Whistleblower Holiday Cheer

Ostrich alert – the following is a political poem about the healthcare debate.  Skip this post if you’d rather not read about that topic.

Over at MD Whistleblower, last Sunday Dr. Michael Kirsch shared a poem which he wrote:

‘Twas the night before Christmas,
In the Senate and House,
Health reform creatures
Were giddy and soused.

The horses were traded,
And promises made,
Nelson and Landrieu
Were handsomely paid.

Some will be winners,
And others will lose.
The majority strategy?
 Scare and confuse!

The conference is coming
Where sausage is made,
Which plan will survive?
Neither! We prayed.

A government option
And sugarplum fees,
Isn’t the cure
Of our health care disease.

“Now Harry! Now Nancy!
On Dodd and on Baucus!”
With a wink and a twinkle,
They held tight their caucus.

The Dems all agreed
One item must fall.
Now dash away! Dash away!
Tort reform all!

Then with a crash
Through the chimney that night,
Popped out Barack
With a smile of delight.

He promised reform
Turning debt into wealth.
The better plan may be
To pray for good health.

He raced through the chambers,
Looking merry and droll
Giving Dems sparkling diamonds
To the GOP – coal. 

In a flash he was gone,
And away sailed his sleigh.
Why do most of us feel
This is not our best day?


I’m not opposed to figuring out a way to improve things, but I really have a problem with politicians telling doctors how to practice medicine.  Somehow I keep hoping that the reform will involve prosecuting insurance companies under the RICO Act, then returning to the day when medical costs were a private matter between physician and patient.

That’s obviously not going to happen, so I think we need an amendment to the constitution that would require congressmen to have the same healthcare plan that they inflict on the rest of our country’s citizens.  Maybe that’s what it will take to get our representatives and senators to address the issues in a more thoughtful manner.


Healthcare Reform Photoshop Contest

This should be good:

In the spirit of the upcoming holiday season and to make sure something on health care reform gets done before the end of the year, Dr. Wes and his wife, Diane, would like to propose the first (and perhaps only) US Healthcare Reform Photoshop Contest.

Bring us your snark, your wit, your creativity about the health care reform efforts encapsulated in a single photograph. Photographs in support or against the current efforts will be equally considered, and you, dear internet devotees, will be the final judge. The winner receives an iPod Touch.

See larger photo and contest rules at Dr. Wes’ blog.


Damocles & Max

Previously, I wrote about the possibility that I might meet Max this year.

After looking a little more closely at all the numbers, it appeared there was a chance to avoid it.  If we pay for my orthotics out of pocket, and if nothing unexpected happens in the next two months, we could barely squeak in under the limit.  Those are pretty big ifs.

There’s something comforting in knowing that the insurance company says, “Amount charged against lifetime benefit limit:  zero.”  When nothing has reduced the limit, I feel like there’s no limit.  It’s as if insurance will always be the safety net to cover anything that might occur.

I don’t feel that way any more.  There is a limit to what insurance will cover.  It’s like a huge sword hanging over my head; the smallest thing could bring it crashing down.


Would I be better off paying cash the rest of the year to avoid hitting the annual out-of-pocket maximum?  Sure, it would cost a bit right now, but in the long-run, if things get really bad, it could save me thousands of dollars.

I’ve talked to our insurance plan administrator.  Co-pays don’t count toward my annual out-of-pocket-max.  Prescription meds don’t count.  My annual deductible doesn’t count.  A lot of things don’t count.  Of the $2200 that I’ve paid out of pocket so far this year, insurance only counts $912 of that amount toward my max.

The rules change once I’ve met my out-of-pocket maximum.  When they’re looking at the benefit limit, they count every penny they’ve paid on my behalf this year.  All those numbers that didn’t count toward reaching the annual limit?  Now they matter.

I could make myself crazy trying to figure out a way to control these costs.  I could pay cash for the rest of the year to avoid having my lifetime benefit reduced by $11K.  In the end, though, I have to take this the way I decided to face RA: one day at a time.

It would take 99 more years like this one to blow through my million dollar lifetime limit.  The chances of my living another 99 years are mighty slim.  Therefore, I’ve decided that insurance will pay for the rest of this year.  I’ll enjoy the slight reprieve while insurance picks up 100% of the tab instead of just 80%.

If, someday in the future, I end up on expensive biologics (isn’t that redundant?), and have that lifetime benefit reduced even further, I’ll deal with it.  In the meantime…

Meet Max