I Am a Health Care Sisyphus

Last March, I wrote about the struggle to initiate my health insurance with Blue Cross Blue Shield of Illinois.

Despite receiving (and paying) two bills, I remained without coverage. I was told several times that while the bills correctly listed my chosen plan and ID number, I didn't exist in any database that would lead to actual coverage.

I had to wait—even if the bills didn't.

In that post, I concluded that Blue Cross' billing department seemed to be the only one able to accomplish anything, and as such ought to be running the show.

That was premature. It turns out they just needed a little time to catch-up to the rest of the company.

From January through July, I was able to pay my bill via telephone, ensuring next month's coverage was, well, covered. It was the only aspect of my plan that was simple, consistent and trouble-free.

But simple, consistent and trouble-free don't jibe with the BCBSIL business model. Complicated, labyrinthine and convoluted do. Which are the reasons I presume OrbiPay was discontinued.

In place of OrbiPay on the August bill was a phone number which didn't contain the promised functionality (at least if the prompts on the menu can be believed). Who knows, maybe if I had recited the Magna Carta in Latin, farted three times and screamed “Death to ObamaCare! Let a free and unregulated marketplace decide our health care choices!” it might have relented.

After several excruciating attempts, I resorted to calling OrbiPay, where lo and behold I was able to make my payment.

September and October have presented larger challenges.

The number listed on the bill again refused to reveal its check-by-phone option in September, and despite being listed on the BCBSIL web site, OrbiPay was no longer in service. I at last reached a human being by dialing a third number and overriding its voice recognition software.

Things didn't go so smoothly this month.

OrbiPay is still dead—and still listed on the BCBSIL web site. (What does it cost to update a web site, anyway? Fifty-million? A hundred-million? A couple hundred bucks?) The number listed on the bill, which again promises to accept payments by phone, won't accept mine. Ditto the number I used in September.

I finally reached a human being after launching a stream of invectives into the receiver at the voice recognition software.

The operator who answered was not able to tell me why my payment had been refused, nor why OrbiPay's number is still listed on the BCBSIL web site. She was able to offer a one-time telephone payment that is somehow different from other telephone payments so that my account might be brought up to date.

Remarkably, the story doesn't end there.

Yesterday I received a customer service questionnaire from BCBSIL, which is certainly laudable. It wanted to know how they did.

I clicked away at the 'Take Our Survey' button, eager to respond.

The little round icon in the upper left-hand corner that tells me the browser is searching for the page went 'round and 'round and 'round. Then it went 'round and 'round some more. It stopped about the time I began to think I was watching the introduction to Vertigo.

The result? Server Not Found.

I realize now fault lies with me. I expected something. And that is where I consistently go wrong with Blue Cross Blue Shield of Illinois.

If I wasn't so exhausted by the struggle to deliver money to a multi-billion-dollar health care behemoth, I'd accuse them of wanting to be a non-profit. Or some other kind of dirty, filthy Obama-styled socialist.

But we all know what a joke that would be, don't we? This is a company that eliminated credit cards as a method of payment. Guess those swipe fees were killing them.

I can hardly wait for the inflated premiums and astronomical deductibles I am told lie in wait for Illinois customers in November.

I'm sure they will be difficult to pay as well.

It's a Good Thing They Didn't Hire Me

Neither the telecommunications behemoth incapable of delivering a reliable cable TV signal to my home, the computer software giant unable to supply my computer with a functional operating system nor the business services firm staggered by the prospect of processing a rebate in less than six months would dream of hiring me.

I mean, as a long-term unemployed old guy, I'd just screw everything up.

The latest example of an enterprise able to remain at peak operating efficiency through its careful and judicious hiring is Blue Cross Blue Shield of Illinois.

A little backstory: after extracting myself from the morass of HFS and their redeterminations and being elevated to an income strata which precluded Medicaid, I signed up with a Blue Cross Blue Shield PPO late last year.

All was fine until the health care insurer announced the plan wouldn't be offered in 2016. Okay, that's not quite right. Technically it would, but in a highly-altered form which would cost 354% more.

Grateful that my health care wasn't veering into simplicity and ease-of-use, and fairly sure that my income wouldn't see a similar increase, I began a search for a replacement after enjoying the PPO for exactly one month.

Affordable options were scarce. I scoured the offerings repeatedly just to make sure I wasn't missing anything. Visions of Helen Hunt in As Good As It Gets nonwithstanding, I swallowed hard and enrolled in a Blue Cross Blue Shield HMO.

(That it cost three times more than the original PPO, offered fewer providers and covered less was just a bonus.)

After clicking the 'submit' button, I exhaled. I thought the fun was over. 

But what did I know?

Predictably, the bill arrived first. Besiged by e-mails warning of the plagues and locusts that would ensue if I didn't enroll and then remit promptly, I hustled my payment off to the mail box and waited for my membership ID card.

I received notices advising me that my PPO would not be offered in 2016. I received notices stating that I needed to select another plan immediately or face government-imposed fines. I received notices detailing the coverage of the revamped PPO.

I received notices about everything except my new HMO and the whereabouts of my membership ID card.

Sigh.

Wanting to continue medical treatment begun under the PPO, I desired urgently to set-up a PCP and locate a specialist who could pick-up where my previous specialist had left off.

Silly me.

Not that I was the only person cast into this healthcare hell by Blue Crosses decision to pull the plug on their PPO. A quarter-million of my fellow Illinoisans were forced to change their plans simultaneously, stretching many Blue Cross Blue Shield resources to their breaking point.

Phone lines were jammed night and day. Provider information was nearly impossible to get. When it was available, it was listed on outdated web sites and it invariably took until the day before an appointment to discover the listings were obsolete.

E-mails to Blue Cross Blue Shield yielded responses which hid behind procedure and protocol. None acknowledged their colossal screw-up.

I was, however, able to print a temporary copy of my plan's ID card. Because of the repeated delays in discovering exactly who was and who wasn't included in my plan, I consider myself fortunate that I never had to use it.

The lowlight arrived in late-January, when I again attempted to learn who my providers were. My joy at having a call answered was, regrettably, short-lived. A carefully-modulated voice on the other end of the line informed me that I wasn't in their database. 

I snapped. I unleashed a torrent of four-letter words. Compound words. Bad words. I took the Lord's name in vain. I was screaming.

"That must explain the bills I'm getting, huh?"

I inhaled. The fresh oxygen provoked a second explosion, the details of which are better left unspoken.

While my health care remained on hold, Blue Cross Blue Shield bills arrived like clockwork. While I was amused to realize they resembled one of my favorite drummers and like him, never missed a beat, I also found this highly irksome.

I pondered it at length. What did it mean? What did it signify? I eventually arrived at two possible conclusions.

Either this was incontrovertible proof that despite the warm, fuzzy marketing that depicts a caring and nurturing collective of medical professionals, Blue Cross Blue Shield is a hard-core, show-me-the-money business as mercenary as any found on Wall Street.

That getting the money is job number-one.

Or, that the folks staffing Blue Cross Blue Shield's billing department were geniuses. They were the only employees able to cope with this giant shift, and by virtue of their unwavering performance, ought to be running the whole show.

That said, it remains a good thing they never hired a long-term unemployed old fart like me. I would've just screwed everything up. 

Not that you could tell.

Random Thoughts, Vol. 7

It has been a hideous year. A wretched, stinking, hideous year. It was the kind of year that immerses you in hopelessness. The kind of year where even a raise was turned on its head and became a liability.

Not surprisingly, the thoughts that collect in your brain resemble the pus that pools in an open wound. They are yellowish and opaque and resemble congealed gravy.

Most of them are sour. A few are jocular. Some aspire to profundity. Of course, there is a difference between aspire and success. Consider this your warning.

This is the caustic send-off 2015 deserves. You will be exultant to see it pass. And if it doesn't, you will cut it out with a knife—with or without anesthesia.

Is there a more-perfectly named basketball player than Tim Duncan?

The tragedy of the eighties was that Hinckley missed and Chapman didn't.

If the Koch brothers earned a combined $910,000 per hour in 2015, can't we make $15?

The FBI processed more background checks in 2015 than in any other year on record, meaning more fire arms were purchased than ever before. Are we safe yet?

Does former Bears coach Lovie Smith deserve early consideration for the Hall of Fame because he reached the Super Bowl with a team quarterbacked by Rex Grossman?

If not for wrapping your brain around the myriad of exclusions, exceptions and conditions that affect your coverage, predicting your needs for the coming year and dealing with the reams of paperwork that arrive (none of which contains the bill—at least until three days before it's due)—all under the threat of a government-imposed fine—we wouldn't need health insurance.

Is there a more-appropriately named street in America than Wall Street?

Do black lives matter only when they're taken by white hands?

Anyone who votes for Donald Trump deserves Donald Trump. But leave those of us with IQs out of it, OK?

And speaking of America, wasn't it a great idea?

The Affordable Care Act and Me

I felt a great relief when the Affordable Care Act was passed in 2009. Despite the perception that Americans routinely enjoy the best of everything, enormous gaps existed in our health care coverage.

Health care reform happened despite the formidable efforts of the well-financed health care lobby and its employees—fear-mongering conservative congressmen who instilled images of cold-blooded death panels in the panic-prone minds of their constituents. They insisted it was the road to a socialist hell.

Somehow, government running health care would be a giant step backwards from the accountants currently in charge.

Implementation has been even more difficult. Conservatives continue to fight it at every turn, and challenge it in any court that will listen. To date, nearly four-dozen attempts have been made to repeal it. As a result, getting nationalized health care up and running has been like shooting a basketball with a gorilla hanging from your arms.

But it happened, and healthcare.gov went live in October of 2013.

Sadly, it has mostly lived down to its detractor’s predictions. The site was inoperable when it wasn’t inaccessible. Links didn’t work. Information wasn’t disseminated. There were billing snafus and miscommunications about policies and coverage. Its failures were (and remain) major news stories.

Against that larger backdrop, this is my experience. Despite initiating the application process three months ago, I remain without coverage.

I was an English major in college. That being the case, I defined ‘household’ as a group of people living at a common address. So when I encountered a request on the Medicaid application to list the members of my ‘household’, I dutifully listed the names of the three people who live with me.

The form immediately requested basic information about them as well.

Thing was, I didn’t realize the government's definition of 'household' meant only those parties seeking coverage. But given that definition, since I had already indicated I was only seeking coverage for myself, why was I even asked about my 'household'?

Perhaps the Department of Redundancy Department had nothing better to do.

I continued on my merry way, blissfully unaware of the fatal error I had committed. I clicked ‘save’ and ‘next’ like the computer savant that I am. And when I came to ‘submit’, I clicked that, too.

All done. Right?

One week later, I received a paper form requesting still-more information. Suffice to say an IRS audit would’ve been less-invasive. About the only thing it didn’t ask was the condition of my dryer's lint trap.

This, of course, ran counter to virtually everything I had been told about Medicaid. My finances and my finances only determined whether or not I was eligible. Not my lint trap (which incidentally is lint-free).

I called my local Department of Health. Then I called again. And again. And again. I called more times than Jennifer Aniston has been engaged. I left nice messages. I left not-so-nice messages. I called in the morning and I called in the afternoon.

But I suspected I wouldn’t hear from anyone anytime soon.

(Hey—you don’t suppose there’s a musical in all of this, do you?)

Then I considered an in-person visit. But I was advised the four-hour window I had before work was insufficient. And taking an unpaid day-off from what is already a low-paying, part-time job won’t ever be an option.

Then I left a message requesting an extension, thinking the extra time would allow me to correct what was obviously a simple misunderstanding. But since this required actual communication, it was like putting ‘Cubs’ and ‘World Series’ in the same sentence. 

Jean-Paul Sartre couldn’t have conjured up a more hopeless scenario. So I let the application lapse.

Shockingly, the Department of Health contacted me (by mail—things weren’t getting that shocking!) and informed me that since I hadn’t provided the requested information by the required date, my application was being denied.

OK.

Flush with the optimism of the new year and newly versed in government-speak, I submitted another application. But only after meeting with a certified, honest-to-goodness government health care representative (called a navigator) at my local library.

Of course, it took six attempts over the course of ten days before the site allowed me to complete it. I again clicked the ‘submit’ button, fully aware of the implications.

A happy message appeared, telling me that my application had been received and that I would soon be enrolled and enjoying healthcare coverage.

That was six weeks ago.

Nothing has shown up in my mail box. Nothing has shown up in my inbox. And I won’t even mention the telephone. And yet healthcare.gov tells me I am enrolled.

When I call or use the online chat function at healthcare.gov, I am alternately told my application is being processed, there is a log jam or that I simply need to call my local Department of Health office.

Yeah.

I tell them that is an act of utter futility. That I might as well attempt to calculate how many fastened buttons there are in the world at this moment versus unfastened ones.

This usually leaves them speechless.

No one can confirm exactly where I’m enrolled, or in what.

Maybe I’m going about this all wrong. Maybe I just need to research the government’s definition of ‘soon’. And ‘enrolled’.