Foolish Choices

Internet Librarian

Alternative Medicine = Foolish Choices according to generally accepted western medical practice standards.  Granted, the insurance company won’t pay for the allowed standards of care, but heaven forbid that one try alternative medicines as a way to ease symptoms of a chronic condition.

Largely self-educated when it comes to my birth defects and self-care requirements, I’m also a tight-fisted Yankee who won’t spend outlandish sums of money on routine care if it’s not going to change the status quo.

I saw what the pursuit of “normalcy” did to my parents finances, and the toll my expenses ultimately took on their marriage.

After my parents separated and divorced, it was up to me to stop my mother’s continued ill-advised spending on my health, and to have the deep, middle of the night, soul-searching conversations about managing expectations and dealing with a tight if not impossible budget.

So, it was with that point of reference that I moved to California in 1985, and watched my formerly-available coverage dry up before HIPPA and as digital file sharing and data mining of information began and became the norm about 1985 – 1992.

“Wall Street”, a film about corporate greed, was released in 1987, and it dealt with how to glorify corporate greed and justify rapacious profits without delivering anything in exchange.  That’s my point of reference when dealing with healthcare insurance companies, which are a bureaucratic nightmare.

By 1997, the insurance industry was coming under scrutiny for its own rapacious practices, and films like “The Rainmaker” dealt with how health insurance firms are designed to deny benefits to people until they give up and go away, or die for lack of care.

Into that denial of care scenario comes me, pre-existing health conditions rampant, who uses as many alternative medicine, palliative care options as possible to keep moving and functioning, with what amounts to one hand being tied behind my back.  I just don’t have the patience to debate medical options with a bunch of idiots whose goal is to get to “denied” as fast as possible, regardless of whether or not your care should be covered under the terms of the medical plan.  You know – the plan you and your employer pay into every month.

I’ve gotten a lot more years on this earth than anyone expected, however, the health care / benefits system isn’t set up to handle a chronically ill patient who doesn’t spend all her spare time in the emergency room, running up medical expenses and co-pays that would break any normal budget.

Instead, as my doctor and I have agreed that it’s time for me to stop working as a safety issue, the insurance company suddenly rears up and demands I keep on working because I don’t have a list of medical expenses a mile long proving that I’m sick.

And, this is from the same insurance company that denied my CT scan as “experimental”, before they finally paid for that treatment 4+ months later.

So, as it’s COPD Awareness month, I’m busy studying up on alternative medicines (and looking for a new way to raise the headboard of my bed off the floor by 3-4 inches safely to ease my breathing while I sleep) while also trying to compose a letter to explain my medical situation to insurance people who don’t care, and who won’t read what I write.  All in the hope that it will change their minds and enable them to grant me my disability benefits.  Benefits that I’ve paid for, and which the theory behind Obamacare would seem to grant me in exchange for such a payment…  Seems like a hopeless case, and cause, but I’m dedicated to trying to achieve 1 impossible thing a week, and that’s my new mission.

2 thoughts on “Foolish Choices

  1. I think your blend of alternative medicines and routine health care plus regular exercise and a good diet is the best course. I hope you find the herb or treatment that truly helps your lungs perform better (if not perfectly). And I’m a skeptic. I don’t buy wholesale into everything the medical doctor/nurse/care provider tells me, but I know that they usually have information that I don’t. Humans (if they’re paying attention) have a built in b.s. detector and one can tell if somebody is trying to sell them a bill of goods and/or just plain doesn’t know what the hell they’re talking about. And there’s quacks in all those fields, both the alternative medicine and ‘real’ medicine. My cousin is a naturopath and if you’d like (I/M me on FB) I’ll give her your name over there and you two can chat and maybe she can refer you to someone in your area that is trustworthy and not horribly costly. Here’s to a brighter future without all this red tape, which on its own can strangle somebody.

    Liked by 1 person

  2. Actually, since I couldn’t sleep last night, tossing and turning over the latest application to withdraw more money from my 401k, I started searching “Aetna Complaints” and from there went on to research “Aetna ERISA Violations”. I found a ton of lawsuits and legal cases, and I’m trying my best to mentally compose a letter with enough caselaw in it that they have to respond. And, if they don’t respond, it will help me build my case for the real lawyer to take over and wipe the ground up with their abusive violations and complicit actions between my employer and Aetna.

    While I will PM you for naturopath options privately, I’ve been mentally composing a new letter to my employer reminding them of their fiduciary duty to me under ERISA, as well as the inherent conflict of interest which exists if the same entity who is in charge of paying out the benefits has a conflict of interest because they want to save money. ERISA laws mandate that the employee’s investment in their benefits be managed by a company employee (who can be jailed due to their failure to ensure their fiduciary responsibilities to the employee are considered above the duty of the plan administrators to make a profit and conserve their assets).

    Not sure if I expressed that clearly, but it’s another legal loophole to chase.

    Especially since the company didn’t answer my question directly last week, but rather turned the question over to Aetna for a response. Aetna’s response was, “blah, blah, blah… You may file an appeal”.

    Apparently, I’m entitled to know the Aetna policy / formula they use to make decisions which are contrary to my doctor’s medical advice, and I am entitled to know the name, education and any medical certifications of the Aetna clinician who has ruled my doctor is mistaken in his medical judgement.

    So, that will start this weeks’ new adventure.


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