Bandaids …

October 1st, 2014.

I know this day well because it was the first day of enrollment for the ACA (I don’t call it Obamacare because that’s not its name …anyway). The perky, young lady on the other end of the phone (yes, PHONE because no one could access the website) was sorry that the system was down (on the first day) and she couldn’t help me. But she told me to send a written inquiry as to what plan I was interested in, and I would be sent all the information I needed, in the mail …in 10-12 business days. GUARANTEED!

I literally stared at the phone. Then I said (direct quote), “you DO realize it’s not 1983. Right?”

She laughed nervously.

“So, let me get this straight,” I huffed, “I can hang up this call and book airline tickets to Brazil, have food delivered – hell, have a CAR delivered – to my house, map my way across any continent, transfer money, send music or books, take a picture, film a movie or start a company …ALL on my phone. But the government – that has just spent four years and six hundred million dollars to build a WEB SITE – can’t send me written information (simple text) in any other form but the US postal service?!”

There was silence on the other end. Finally, she said, “yessir …b …but I could kind of go over the three basic plans with you.”

I said, “I would LOVE to hear them. Please …go on.”

She introduced me to the Platinum, Gold and Bronze packages. When she got to the Bronze, she said, “I think this will be the most popular and probably perfect for your family. It’s not a big monthly payment. Now …you DO have to cover 40% of the medical costs out of pocket. But, it’s a great plan.”

I butted in, “Wait …you’re saying that if I go to the hospital, 40% of the bill is MY responsibility?”

“Yessir,” she answered, sheepishly. She could feel my snark rise up.

I waded in, “Young lady, do you realize I can make a 40% cash deal with any hospital in the country? I don’t need a ‘bronze’ healthcare plan to do that. I can literally go to their billing department and tell them I’ll pay cash if they’ll do the procedure for 40% of the original quote. And they’ll do it …almost every time. So what will I be getting for the other 60% I pay in to your plan?”

She, again, had no answer. But re-assured me that there was a perfect plan for me and if I could afford THIS, then THIS would drop off HERE and if I couldn’t afford THAT then THIS would kick in THERE, and so on and so forth. Then she reiterated that all my questions would be answered …in 10-12 business days.

And THAT was my introduction to the Affordable Care Act.

This is how the government manages things.

In fairness, however, my family was right in the crosshairs of the way healthcare had been delivered BEFORE the ACA was passed. And it was a big contributor in bankrupting us (second only to the IRS and the music business …don’t get me started). So I know first hand that there were cracks in the system that absolutely needed to be addressed. I lived it. And I was FOR reform. But I would’ve taken reform in the opposite direction.

Years earlier, when I knew absolutely nothing about healthcare and my daughter (with special needs) was losing her coverage due to a loophole in our policy, I asked the Tennessee insurance commissioner why I couldn’t buy coverage in a different state. He literally laughed at me. I didn’t understand. I said, “dude, I can buy car insurance all over the map. This all seems like state run monopolies to me.”

He got more serious and said, “you’re a very perceptive young man.” That didn’t make me feel better.

For the next seven years my daughter got dropped from and picked up again by seven different insurance companies …that were ALL named Blue Cross Blue Shield. I have literally filed paper work into the same insurance company on the day AFTER she was dropped by THAT company …only to have her re-instated …by THAT company …the next day. It was a stupid shell game.

But at least that didn’t happen with the ACA …if you count having it happen THREE times not happening.

You’d think maybe I’d be a drum beater for single payer, government run healthcare. Get rid of all this greed and corporatism messing with our health. Well …not so fast.

The only business in American history that has been completely managed and controlled by the federal government is mine …SONGWRITING. Songwriter royalty rates have been set BY the government since 1909 (pretty much the beginning of the profession). And while other aspects of the music business have started later and catapulted faster, songwriting has been a steady drip of trying to keep up with technology and constantly trying to get paid a decent rate for the work done.

You see, the government has basically established a MAXIMUM wage for us all these years. And now, the rates they’ve set for us don’t apply to anything. Because the market has left the governing bodies, taking care of us …in the dust. The government, while initially trying to protect us from being ripped off, has driven us into near extinction. It is always well intentioned. But it doesn’t realize it’s inadvertently standing on your throat until you’re turning blue and have lost most of your brain function. And that gets me back to healthcare …

We need to define some terms in this country. Is healthcare a RIGHT? Well, I suppose in an existential way it is. You have the right to life – and that includes the care of your health. But nutrition is a part of health care too and you’re not allowed to just take food from a business …even if you’re starving.

Proper sleep is part of health care. But you have to pay market value for mattresses.

And even if you’re bleeding, you can’t go into a Wal Greens and just take bandaids.

If healthcare is a right, then bandaids are a right. Aren’t they? But wait …you have to pay for them. And they are remarkably affordable and accessible. How can that be? Could it be that the market did that? All on its own? Without some politician deciding how much people SHOULD pay for a bandaid?

I wonder …

I haven’t read this new iteration of how healthcare will be delivered. But I hope it gets me closer to my doctor and further away from the government. Because the larger a bureaucracy, the more cumbersome and unwieldy it becomes. And while technology and the private sector are inventing the self-setting broken leg through the iPhone, government will still be filling out paper work in triplicate …on a typewriter.

I don’t know what our new healthcare delivery system will be. I just hope I don’t have to have it mailed to me …in 10-12 business days.


9 thoughts on “Bandaids …

  1. Thank you for re-posting this! It’s perfect for where we are once again at. I have now lived both sides of the ACA. I was a technician that specialized in Medicaide. For families, the elderly, children, you name it, I’ve done it. And I saw how horrible it was for the clients. How I couldn’t get care the elderly and disabled and couldn’t take it away from a perfectly healthy 25 year old slacker living at home with mommy. We had baby’s die from lack of care because “the system” wouldn’t accept the baby so doctors wouldn’t see them. It’s a horror show! When I couldn’t take it any more I left and started my own business and was eligible for Medicaid. Technically I still should be, but the lady who is now working the cases doesn’t deduct expenses correctly so it puts me over income. I have complained all the way to the State and no one has ever gotten back with me. And it’s been 9 months. I don’t know what the answer is, but it’s definitely not the ACA! By the way, I have several ideas on your daughter’s coverage. If you’re interested please feel free to email me at the email I used to subscribe to your blog. Thanks! Kristi Ross

    Liked by 1 person

  2. Very well written and timely. I like your thoughts on healthcare rights. I’m not sure what the answer is especially for the poor…. who will always be with us and it may be us at times. I know our church has a discretionary fund to help those in need.


  3. I wish you would have been one of the people that President Trump listened to regarding ACT (referred to by almost all news sources as “Obamacare”. You have seen it from first hand experience with not only a love and wish of taking care of family but also with a knowledge of economics. No matter who is the President I’m just so wishing that it all could just be worked out with common sense and for the good of all.


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