Talk Walker

As a Baby Boomer, I remember in my earlier years having the insurance system being explained to me as: The insurance companies take money from you as part of a bet. They are betting you will not get sick and you are betting you will. As long as you are losing the bet, they will take that money, invest it and keep the profits. When you win the bet, they are to pay for a substantial amount of your healthcare with the profits they have made on money invested, which came from you and countless others.

That seemed to work fine, until they started making ridiculous, ill-conceived and irresponsible  investments with money from a bet they would eventually lose. When their investments turned into losses, they started tweaking the original agreement, saying healthcare costs had gone up so much, they could no longer afford to pay out. In insurance speak, that is ” we do not approve paying for this treatment.”

In an effort to increase their profits, they started driving up premiums and reducing payouts, to the point that they now occupy 16% of our economy. I often wondered why I had to pay for their bad judgment and I still do. NOW they argue against insurance reform because it would negatively impact a significant portion of our economy, especially if they were driven out of business. EXCUSE ME!!!!

They weaseled their way into our economy, trying to make up for their own shortcomings by living off the the backs and deaths of tens of thousands of consumers and now they have the nerve to claim we owe it to them to keep them not only alive, but highly profitable. I say if their profits decrease as our well-being, both economic and physical, improve SO WHAT?

We suffered through the Dot-Com bubble bursting and we have handled two Real Estate downturns since the 1990’s. Not exactly grandly, but many of us are still standing. Making healthcare affordable and easily accessible, will make domestic businesses competitive with foreign-owned. Who knows, maybe there are more than a few jobs in that mix, which  is good for all of us. If the insurance industry shrinks to 5% of our economy and small businesses, especially local, grow to 10%, I say great.

Go for it! Call your Senators, Congressperson and President, and tell them it’s time for them to care of us and not THEM.

If you take a look at the date of my last post, you will see I have been “running silent” for the last six months. Some of you know me well, others not so. Regardless, I have felt for a long time my life experience in the U.S. of A. has been pretty typical, and my recent past has been no different.

In June of this year, in the midst of making plans to run for local office, I discovered a lump that turned out to be malignant. Because I a have PPO I bought online,  I was able to get to a surgeon right away without having to wait for “prior approval.” Then the fun began. True to form (according to Sicko), after subsidizing my surgery (I have a $2500 deductible), my insurance company found a tentative loophole which would have given them the right to make me wait three months before starting chemotherapy, in spite of being in Stage III. I called on a few politically active friends who recommended I report this to the Insurance Commissioner. I did, and within a week the issue was resolved and I was able to begin chemo in the recommended time.

That’s the bad news. The good news is I have benefitted immensely from advancements made in the last five years in breast cancer, particularly with managing the side effects of chemo. During my four months of treatment, I never threw up once, and my immune system remained fairly intact. This was primarly due to the wonder drugs Emend , Neulasta and Zofran. Emend neutralizes the receptor in the brain that tells you, you’re nauseous. Some chemos, especially the strong ones, are known for suppressing white cells. To compensate for that, Neulasta stimulates the bone marrow to produce more.http://www.virtualcancercentre.com/drugs.asp?drugid=1795&type=

The down side of this event was I have a $500 pharmaceutical deductible, so the first dose of Emend cost me $300, and the second $200. After that, it went down to $30. Fortunately the Neulasta was administered at the hospital, so it was included in my overall bill. Zofran (another anti-nausea drug) has been around long enough, it is available in generic form, which calls for a minimal co-pay. However, for some reason my insurance company would not approve payment for more than 12 pills a month, no matter how badly I needed it. Out of pocket cost for that was around $50.00.

Nevertheless, I have now finished my chemotherapy and am preparing for radiation, and doing diagnostic testing to make sure the little buggar hasn’t popped up someplace else in my body. The side effects of the chemo and steroids (for anti-nausea) are dissipating, and I feel well enough to put my opinions to the keyboard. With the Bush Administration truly showing its colors brightly enough for even the most blinded American to see, and the upcoming 2008 election, this should be fun.

On the health front, I cannot encourage ALL women over over 40 to  do monthly breast exams, and a yearly mammogram ( preferably sonogram vs. x-ray). Although most abnormalities found in mammograms are benign, 85% of those found to be malignant are in women over 50. Had I taken this advice, I could have detected the tumor early enough I would not have had to deal with chemotherapy, and my life revolving around fighting this disease during a time I could have been pursuing my passion.