A local Schoolyard Bully (a.k.a. Average Health Insurance Company) told a class full of terrified children that if they “know what’s good for them” – no one will tell on him when the teacher comes back.
As it turns out, the Bully has been taking lunch money from kids and promising to “take care of them “. Convincing the children that they need his help, the Bully has collected the quarters, nickels and dimes of the entire class since the beginning of school. Newer students have started handing over their money without question because they believe it’s “just what you do”.
But according to multiple sources, when the children start getting hungry, the Bully is refusing to actually pay for their food citing the “Proof of hunger pre-authorization” clause that must be filled out before any food will actually be distributed. Several children filed an anonymous complaint with their teacher that they are having to do without their lunches, even after Bully promised them.
While the teacher left the room to speak with the cafeteria cashier, the bully reportedly grabbed the smallest kid in the class by the throat, causing him to choke, cough, and turn purple. According to eye-witnesses, the Bully told the entire class that if the teacher gets involved in the lunch money dispute, they will all be turning purple. He claimed to be “giving them warning” and showing them “what it will be like” if the teacher begins to oversee the processing of the lunch money.
Upon the teacher’s return, 98% of the students claimed they did NOT want the teacher involved and that to their knowledge, there wasn’t even a problem. The boy who had been allegedly choked was unable to speak but speculation is that he would have most likely agreed with the majority of the class.
In an exclusive interview, the Bully stated that there is no reason for the teacher to “get involved” or “takeover” the lunch money collection. “Things are just fine like they are – we don’t need a teacher keeping an eye on us”.
When asked about the supposed strangling incident, the Bully replied that while he had no direct recollection of such an event, he would readily address any specific student complaints behind the swing set during recess.
“Teachers need to just leave us kids alone. Why do they have to meddle in our business? This is private stuff and everyone thinks it’s fine. It’s just FINE the way it is.”
When asked if he was blaming the teacher for the purple toned discoloration of the student’s face, Bully nodded in agreement saying,
“Well, it’s for their own good – I’m just trying to show them what it will be like if the teacher gets involved. I figure I owe them that much.”
The student whose neck had allegedly been strangled refused multiple requests for an interview. His handwritten statement, scrawled out in red crayon, said only: “Things are fine – just FINE.”
In the last few weeks, I’ve heard some pretty interesting things that insurance companies have told their customers. One friend called and told me they were unable to get their prescription filled, even though it had been submitted to the pharmacy with a current, signed PAPER prescription from the doctor. The insurance company wasn’t filling it because they said it wasn’t “pre-authorized”. That’s crazy enough on its own – but wait – it gets even better.
The next thing the insurance rep told my friend was that this is “because of healthcare reform”, (which is fascinating to me since no legislation has actually passed, much less gone into effect). When I mentioned that to my friend, she shared with me the insurance company’s explanation for the “logic”.
“We’re just showing people what it will be like if it does pass. We think people should know.”
Wow. I don’t know if I should feel grateful or insulted. Wait a minute . . . . yep . . . . I’m insulted.
Then, a week or so later, it happened to me with a written, current prescription for a medication I’ve used for years. When I was complaining about my dilemma on Facebook (which is a perfectly rational response I think), a completely different friend told me he’d called his insurance company about a similar situation.
Guess what he was told. Hmmmmm. I think I’m seeing a pattern here. I’m no financial genius or world-class economist, but . . . I am a mom who uses the hell out of our insurance and I smell a RAT.
I’ve worked for doctors and have helped bill insurance companies including medicare & medicaid. I’ve worked in the HR department of an international corporation explaining medical and dental benefits to employees of all income brackets and going through open-enrollments with them. I’ve worked for an insurance broker who helps smaller groups find affordable insurance for their employees. I’m not exactly unexperienced. I know the procedures, I speak the language, and unfortunately I also understand the bottom line. Which is, not surprisingly, the actual $$BOTTOM LINE$$.
The Method and the Motive
Fear is one of the oldest, most effective motivators known to man. The examples of its abuses are too many to name, but I’m sure you’re already thinking of a few. When fear is used in such a widespread way, it’s often to help one person or group get power or stay in power. In this situation, the fear is being perpetuated by huge insurance companies who desperately want things to stay exactly the way they are.
Any time I’m trying to figure out who’s being honest in a given situation, I try to look at what each person stands to gain or lose, and judge their honesty based on what their motivations might be. When an insurance company tells someone the reason they can’t get their prescription filled is because of legislation that hasn’t even gone through yet and/or they’re just “showing people what it will be like” if healthcare reform happens, it doesn’t take long to come to a conclusion. Does the Insurance company stand to gain or to lose something if reform passes? Absolutely. They stand to lose and lose BIG. Do they have a motivation to keep it from passing?
Ummm . . . . yeah.
Why would the insurance companies say those things if they weren’t true? Because they need to block reform. They are doing fine the way it is. They don’t want the government (which by the way is you and me) getting involved and keeping an eye on them. They NEED things to stay just the way they are. They NEED us to be scared.
Of course they’re going to blame the government; of course they’re going to tell us it’s for our own good. After all, we matter more to them than profits, right? They’re delaying the medication our doctor wants us to take because they care so much about us.
The week I had to go without my medicine, I spoke to the pharmacist in person about it one time. “Why would they do something like this”, I asked. “Why would they hold up a medication they’ve been approving for years?” He shook his head in frustration as he rang up my stuff and said simply, “Because the insurance companies control everything.”
The Stuff that Matters Most
There are many smart, concerned, caring people out there who aren’t happy with the current administration, many of them are close friends of mine; and I really do respect their right to disagree and voice their concerns. But this is not a political issue. This is a human issue. This isn’t about Republicans, Democrats, Libertarians, Tea Parties or any other group. This isn’t about Obama “winning” or Obama “losing”. It’s so much more important than that.
Healthcare Reform is about cancer, heart disease, stroke, birth defects, diabetes, rare diseases, broken legs, migraines, prenatal care, accident victims, Alzheimer’s, arthritis, kidney disease, chemotherapy, radiation, back surgery, knee surgery, hip-replacement, hysterectomy, childbirth, burn victims, rich people, poor people, old people, young people, people with jobs, and people without jobs.
It’s about people living, or people dying. It’s about children getting care their parent’s can’t afford or going untreated. It’s about being able to see the doctor who’s most qualified for your condition whether they are contracted with your insurance company and not going broke in the process. It’s about getting the test or treatment your doctor wants in time for it to do some good without getting bogged down by insurance procedures.
It’s about strangers, neighbors, friends, enemies, co-workers, children, parents, spouses . . . . real people. If you’ve been lucky enough to not really need your insurance to come through for you yet, be thankful. Because one day you will. Some of us have gone through it sooner than others, and trust me, it’s a pretty harsh wake-up call.
Cancer doesn’t care who you voted for in the last election. Diseases like Vascular EDS don’t care who your insurance company is. The heart attack waiting for you someday doesn’t give a damn if you have an HMO, PPO, POS, or whatever.
Guess what . . . . when something like cancer strikes you – or God forbid your children – you won’t care either.
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