Saturday, March 28, 2009

Weekly Groceries

I open my pantry then refrigerator, hoping to find something to eat before I go to work. After searching for a few seconds I close them disappointed that there isn't much food in my house; a good reminder that it's time to go grocery shopping. I quickly slap together some peanut butter and crackers to take with me. It's raining again and I'm not looking forward to my commute. 

I drive through puddles and hear the rain pound on my windshield as I make my way slowly down a busy street. I feel my stomach growl and review my shopping list in my head: all the basics, plus my favorite cheeses, some truffle oil, and my favorite chocolate.

Then I pass the food bank near my clinic and I make myself look. There is always a long line on the weekend as people try and get something for their families for the week. I look at the people in line today, in the rain. Some are wearing coats, some are holding an empty box over their heads to try and keep dry. I wonder what the cold rain sounds like as it hits the boxes on their heads. It must sound different then it does on my windshield as I sit in my warm car. I see young and old, black and white, and everything in-between. I wonder how long they've been there in the rain, slowly inching their way toward food, their commute for the day. A poor person's traffic jam.

Thursday, March 26, 2009

Health Insurance Claim Denied!

I decided to tackle an insurance company for a patient today. Actually, this was worse than an insurance company. This was a company that health insurance companies use to review and then deny coverage. They do the ultimate dirty work. 

English is not this patient's first language and I'm convinced he was lied to and taken advantage of by his insurance company. He was referred to a specialist last year by one of our doctors and had a procedure done. He says he called his insurance company before the procedure to make sure it would be covered. They told him it would be covered but then he got a bill for $4,000 with a letter saying he hadn't finished his 9 month waiting period for a pre-existing condition. He was 3 days short of his 9 month waiting period. He has now lost his job and has no more coverage and no money. He's been sent to collections. 

First I talked to a woman who kept repeating what his letter, which I had in front of me, said. "After a careful review by our company, we have determined that you did not comply with the 9 month waiting period for a pre-existing condition and therefore your claim has been denied." But he called and was told this would be covered. He doesn't have a penny to his name. Trust me, he never would have done this if someone didn't tell him it would be covered. Surely you must have record of this conversation." I said. She wouldn't acknowledge or deny such a conversation but just kept reading what was in the letter. Then she transferred me to someone higher up the predator chain. 

This woman, who had already been briefed of the conversation by the first woman was ready for me. She told me she couldn't discuss this case because I wasn't the patient. I imagined her face looking like a cross between a bulldog and a pitbull. "But I have the letter right in front of me and his English isn't very good," I pleaded. She repeated, like a robot, that he did not wait his full 9 months and therefore the claim is denied. "He's 3 days short of his 9 months! You're kidding, right?" Sadly she wasn't. This conversation could have been right out of Michael Moore's movie, "Sicko". "He can go through the appeals process again if he wants but it will just be denied again." The more I tried to explain his situation, the more I realized she didn't care. She couldn't care because if she did, she couldn't work at a place like that. 

"Can I ask you a question?", I said. "Do you LIKE your job?" She replied by demanding to know if I like my job. "I love my job. But then again I'm an advocate for my patients." Then she said, "I know you're just mad because your clinic won't be paid for this procedure." "No, that's not true. I'm doing this for HIM. He didn't even have his procedure done here. I'm just advocating for my patient." She replied by demanding to know my name again and telling me she doesn't like my attitude. 

MY attitude?! Doesn't she get it? She's the one with the attitude and most people in America would think so. I got off the phone and was cheered by a couple of co-workers. I wonder how people can spend their day denying the poor their medical coverage. I suppose one can only do this if they don't have an ounce of empathy. I wonder what would happen if all the money spent to deny claims were used for universal healthcare. I suppose she'd be the one out of a job.

Sunday, March 15, 2009

Lucky Boy

He's three years old. He has long black kinky hair tied in a ponytail. He looks more like a she than a he except that he's wearing jeans with a brown leather belt, brown shoes, and a plaid shirt. He's with his foster mother who turns out is his aunt. He calls her mommy. She has permanent custody of him. His biological mother was using crack while she was pregnant with him and he was rescued from the crack house when he was a baby.

His foster mother was very heavy set and looked older than her 36 years with a mottled dark complexion. She wore a purple printed bandana tightly on her head to cover her hair. Her fingernails  were long and they didn't look like her real nails but she said they were. They had the most intricate design which was perfectly applied. Her toenails matched her fingernails. She told me it only took a few minutes for someone to paint them. 

I ask him about his friends and about his favorite foods but he's acting like a tired three year old, putting his hands on the computer followed by falling on the floor. I realize I'm waiting for her yell at him and threaten him as I've seen too many times with other patients. Instead, she picks him up from the floor and puts him on her lap and as he squirms away, she laughs. She tells me how smart he is and how happy she is that they live together.  

Saturday, March 14, 2009

His Own Personal Arsenal

He was a 48 year old new patient to our clinic. He had a pasty white face and grey scraggly hair. His wire rimmed glasses drooped past his cheekbone. He talked to me in a serious monotone voice.

I asked him questions I ask every new patient. One question I ask is, "Do you own any guns." It is illegal for someone to own a gun if they have been incarcerated and whenever I ask those patients that question, I usually get a resounding "No!" followed by something like, "I'm not going back to that hell hole." I stopped asking my Somali patients that question a long time ago when I was laughed at by an interpreter. She told me that these Somalis have fled a country full of violence and that's the last thing they would want to own. 

Occasionally, our African American or Caucasian patients have answered, "Yes" and then I ask them if there is a trigger guard, if the ammunition is kept separate from the gun, and if the guns are locked up. They have almost always answered, "Yes" to these questions.

"Do you own any guns?", I asked this pasty white patient. He immediately said, "Yes I do. I have one loaded, cocked, and ready to go. It's sitting right on my coffee table". "On your coffee table?!" I said without even thinking. "Yep. As soon as I moved here, I started hearing gunfire. So I decided I needed to protect myself". "Okay, so you have one gun?" "No, ma'am. I have five pistols and two rifles. I have another pistol ready to go, sitting next to my bed." 

I instantly became afraid of this paranoid man and didn't want to ask him anymore questions. I did, however, ask him if he brought one to the clinic. "Not on my person but I've got one ready in my car. "

I don't know if it's legal to own this many guns but I sure wasn't willing to ask him.