolution sometime soon!!!


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