Forget Clinton, forget Trump. Who cares about our differences in race, creed or religion? As ‘Muricans we are all united in a common cause at this crucial moment in history… our shared disgust with health insurance, the companies that provide it and the federal law that totally screwed it up, perhaps forever.
The annual enrollment period for Obamacare has rolled around again. Time for a little pop quiz, kiddies.
If I am on the phone waiting to speak with a “customer advocate,” who am I trying to reach?
- Better Business Bureau
- Small Claims Court
- Health insurance company claims adjuster
- Carry out counter at the China Palace
First, let’s eliminate the obvious. An “advocate” is one who represents and pleads the cause of another. That’s probably not going on at #3 or 4, so we’ll cross them out. The word “customer” indicates a business, so we’ll cross out #2. That leaves #1, the Better Business Bureau, right? Wrong.
I had a little accident in the kitchen the other day. The cut was pretty deep and I thought I might need medical attention, so I called my health insurer’s claim department to find out what my plan would pay.
I’m not going to name the insurance company; suffice it to say they’re big. Really big. We’ll call them the Indigo Plus Sign Insurance Company of Illinois. After navigating a phone tree so convoluted it reminded me of the old kids’ game, Chutes & Ladders, I finally reached the claim department. Their on-hold message promised my call would soon be handled by the next available “customer advocate.”
I thought claims adjusters were employees. I thought they were mere corporate tools, forced to toe whatever party line “the man” laid down. I assumed their job description would be, “Avoid shelling out even one, thin dime to the poor, working slobs who pay our salaries. Maximize profits so corporate big wigs can fly around in the company jet, eating caviar and drinking champagne from the shoes of high-priced floozies.”
I was so wrong.
This company’s claims department is staffed with “advocates”. They’re on my side.
As my on-hold wait extended into its 3rd hour, I thought about my “advocate” while I alternatively loosened and tightened my tourniquet. I pictured her as an earnest young woman with long hair, glasses and Birkenstocks. She’d thought about joining the Peace Corp when she graduated from college, but chose to give back to society by working for the Indigo Plus Sign Insurance Company of Illinois instead.
I would go into the claims review board feeling like I was facing a firing squad, but no worries – my advocate would be by my side. She’d pound the table and shout, “Peg has been paying us $1317 per month for the last 18 years (going up at least 25% next year, of course.) This is her first claim. Now that she needs us, we can’t turn our backs on her. She needs proper care, she deserves proper care, and I won’t rest until she gets it. With God as my witness, we will approve full payment of one Band-Aid!!! (After her $30-per-residential-dressing copay, of course.)”
That’s when I knew; this time would be different.
Am I wrong to hope? Could this be the delusional fantasy of a starry-eyed idealist? Maybe. Or it could be the delusional fantasy of someone experiencing extreme blood loss. We’ll find out as soon as it’s my turn to talk to my “advocate”. I’m sure it will be any time now; I’ve been on hold for 4 days.
It’s such an alien thought to those of us on this side of the pond that you would have to find about cost coverage for anything before seeking medical treatment! I expect that advocate is busy preparing your case right now, even before speaking with you. I’m sure you have nothing to worry about Peg…almost nothing at all…pretty much.
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Heck yeah! Nothing to worry about at all. I’m barely sweating this. Hardly at all.
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just remember “Your call is important to us.”
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That thought is such a comfort. They wouldn’t say it if it wasn’t true, right?
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Will they cover your psychological trauma expenses from waiting and waiting and waiting and rotting while waiting??? UGH! My rates are going up too but I admit I’ve used my share of claims. Oops.
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So YOU’RE the one whose messing it up for all the rest of us! 😉
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Guilty as charged!! 🤓
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Peg, let me be your advocate with the advocates. Just the other day I was thinking about the terms we use and how a soulless corporation can choose to put a warm job title on a cold job description. Lots of companies call their minimum wage workers not ’employees’ but rather ‘associates.’ ‘Don’t think of yourself as our employee. You’re an associate. A colleague. Now get back to work.’
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Exactly. That’s something that annoys the hell out of me about modern life. Why can’t we call a spade a spade? Or an hourly grunt worker a cog in the soulless machine?
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‘Cog in the Soulless Machine’ would never fit on a name tag.
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No, but it would make a great name for a band.
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That’s a brilliant idea. I’ve got to start writing down all these band name ideas. There’s got to be a way to sell these to kids.
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Isn’t there an e-mail-addy?
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Probably, but I don’t trust those. I want a real, live human being explaining things to me.
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Thank goodness for the NHS…
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Although I’m sure that has ITS share of problems too, right?
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Just “kill me now.” The credo of our health system is more money, less care. These days the office visit means checking to see that your heart is still beating, and then writing a prescription for whatever drug you saw advertised on television. By the way, and this is actually genuine information: when you are seriously bleeding and you are on hold with your advocate, powder the cut with cayenne pepper. It’s am emergency coagulant that works pretty well, and it doesn’t really sting much either.
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Are you serious? I’ve never heard that before – cool!
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Yeah I am serious about that, as I tried it when I cut myself when alone in the kitchen.
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Are you serious? Is that so you will scream so much in agony that an ambulance will be at your house in two minutes? What does the pepper do?
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Yeah I am serious about that, as I tried it when I cut myself when alone in the kitchen.
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Stings a bit, but for the most part the heat receptors are in the tongue not the skin. Honest I don’t know what or how the cayenne works. Growing up as a country girl ten miles from anywhere, out family also used it as an energy fix for bleeding wounds until we could get to the doctor for stitches. Not recommending this in place of a doctor but as last ditch fix while on hold. . .
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Very interesting!
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The US Insurance Industry’s vision statement:
Take everything you dare (and then some!) – give nothing back.
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Although, as an insurance agent in real life, I gotta admit that for most of us it works pretty well. Except when it doesn’t. 🙂
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Ooooo – this is as big a faux pas as when I told a postal worker (I didn’t know she worked for the USPS) that ‘They call it ‘Snail Mail’ for a reason.’
I’ll just sit quietly in a corner for a bit – with my foot in my mouth…
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Nah, you’re good. It is pretty messed up. Except when it isn’t. 🙂
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I still cry over my long lost dreams of being a “sandwich artist.” I could have made you a sandwich so beautiful, Peggles, that you wouldn’t have even cared that you lost a thumb after Indigo Plus Sign refused to pay for stitches.
P.S. – Is your hand okay?! (I assume you cut your hand, but perhaps I’m not being creative enough. Maybe it was a leg. Or your nose! Sigh. I probably never would have made it as a sandwich artist.)
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I bet you craft a mean sandwich, Miss Julesie. Maybe a lobstah roll?
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I buy a beautiful sammie from you any day of the week, Julsey. 🙂
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I just looked up the definition of “oxymoron’ in the dictionary. One of the examples they gave was “customer advocate.” Who knew?
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The other thing that frosts my cookies is when I call a company and they say to hold for an “agent”. I always want to ask, “Agent? I’m an agent and I have to go through proficiency exams and yearly continuing education in order to be so designated. How, exactly, are you an agent?” That question is usually good for a few minutes of silence on the other end of the line.
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Maybe they switched you over to an IRS agent. Hmmm……?
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When even an insurance professional can’t get attention, you KNOW the system is totally screwed up.
Don’t worry about your hand, Peg. You’ve got another one don’t you? ❤
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I know, right? I know how to navigate this crap and it bugs me – what chance does the average man in the street have of figuring it out?
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None. Like the tax code. My husband worked as a tax lawyer for several years and he can’t figure out our taxes!
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Oh Peg, that’s why I fear retiring and going on hubby’s insurance, even though my sanity is in the balance. Love your prose. 🙂
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I’m sure his would be fine, Tar. Don’t risk your sanity!😃
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I don’t know much about health insurance, but I do know that this post had me at “Forget Clinton, forget Trump.”
And why for the love of all that is holy, can’t we just go back to the good ol’ days of healthcare when all we needed was a shot of whiskey and a good bullet to bite down on?
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We will soon be going back to those good old days, Miss Darla. Now that rates are going out of control for everyone except the very poor and very wealthy, the Shot and Bullet Plan will be the only option for the rest of us.
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I was just about to recommend the whiskey (to sterilize the wound, of course)…I always take a shot (I mean, apply a generous amount) no matter what the injury.
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I like how you think.
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Also, I once crocheted an entire afghan while waiting for my customer advocate to locate my records, only to be transferred to the claims specialist, who transferred me to the janitor (I mean, the Director of Environmental Cleanliness). Now I have carpal tunnel. Better take a shot of whiskey.
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Too bad the Director of Environmental Cleanliness isn’t in your network anymore. That phone call isn’t covered and will cost you $1000.
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Dammit…I still haven’t met my $1,000,000 deductible
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But I’m sure you’re comforted by the fact that “most Americans who get coverage through healthcare.gov are paying less than $75 per month.” according to the Centers for Medicare Services. Never-mind that figure is an average of the poor slobs who are not eligible for a subsidy and are paying $900 per month (like me,) and all the millions who are now eligible for Medicaid and HAVE to take that instead of a conventional policy from an insurance company, which at least a couple of doctors would be willing to accept.
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Dammit…
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The question is: Who’s going to clean up the blood on the phone? Can you take it to the emergency room with you for sterilization? I know, you think that is a minor problem, but bloody phones are just messy after 4 days on hold.
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Good point. The INdigo Plus Sign Insurance Company has a lot to answer for.
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Hope you and your owie are all better now!
Your health care system is all so alien to us Canadians! We take for granted that in a situation like yours, we’d just go get the cut looked at, and the treatment would be paid for because we all pay into a universal system that covers the majority of our services. Canadians also buy other health insurance to cover the extras that aren’t part of the universal plan – dental, drugs and out of country services, mostly.
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Is it true, Margie, that Canadians with money buy coverage to get things like MRIs done in the US to avoid waiting in lines? We Americans want healthcare cheap, fantastic, and right-damn-now.
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Some Canadians do get treatment in the USA, especially if they want faster access for specialized treatments.
Alternately, more privately operated facilities are opening in major centres in Canada – you or your insurance company pay for the procedure.
Sometimes you can get a procedure done faster if you are simply willing to drive to a smaller facility in a nearby town!
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The Buddha said: all suffering arises from expectations. So, here’s a thought. Eliminate every expectation for anything and you won’t need insurance because you won’t be suffering! That’s what I’m trying. I’ll meet you on the 12:05 train to Delusion Junction. Deal?
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Deal! I’ll be the one with the tourniquet.
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Hi Peg,
The wife and I noticed your blog and appreciate the content you have here. Please allow me to encourage you to keep writing and never abandon this site. I am a mobile developer, and if you are ever curious about having a mobile app version of this blog, I would love to help. We appreciate the hard work you have put into this blog and wish you all future success in business and in life.
Thank you for your time, it is the most precious thing we all possess.
-Jacque’
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another side : yes and no
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