Sicko, Indeed

I just received an email that was all "Hey dude! What's up?!" from the "folks" at The Tonik Plan, Blue Cross' insurance company for the X Games set.  At least that's whom they THINK they're directing their off-the-cuff-isms to. They have this ersatz ironic tone to all of their literature and web stuff that is meant to convey a sense of "Hey, we know we're supposed to be a crusty old health insurance company, but dooood! We are just like you!"  In reality, it comes off about as cool as Grandpa doing the f**king cabbage patch at your little sister's high school graduation.  But I am getting off message.

I had recently applied for private health insurance through the company that insures the rest of my family knowing that I would most likely be denied, but I figured it was worth a shot.  The email they sent back was to tell me that I did not qualify for their Tonik Health Care Plan.  Also, I did not qualify for ANY coverage in the Blue Cross group of "medical underwriters."  Perhaps I would consider researching my options with the California Major Risk Program, "A 36 month program developed to provide health insurance for Californians who are unable to obtain coverage in the individual insurance market."  That sounds promising.

I know why they rejected me, I'll get to that in a second, but first humor me by allowing me to recount my health insurance wet dream that was my life before recently.

Until Age 18:    Dad's Blue Cross/Blue Shield, courtesy of the City Of Boston, where my Father spent his career.

Age 17-19:    Overlapping coverage!  I paid 15 bucks a month through my union.  I was a janitor at Boston City Hall.  Sweet!

Age 19 -24    I paid for coverage that was offered through my various restaurant gigs.  Again, totally civilized monthly cost.

Age 25 -37    The promised land: Tippee top of the line health and pension benefits through 2 awesome unions, SAG & AFTRA.  Quarterly premium maxed out at $525 for my family of 4!!  We had more coverage than we could use, seriously.

Age 37-38    Shitty "private" coverage for my husband and 2 young children through Tonik/Blue Cross.  Me: uninsured

We lost my SAG benefits because I didn't reach my earnings quota.  No biggie, as we were able to able to arrange for our son's c-section birth before time ran out.  The big surprise was when AFTRA raised their earnings requirements just as we were relocating from Boston to Los Angeles and our union earnings were decreasing.  We were out of luck a year later.

COBRA was going to cost us $1200 per month, which was impossible as we were trying to get our lives and careers off the ground.  I made an executive decision to buy coverage through Tonik for my husband and our 2 kids, but not for me.  I felt comfortable gambling on my history of good luck and excellent health while holding out for my AFTRA and/or SAG benefits to come back.  I hardly ever used our insurance for anything other than childbirth and yearly OB/GYN exams. And since we weren't planning any more kids and I've always been a healthy person I thought I'd save a few bucks.  I made the wrong decision.

Cut to the chase:  In 2006, I promised my 7 year-old daughter that I would quit smoking, just as my husband had a few years before.  I planned to stop in Jan 2007 when we got home from our Christmas visit with the family in Boston.  Before we left Los Angeles, I got a prescription for an anti-depressant called Wellbutrin, which my sister and Dad had both successfully used (off label) to quit smoking.  I began taking it just before we flew back to LA.  Wellbutrin, as it turns out, has a high risk of seizure.  On my 5th day of taking the drug, I had one of the grand mal variety. 

The experience of having a seizure is terrifying, unexpected and scary. It feels like a violation. But the aftermath was just as bad.  I lost my driver's license. My brain didn't work quite right for a while (and some would argue that my brain never worked quite right).  I was never an anxious person before, but I soon became consumed with fear, mostly that a seizure might happen again.  And then there was the issue of my ambulance ride, my brief hospitalization, the CAT Scan, EEG, MRI, and other assorted interventions.  An American with no insurance shouldn't be having grand mal seizures out of the blue because it's quite costly. 

I will never be able to buy decent or reasonably priced private insurance now.  I may not be able to purchase any health insurance at all.  So after an entire lifetime of being an American taxpayer (I have worked and paid taxes literally every year since I was 13) and a responsible consumer of health care, I am suddenly drowning in hospital bills. It seems grossly unfair that if anything else happens to me, the money that I've worked so hard to save and invest will be wiped out.

As musicians, our savings are critical because some years we get paid and some years we don't.  Maybe I should have blown it all on cocaine and vacations while I had the chance so that there wouldn't be anything to come after.

That's not even the end of it.  My husband had to see a specialist which led to a common but expensive procedure and Tonik/Blue Cross is doing whatever it takes not to pay.  At this point, they don't even pretend that there's a legitimate reason, they just won't pay.  What is a person supposed to do in that case?  The creditors are calling him and he HAS coverage.

I have always found it immoral that our health care system is a for profit business.  It's so f**ked up that bean counters are making unilateral decisions - with zero regard for individual nuance - that dictate whether a person can get a basic need met.  Medical care should be like eating or breathing.  My bitterness is only exacerbated by the fact that so much of the extraordinary costs go toward the paperwork that gets shuffled back and forth, mostly in the service of insurance companies denying people coverage. 

I know my situation is a bit boring and not as inflammatory as other people's stories, but it feels pretty all-encompassing to me.  I wasn't outraged when I was over-insured, of course.  I am pretty pissed now.

Ed. note:  In a strange turn of events, this former frontperson of the seminal Boston band, Letters To Cleo, is now on tour singing back up for Miley Cyrus, aka Hannah Montana.  She is writing about her experience at http://www.kayhanley.com/blog/. Also, here is a song from Kay's upcoming album "Weaponize."  It was not written about her nightmare insurance experience, but it's called "It Hurts" and we thought that was appropriate.