I write all day at work. Lucky! you might say. And yeah, it’s the kind of work I’m good at. But it’s not that simple.

You see, I work for a health insurance company, and my job is to write correspondence, all day long, letting doctors and hospitals know why we’re not paying them for treatment–or not paying them as much as they thought we would be.

There are all kinds of reasons for why a medical provider might not get paid. They didn’t jump through the hoops of getting the treatment authorized. They did not sign a contract with us. Our medical experts have reviewed the treatment and deemed it to be experimental.

I can take some slight comfort in the fact that most of the time, when the insurance coverage is denied, the provider is required to write the charges off–so they are not allowed to bill the denied amount to the patient. Still, I’m sure the extra costs are passed on in one form or another.

Why am I telling you all this? Well, just to let you know that I am, in fact, what Sarah Palin and the Tea Party warned you about back when they were screaming about Obamacare. I am the bureaucrat who stands between you and your health care.

Of course, Republicans are strangely silent about people like me. Apparently, the fact that I’m getting paid for my health care denials by a private corporation rather than the government makes them more acceptable. On their end, medical providers have to create entire departments to deal with insurance billing and authorization rules, time and money which isn’t being spent on treating patients. Once again, though, the same conservatives who abhor extra government regulations are very capable of turning a blind eye to those same regulations when they are created in the name of private profit.

The truth is, health care costs will need to be controlled, no matter what the system in place. If we ever do have a single payer system, it will be funded with taxpayer money, and that taxpayer money should be treated with respect. We will still have to determine that the treatment being prescribed is reasonable, and that providers aren’t recommending unnecessary procedures (and by the way, providers trying to charge patients for fraudulent or ineffective treatment is something which happens frequently in our for-profit health care system). Republicans try to paint a scary picture of a single payer system in which you will be restricted from getting the care you want, whereas they claim that in a privatized health care system you have the freedom to choose any doctor and treatment you like. That is simply not true. Sure, you are free to choose any service you like–if you can pay the sky-high uninsured costs for it, which the vast majority of people can’t. You need health insurance to help pay for your care, and when you have insurance, the insurance company restricts what care you can get.

Of course, in our system the very wealthy do have the freedom to pursue whatever kind of medical treatment they want–and travel to get it wherever they like–and these are really the only people the conservatives in Congress care about, anyway.

My fundamental point is that single payer health care is nothing to be scared of. Your health care options are not going to be any more restricted than they are now, and you will be able to get treated for your illness or injury without having to go bankrupt in the process. Not a bad idea at all.

Take it from a health insurance bureaucrat.

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This blog post dedication goes out to a very special presidential candidate…and the way he’s changed my life.

As some of you may know, I work in the health insurance industry, for a local company which shall remain nameless.  Yes, it feels paradoxical to be working in that field when I’m a supporter of a single payer system, but that’s life for ya.  Working in insurance may seem like the most boring career path ever–I’m like Kafka without the brilliant novels–but over the years, I’ve enjoyed my job and found some good friends among my co-workers.  It’s been a nice stable paycheck, and I was hoping to keep working there for years to come.

And now the company I work for is imploding.  Why?  Well, there are multiple factors, but a major one stands out.

When insurance companies agreed to join the Obamacare exchange, the government promised them payments from something called a risk corridor program.  This was meant to compensate them for the fact that they would be taking on a large number of new customers who had been uninsured for a long time, and thus would be very sick and would need costly treatment.  This turned out to be true, and costs for the industry have been even higher than expected.  If anything, this is evidence for just how broken our healthcare system was previous to the Affordable Care Act.  All these newly insured Americans are now finally receiving care for medical conditions they were often forced to neglect because they couldn’t afford to have them treated.

I certainly do not expect sympathy for insurance companies in this scenario.  However, the risk corridor payments were supposed to make the transition to Obamacare smoother and keep the health care infrastructure from falling to pieces.  Supposed to.  But only 13% of the risk corridor money which was promised has been paid out.  And it’s all because of that one very special guy.  Yep, Marco Rubio.  Marco cut most of the risk corridor money out of the budget, and he’s very proud of it.  He brags about being the only conservative who has truly succeeded in damaging Obamacare.  Because it’s so much more important to stick it to the President than to allow Americans access to health care…

So now, insurance companies across the country are going out of business, employees are facing layoffs–and the truly frustrating thing is that Obamacare is getting the blame.  I’m hearing it myself around my own workplace.  It’s easy to think that it’s Obama’s fault, if you haven’t heard all the facts.  Rubio knew what he was doing.

Okay, so saying that I’m not voting for Marco for President is a bit of an empty threat–it’s not like I was going to vote for him before.  Still, I’m definitely never voting for him now. Not for dogcatcher.  I’d gladly vote for Bernie over him.  A shoe could be running against him and I would vote for the shoe.  Call it a personal grudge.

Say it with me, everyone:  elections have consequences.  Think there’s no difference between the candidates?  Think it’s not worth your time to vote?  Nope, nope, nope.  My future, and the future of almost 2,000 other workers, hangs in the balance right now because of the actions of one man.  Vote like the quality of your life depends on it… because it does!!!

Well, the election is just a few weeks away and my mind is in pieces. Politically speaking, I’m stuck in a no-man’s-land between disappointment and anxiety. I’m sure I’m not the only one feeling this way right now.

I’m disappointed by the airstrikes in Syria. Disappointed that no matter which party is in power, we keep doing our perpetual war thing. Our addiction to constant military conflict seems to be a train which has jumped the tracks and cannot be stopped by anyone. I just hope it doesn’t end with our country’s demise.

But I’m anxious that if the Republican side gains too much strength, they could do even more damage. Their openly stated goal from the beginning has been to block and get in the way of anything the President proposes. I can complain about the Middle East, but thanks to the Affordable Care Act, my mother has health insurance for the first time in years. Repealing the ACA would have a real effect on my life and my family. Also, I’m in no mood to see the guys in Congress try to force more socially conservative stuff down our throats.

Having Obama in office hasn’t made as much difference as I had hoped it would. But having more Republicans in the House and Senate could make a bigger difference than we think it will.

So the disappointed side of me will continue to shake a fist at all the pictures of pretty, pretty missile explosions which my TV box keeps showing me. But the anxious side of me will vote for and is signing up to volunteer for the local Democrats in our state.

The rest of me remains in no-man’s-land.

July 4th seems like a good time for an optimistic post. I’ve been experiencing the implementation of the Affordable Care Act (“Obamacare”) first hand, as I work in the health care industry, and here’s a little update about how that’s been going….

The start of this year was complete insanity, as the insurance company I work for scrambled to deal with a steep increase in business. And no, the fact that we weren’t *quite* as prepared as we should be was not the government’s fault… Thankfully, things have stabilized now and my days are no longer crazy and overwhelming. However, we still have a lot more customers and a lot more work, so there is still overtime available. And this, of course, means fatter paychecks for me. Sheesh, thanks a lot, Obama! 😉

At home, my mother finally has health insurance, after years of going without. Now it’s just a matter of talking her into going for a check-up…but that’s not an issue of cost anymore, just her dislike of going to the doctor!

So far, the effects of the Affordable Care Act on my life and the lives of my loved ones have been positive. Could things have been better? Sure. A friend of mine recently received some very bad news about her health, and this has been a blow to all of us who know and care about her. The one silver lining? She is very grateful that she made the decision to move to Canada shortly before she was diagnosed with her illness. In her Facebook posts, she almost always mentions how thankful she is to be part of the Canadian health care system. She has more than enough to deal with right now, but at least she doesn’t have to worry about going into debt or not being able to afford her treatment. And that’s a relief.

So yes, single payer would be even better. But, since that doesn’t seem like a realistic option in the States anytime soon, I’ll take the health care reform we’ve had over nothing. Here’s to our beautiful country reaching even higher in the years to come. And remember, you don’t have to believe the anti-ACA propaganda–Happy Independence Day!

At work, I have been going through a few weeks of…well, if I can’t call it Hell, it can at least be described as Purgatory.  I work for a health insurance company which is participating in the Oregon insurance exchange, and we have been flooded by calls from new members.  Almost everyone in the company has been on the phones, talking to people who are frustrated about having to deal with Cover Oregon (the state exchange) and frustrated about having to deal with us.

Which leaves me with some questions.  Yes, the Cover Oregon website and phone line have been a fiasco, sort of like the federal healthcare.gov operation was when it first started.  But–and I can’t get into too many details here, because it’s a public blog and this is my employer I’m talking about–the company I work for was not exactly prepared for all the new business coming our way, either.  We were understaffed, so customers have been on hold for long times, often only to have the phone system hang up on them.  We’re not always sure where the applications of the new members are, or what their status is.  And yes, our website has been so overwhelmed by the amount of people trying to use it that it has experienced–can I use the word?–glitches. 

If we were a government agency, the conservatives would be all over us.  Healthcare.gov was bashed for the exact same things that are happening to us, by the usual suspects who say government can’t do anything right.  Yet I’m not hearing any commentary from our local talkers about the problems at the insurance providers.  It’s as if our mistakes somehow don’t count because our company is run for private profit.

It makes no sense to me.  But I know that our glitches are not going to be talked about the same way the government glitches were, because they can’t be used for a political purpose.  And it doesn’t make a difference to my daily life.  I’ll keep taking the angry calls, anyway.

It has been a little surreal watching the conservative reaction to Obamacare problems over the past few weeks.  I have never before seen conservatives get this upset over people not having insurance coverage.  The hand wringing as they read the letters from their constituents who have lost their insurance plans…the fiery anger as they ask, what will those poor families do now??  As I watch them cry their crocodile tears, I feel the urge to ask a couple questions–

Where were you guys when many of us were suffering under the existing health care system?  Where were you when people were being refused insurance coverage for pre-existing conditions, or kicked off their insurance plan because it was discovered that they had a doctor’s visit somewhere in their past?  I don’t remember your sadness then–in fact, it seemed that you didn’t care at all.  Okay, I get it.  The website isn’t working and that’s embarrassing.  And it is frustrating for people to lose an insurance plan they happened to like, even if it wasn’t a very good quality plan.  But at least there is a website, and the people who lose their coverage can go to shop on the exchange.  Before, if you were rejected by an insurance company for whatever reason, you were likely to be rejected by other insurance companies as well, and there was nowhere else for you to go.  Did you have anything to say about that?

We know, we know, you’re against Obamacare.  So what is your solution, your alternative?  And please don’t say it’s to leave the health care system as it is now–that’s not an acceptable answer.  If you have a much better idea for fixing health care, what is it, and why didn’t you present it earlier, back when the system badly needed reforming?  You’re whining about it now, but it is too little, too late. 

Where have you been?

Ohhhhkay…so as everyone knows by now, the Obamacare website isn’t working so well.  And sadly, neither is the local insurance exchange website for my state, even though I live in one of those states which were eager to participate in Obamacare, and did not have to be dragged kicking and screaming into it.

I’ve listened to Jon Stewart make fun of the problems.  I’ve heard President Obama quipping about how frustrated he is, in his usual suave way.  Conservatives have been mocking the situation, and rightly so.  It’s an embarrassing mess.  Although their solution would be to scrap the whole thing and go back to the old, badly functioning health care system, so I don’t know how seriously I can take their point of view. 

Thing is, this is no humorous matter to me.  I’m not laughing, I’m a little anxious.  As I’ve written before, I have family members who are uninsured and need access to the exchange.  I agree with President Obama–I think the Obamacare product itself is good.  And I love the hippie trippy psychedelic commercials Oregon is running for its CareOregon site.  But what’s the point of cool advertisements if you’re not able to purchase the goods?  As always, my home state is better at creative expression than it is at being practical 🙂

My family is going to give it a couple more weeks, as we hope that all the “glitches” will get worked out with time.  Worst case scenario, we’ll just fill out one of the paper applications.  We need this and are determined to get it.  But there could be an easier way.

So c’mon, President Obama.  We want to buy the product you’re selling.  Let us be your customers!