It's unbelievable how Americans have been told this lie about how we are the greatest country on Earth and then we are (with nearly full support from both parties of our sellout so-called democracy) ripped off from the cradle to the grave. Jobs stolen, houses stolen, rights stripped. Homeless veterans, teachers, seniors, and families. American Greed is the American Way now. It was already horrific, but the current administration seems to be engaged in a looting spree on steroids. What will become of us? I am so worried for my children. Thank you for sharing your story.
It's incredible you are able to write this at all, without your head exploding in a rage of unfairness. I swear my blood pressure elevated just reading your story. I despise the American healthcare system. I had the exact same talk as you did w/ that long ago colleague, and it ended the exact same way. It's such a shame that selfishness is a crime that other people pay for. I'm glad you have your family, and they you. xo
What is also especially horrific is the insurance company KNOWING people are being forced into the desperation of living in their automobiles - sick, injured people! - and just giving you that information like they are being sympathetic or helpful. In a just society, the company would call a meeting among the adjusters and execs to discuss this horrible problem and how to fix it. But it's intentional.
These stories blow my mind and enrage me. I am Canadian and though most Canadians will tell you our system is far from perfect you will never hear stories of inhumanity and insurance grift like this one. It’s truly mind boggling that such a rich and powerful country treats their citizens so poorly.
As a Brit - with a creaking but functioning National Health System I can not understand how anyone thinks in such a wealthy country that poor people, middle class people, children are left to suffer and die?
Really? Lives lost, potential squandered? Far more productive, if that is all that humans are, to have a healthy population?
It is all very Dickensian.
With a body that is constantly breaking down, I would have been off this mortal coil a very long time ago.
It seems that money and profit is valued more than life? If all that energy the right put into denying women sovereignty over their bodies, and focused on those who were alive now as, then surely something far superior to this despicable situation would be available.
As an American, I can say that absolutely money and profit are valued more than the lives of others. (Unless of course that other is in the womb. But once they’re out of the womb, eh.)
So humans are ok in theory but once exist in the world....meh. still believe in the goodness of our species..listening to the response to the cutting of funding for research. Illegal ...so much for lecturing europe about democracy and freedom of speech while getting all cosy in suadia arabia with russia. This part of the world really needs to stand up and be counted.
That’s a familiar story. They always deny your first attempt. Then the lawyer that is recommended to ‘help the low income disabled types’ turns out to not be a helper at all: takes 30% of that retroactive payment, for maybe 5 hours of work. It’s all a scam, preying on the most vulnerable.
I know there are sadists in this world: they find a happy place in disability administration.
I had a significant L&I injury in the 90s and the doctor told me that he was ‘forced to lie about me’. The job I was supposed to take was parking cashier @ 1/4 the pay. This from a 22yo idiot with zero work experience
It’s a miracle there aren’t more Luigis every day.
I so sorry you and your family went through that. I have had my own unbelievable situations with insurance companies. It’s disgusting the way they delay decisions and arbitrarily deny people coverage.
Oh Marlon, what a terrible story. When the system is sicker than the patients it’s time for desperate remedies. When it’s our turn again let’s not be polite about demanding a health system without intermediaries for all Americans.
I live in Ontario. Last year I contracted an infection which required open heart surgery eight teeth removed four trips down my gullet to stop a bleeding ulcer. I was six months in and out of hospital and two weeks in rehab. The cost including parking was about $145 upper and lower dentures cost me $350. My Drugs cost me four dollars a refill.
Oh my word. That’s almost unbelievable. When people from other countries talk about wanting to move to the US, I think, well, I guess, but let’s hope you stay fit as a fiddle or make a lot of money.
I’m very glad that you are here and better! Thank you so much for sharing your story. This sentence made my tears well up and wrenched my heart:
“I can remember the panic on their faces like it was yesterday.”
As a parent, I felt this to the depths of my soul because I’ve been in a situation where I was injured (accidentally) in front of my children and stifling my screams of pain to not panic them any further.
As you’re aware, I work in health insurance. Your coworker, like many people, was uninformed about COBRA which in and of itself is not health insurance. COBRA stands for Consolidation Omnibus Budget Reconciliation Act, passed by Congress in 1985.
COBRA gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time [this is key] under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102% of the cost to the plan.
The key point is that it allows a worker 1) the right to continue to purchase the same insurance that they had when they were employed, under their former employer’s policy, 2) it’s limited, usually six months, and 3) the former employee pays 100% (or up to 102%) of the premium that your former employer might have paid a portion of when you were employed.
One of the most truly evil things I’ve seen & read in my decades of experience is the rise of ‘middlemen’ companies (TPA) that will administer a business’s COBRA plan and how they make their money. They skim off the top. They get a percentage of the “savings” that they generate for the employer’s company. How did they do that? By denying your legitimate medical claims, especially denials for “pre-existing conditions”.
Yes, there was an appeal process but there were built in bugs to deny those as well. You might as well call the movie you referenced about the HMO a documentary. Those of us who worked in the industry at the time all knew how accurate that movie was depicting the state of our health insurance at that time.
The Affordable Care Act (ACA) was a good step in the right direction to fix our broken health insurance system. Primarily, the removal of denials for “pre-existing conditions”.
I watched the development of the ACA very closely. Its first iteration was really promising because it proposed to expand the eligibility requirements for our most vulnerable populations for our two government health insurance programs: Medicare and Medicaid.
If that had gone forward, I would be on Medicare right now. Instead, I’m staring down five more years before I’m eligible and wondering if, after paying Medicare taxes for 46 years, whether the fuckwads currently ruining our government are going to take it away from me.
As most are aware, the ACA did not keep that great idea because all the for-profit health insurance corporations whined about how they can’t compete with government insurance and poured millions of dollars into Republican lobbyists and disinformation ads.
Remember the summer of the town halls for MoCs (mostly Republicans because they were the minority party) to discuss the ACA with their constituents and the lies spread about the ACA? I do. I remember watching one town hall (maybe it was McConnell) filled with white people, mostly Boomers (my generation I’m ashamed to say) who were whining and crying about they didn’t want their taxes paying for this bill. Bitch, the only people who are taxed for the ACA are the ones who make over $200,000 annually and that ain’t none of you people in Kentucky attending that town hall.
One particular white woman was bawling about how she wanted her country back. [NB: I was so naive back then about the racism still living under the rocks in this country. I’ve learned more & grown up since then. I voted for Obama twice & was really happy about the progress of my country. 😳]
I remember the rise of the Tea Party (which MAGAs make TP’s look like kindergarteners).
Thankfully, the ACA did pass. It’s not perfect because nothing is perfect. We got a bastardized version of a healthcare law but at least the pre-existing condition denial was removed.
Nowadays, of course, for-profit health insurance has replaced PEC with “prior authorizations” which is ONLY a cost control tool. No matter what the UHG’s and Blue Cross Blue Shields and CIGNAs and the other for-profit fucks say on their websites about PA being value/quality care for your health, they’re LYING.🤥.
Anyway, I’m so glad you’re here, Mr. Weems. I enjoy your writings. Apologies for running long winded, I didn’t intend to write an essay in your comments. As you can tell, health insurance is my wheelhouse and nothing but nothing pisses me off more than a patient who isn’t getting the full benefits of their health insurance policy. My motto is - Take care of the patient first and chase the administrative paperwork afterwards because paperwork doesn’t bleed.™️ (Ha, I just trademarked my motto! 😁)
Take care. Stay healthy. (And fuck that disability benefits administrative judge!)
I understand your opposition to the ACA. I agree that bringing private insurance to the table (which was not in the original version) was a mistake. I pointed that out, mentioning the lobbying that private insurance companies did to get a piece of the pie & not compete with the government on costs. Hence, the summer of town-halls that Republicans held to lie their way into defeating one of the best things about the first version of the ACA - no for-profit private insurances. Oh, that and hOw aRe wE gOiNg tO pAy fOr iT 🫤
The full context: “Thankfully, the ACA did pass. It’s not perfect because nothing is perfect. We got a bastardized version of a healthcare law but at least the pre-existing condition denial was removed.”
A health insurance scheme is what we have because of the fundamental flaw baked into this scheme. The flaw is that we treat human health, illness, sickness, and disease as a commodity instead of a human right.
A perfect example of treating human health as a (sort-of but with its own flaws) right is the DoD providing health care to our active-duty armed forces because a healthy fighting force is considered part of our national defense. The DoD healthcare system is a closed universe, but it, too, is a type of insurance.
Please point me to a developed nation that does not have health insurance. Countries have national health insurance (which btw, that’s what Medicare and Medicaid are - NHI - for eligible people.)
If you don’t like health insurance, in whatever imperfect form, then please explain what is your alternative solution?
Lastly, don’t cherry-pick my own words at me again. Ever.
No cherry picking. “Thankfully, the ACA did pass." This is what you said. You approve of the ACA. You may wish for modifications, but you approve.
I don't approve the ACA, regardless of modifications. I don't approve of mandatory, private health insurance, which is what we have. Other countries provide health care to all. One is perfectly free to buy additional care. But this is unnecessary. Most in the UK or Canada are perfectly happy with their health care, and don't pay a dime extra.
You will perhaps jump thru every conceivable hoop to endorse our system. Obama is just so wonderful, right? But our system is wrong. People should not have to appeal to insurance companies for health care. This is the obvious lesson in this article.
Thank you for sharing your thoughts. I’m not denying what I said. I’m disagreeing with your taking it out of context of the entire paragraph. You’re a writer, from your bio, and you know this. Or you should.
I do not endorse our system. Also, I’m NOT jumping through every conceivable hoop to approve our screwed up system. I don’t know where you came up with that interpretation of my comments. It’s wrong.
What I said was that this is the system that we have, something that neither you nor I created. I pointed out its fundamental flaw. Health care should be a human right, not a commodity.
I am all for universal healthcare (not health insurance). As I stated, I was excited when the first version of the ACA was expanding the eligibility of our current government insurances because it was my belief (and others who work in the industry) that this was a good step in working towards universal healthcare. Plus it got rid of pre-existing conditions denials, a major blocking tool used by insurances to deny anyone needing health insurance (by which they access healthcare - again, it’s fucked up.) And it was derailed by the for-profit health insurance corporations.
Yes, the lesson is that people should not have to appeal to insurance companies for their healthcare. I’m glad you got the point. This was the intent of my pointing out the ridiculous “prior authorization” scheme initiated by these same companies. A policy holder should not have to ask permission to utilize the benefits for which they pay.
I would love a national healthcare similar to the U.K. or Canada or Germany or Brazil. Brazil’s system, imo, is the one to model. Completely free to any person in Brazil for whatever medical services are needed. Best of all, no paperwork. I would love for my job in health insurance to become obsolete. Is Brazil’s healthcare system without its issues? Of course not because nothing is perfect.
I oppose the ACA. The ACA has got to go. It is enforced private insurance, and no part of that is good. Let's replace enforced private insurance with free public healthcare.
This makes me want to scream -- I'm sending you, Marlon, my deep admiration for surviving the insane cruelty of our healthcare system and being able to tell your story without apparent bitterness. This should never happen to anyone.
It makes no sense how insurance companies and disability claims are processed. It’s completely dystopian. No wonder we have executives being targeted! People are frustrated! Look at what you went through! There should be far more transparency.
I'm so sorry this has been your frustrating experience. I don't understand how so many Americans think this country is #1 when in reality we are last in so many areas, none more glaring than healthcare of its citizens. That and education. Wishing you improving physical and monetary situations.
It's unbelievable how Americans have been told this lie about how we are the greatest country on Earth and then we are (with nearly full support from both parties of our sellout so-called democracy) ripped off from the cradle to the grave. Jobs stolen, houses stolen, rights stripped. Homeless veterans, teachers, seniors, and families. American Greed is the American Way now. It was already horrific, but the current administration seems to be engaged in a looting spree on steroids. What will become of us? I am so worried for my children. Thank you for sharing your story.
Oh, Marlon... I can't even imagine... I'm so glad you are still here.
So am I! ☺️
It's incredible you are able to write this at all, without your head exploding in a rage of unfairness. I swear my blood pressure elevated just reading your story. I despise the American healthcare system. I had the exact same talk as you did w/ that long ago colleague, and it ended the exact same way. It's such a shame that selfishness is a crime that other people pay for. I'm glad you have your family, and they you. xo
What is also especially horrific is the insurance company KNOWING people are being forced into the desperation of living in their automobiles - sick, injured people! - and just giving you that information like they are being sympathetic or helpful. In a just society, the company would call a meeting among the adjusters and execs to discuss this horrible problem and how to fix it. But it's intentional.
These stories blow my mind and enrage me. I am Canadian and though most Canadians will tell you our system is far from perfect you will never hear stories of inhumanity and insurance grift like this one. It’s truly mind boggling that such a rich and powerful country treats their citizens so poorly.
As a Brit - with a creaking but functioning National Health System I can not understand how anyone thinks in such a wealthy country that poor people, middle class people, children are left to suffer and die?
Really? Lives lost, potential squandered? Far more productive, if that is all that humans are, to have a healthy population?
It is all very Dickensian.
With a body that is constantly breaking down, I would have been off this mortal coil a very long time ago.
It seems that money and profit is valued more than life? If all that energy the right put into denying women sovereignty over their bodies, and focused on those who were alive now as, then surely something far superior to this despicable situation would be available.
Wish you well - literally and metaphorically
You put your finger right on the answer: Money and profit is valued more than life. Tragically.
As an American, I can say that absolutely money and profit are valued more than the lives of others. (Unless of course that other is in the womb. But once they’re out of the womb, eh.)
So humans are ok in theory but once exist in the world....meh. still believe in the goodness of our species..listening to the response to the cutting of funding for research. Illegal ...so much for lecturing europe about democracy and freedom of speech while getting all cosy in suadia arabia with russia. This part of the world really needs to stand up and be counted.
That’s a familiar story. They always deny your first attempt. Then the lawyer that is recommended to ‘help the low income disabled types’ turns out to not be a helper at all: takes 30% of that retroactive payment, for maybe 5 hours of work. It’s all a scam, preying on the most vulnerable.
I know there are sadists in this world: they find a happy place in disability administration.
I had a significant L&I injury in the 90s and the doctor told me that he was ‘forced to lie about me’. The job I was supposed to take was parking cashier @ 1/4 the pay. This from a 22yo idiot with zero work experience
It’s a miracle there aren’t more Luigis every day.
A great argument for universal healthcare for all Americans no matter how old we are.
Yes.
I so sorry you and your family went through that. I have had my own unbelievable situations with insurance companies. It’s disgusting the way they delay decisions and arbitrarily deny people coverage.
And sometimes they know if they hold out long enough, the person will die before they give them the coverage.
Chilling and infuriating what happened to you, and how this medical injustice is replayed every day across America by insurance industry fat cats.
And yet our news media seem to find it strange that people in this country haven’t been shedding many tears for that CEO!
Oh Marlon, what a terrible story. When the system is sicker than the patients it’s time for desperate remedies. When it’s our turn again let’s not be polite about demanding a health system without intermediaries for all Americans.
"When the system is sicker than the patients" yes.
I live in Ontario. Last year I contracted an infection which required open heart surgery eight teeth removed four trips down my gullet to stop a bleeding ulcer. I was six months in and out of hospital and two weeks in rehab. The cost including parking was about $145 upper and lower dentures cost me $350. My Drugs cost me four dollars a refill.
Move, Marlon
If only Canada would have us...
Oh my word. That’s almost unbelievable. When people from other countries talk about wanting to move to the US, I think, well, I guess, but let’s hope you stay fit as a fiddle or make a lot of money.
You can believe it. I needed to pay for ambulance and Internet.
I’m very glad that you are here and better! Thank you so much for sharing your story. This sentence made my tears well up and wrenched my heart:
“I can remember the panic on their faces like it was yesterday.”
As a parent, I felt this to the depths of my soul because I’ve been in a situation where I was injured (accidentally) in front of my children and stifling my screams of pain to not panic them any further.
As you’re aware, I work in health insurance. Your coworker, like many people, was uninformed about COBRA which in and of itself is not health insurance. COBRA stands for Consolidation Omnibus Budget Reconciliation Act, passed by Congress in 1985.
COBRA gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time [this is key] under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102% of the cost to the plan.
The key point is that it allows a worker 1) the right to continue to purchase the same insurance that they had when they were employed, under their former employer’s policy, 2) it’s limited, usually six months, and 3) the former employee pays 100% (or up to 102%) of the premium that your former employer might have paid a portion of when you were employed.
One of the most truly evil things I’ve seen & read in my decades of experience is the rise of ‘middlemen’ companies (TPA) that will administer a business’s COBRA plan and how they make their money. They skim off the top. They get a percentage of the “savings” that they generate for the employer’s company. How did they do that? By denying your legitimate medical claims, especially denials for “pre-existing conditions”.
Yes, there was an appeal process but there were built in bugs to deny those as well. You might as well call the movie you referenced about the HMO a documentary. Those of us who worked in the industry at the time all knew how accurate that movie was depicting the state of our health insurance at that time.
The Affordable Care Act (ACA) was a good step in the right direction to fix our broken health insurance system. Primarily, the removal of denials for “pre-existing conditions”.
I watched the development of the ACA very closely. Its first iteration was really promising because it proposed to expand the eligibility requirements for our most vulnerable populations for our two government health insurance programs: Medicare and Medicaid.
If that had gone forward, I would be on Medicare right now. Instead, I’m staring down five more years before I’m eligible and wondering if, after paying Medicare taxes for 46 years, whether the fuckwads currently ruining our government are going to take it away from me.
As most are aware, the ACA did not keep that great idea because all the for-profit health insurance corporations whined about how they can’t compete with government insurance and poured millions of dollars into Republican lobbyists and disinformation ads.
Remember the summer of the town halls for MoCs (mostly Republicans because they were the minority party) to discuss the ACA with their constituents and the lies spread about the ACA? I do. I remember watching one town hall (maybe it was McConnell) filled with white people, mostly Boomers (my generation I’m ashamed to say) who were whining and crying about they didn’t want their taxes paying for this bill. Bitch, the only people who are taxed for the ACA are the ones who make over $200,000 annually and that ain’t none of you people in Kentucky attending that town hall.
One particular white woman was bawling about how she wanted her country back. [NB: I was so naive back then about the racism still living under the rocks in this country. I’ve learned more & grown up since then. I voted for Obama twice & was really happy about the progress of my country. 😳]
I remember the rise of the Tea Party (which MAGAs make TP’s look like kindergarteners).
Thankfully, the ACA did pass. It’s not perfect because nothing is perfect. We got a bastardized version of a healthcare law but at least the pre-existing condition denial was removed.
Nowadays, of course, for-profit health insurance has replaced PEC with “prior authorizations” which is ONLY a cost control tool. No matter what the UHG’s and Blue Cross Blue Shields and CIGNAs and the other for-profit fucks say on their websites about PA being value/quality care for your health, they’re LYING.🤥.
Anyway, I’m so glad you’re here, Mr. Weems. I enjoy your writings. Apologies for running long winded, I didn’t intend to write an essay in your comments. As you can tell, health insurance is my wheelhouse and nothing but nothing pisses me off more than a patient who isn’t getting the full benefits of their health insurance policy. My motto is - Take care of the patient first and chase the administrative paperwork afterwards because paperwork doesn’t bleed.™️ (Ha, I just trademarked my motto! 😁)
Take care. Stay healthy. (And fuck that disability benefits administrative judge!)
I understand your opposition to the ACA. I agree that bringing private insurance to the table (which was not in the original version) was a mistake. I pointed that out, mentioning the lobbying that private insurance companies did to get a piece of the pie & not compete with the government on costs. Hence, the summer of town-halls that Republicans held to lie their way into defeating one of the best things about the first version of the ACA - no for-profit private insurances. Oh, that and hOw aRe wE gOiNg tO pAy fOr iT 🫤
"Thankfully, the ACA did pass" Really? That's a the bottom of all this. Insurance, which the ACA cemented into place.
The full context: “Thankfully, the ACA did pass. It’s not perfect because nothing is perfect. We got a bastardized version of a healthcare law but at least the pre-existing condition denial was removed.”
A health insurance scheme is what we have because of the fundamental flaw baked into this scheme. The flaw is that we treat human health, illness, sickness, and disease as a commodity instead of a human right.
A perfect example of treating human health as a (sort-of but with its own flaws) right is the DoD providing health care to our active-duty armed forces because a healthy fighting force is considered part of our national defense. The DoD healthcare system is a closed universe, but it, too, is a type of insurance.
Please point me to a developed nation that does not have health insurance. Countries have national health insurance (which btw, that’s what Medicare and Medicaid are - NHI - for eligible people.)
If you don’t like health insurance, in whatever imperfect form, then please explain what is your alternative solution?
Lastly, don’t cherry-pick my own words at me again. Ever.
No cherry picking. “Thankfully, the ACA did pass." This is what you said. You approve of the ACA. You may wish for modifications, but you approve.
I don't approve the ACA, regardless of modifications. I don't approve of mandatory, private health insurance, which is what we have. Other countries provide health care to all. One is perfectly free to buy additional care. But this is unnecessary. Most in the UK or Canada are perfectly happy with their health care, and don't pay a dime extra.
You will perhaps jump thru every conceivable hoop to endorse our system. Obama is just so wonderful, right? But our system is wrong. People should not have to appeal to insurance companies for health care. This is the obvious lesson in this article.
Thank you for sharing your thoughts. I’m not denying what I said. I’m disagreeing with your taking it out of context of the entire paragraph. You’re a writer, from your bio, and you know this. Or you should.
I do not endorse our system. Also, I’m NOT jumping through every conceivable hoop to approve our screwed up system. I don’t know where you came up with that interpretation of my comments. It’s wrong.
What I said was that this is the system that we have, something that neither you nor I created. I pointed out its fundamental flaw. Health care should be a human right, not a commodity.
I am all for universal healthcare (not health insurance). As I stated, I was excited when the first version of the ACA was expanding the eligibility of our current government insurances because it was my belief (and others who work in the industry) that this was a good step in working towards universal healthcare. Plus it got rid of pre-existing conditions denials, a major blocking tool used by insurances to deny anyone needing health insurance (by which they access healthcare - again, it’s fucked up.) And it was derailed by the for-profit health insurance corporations.
Yes, the lesson is that people should not have to appeal to insurance companies for their healthcare. I’m glad you got the point. This was the intent of my pointing out the ridiculous “prior authorization” scheme initiated by these same companies. A policy holder should not have to ask permission to utilize the benefits for which they pay.
I would love a national healthcare similar to the U.K. or Canada or Germany or Brazil. Brazil’s system, imo, is the one to model. Completely free to any person in Brazil for whatever medical services are needed. Best of all, no paperwork. I would love for my job in health insurance to become obsolete. Is Brazil’s healthcare system without its issues? Of course not because nothing is perfect.
I oppose the ACA. The ACA has got to go. It is enforced private insurance, and no part of that is good. Let's replace enforced private insurance with free public healthcare.
This makes me want to scream -- I'm sending you, Marlon, my deep admiration for surviving the insane cruelty of our healthcare system and being able to tell your story without apparent bitterness. This should never happen to anyone.
It makes no sense how insurance companies and disability claims are processed. It’s completely dystopian. No wonder we have executives being targeted! People are frustrated! Look at what you went through! There should be far more transparency.
I'm so sorry this has been your frustrating experience. I don't understand how so many Americans think this country is #1 when in reality we are last in so many areas, none more glaring than healthcare of its citizens. That and education. Wishing you improving physical and monetary situations.
Lord have mercy. You wrote a horror and crime story combined. I’m speechless. I’ve felt all of my life that most insurance plans are a sham.