Tuesday, November 09, 2010
Wednesday, December 12, 2007
Insurance companies suck
Baby is now about two months old and doing well. But these first two months have been an adventure.
Baby was breastfed for the first few weeks, but she lost nearly a pound and she had blood in her stool so her pediatrician recommended stopping the breastfeeding and put her on a hypoallergenic formula at about $25 per 16 oz. can. She gained some weight but she was still in terrible pain with each feeding so after a few weeks her pediatric gastroenterologist changed her formula to Neocate which costs $135 for a case of four 14 oz. cans. Right now we are using a can of Neocate every two and a half days.
We tried to get our insurance company to help with the cost of the formula. I called the insurance company and they told me that infant formula is not covered. I called Health Advocate the next day and they talked to the insurance company and again they told me that infant formula is not covered unless the baby has one of four conditions that they are required by state law to pay for formula--she does not have one of the four--and they told me to have her primary care physician (PCP) put through a pre-authorization request for the formula. The PCP's nurse called me back the next day and told me that they got a fax from the insurance company saying that infant formula is not covered. I called my wife's employer's benefits office who called the insurance company and got the same response.
Next, I called my state representative. His office took the information and contacted the state insurance department and they got back to me and said that there is nothing they could do to help. The representative's office suggested calling the manufacturer to see if they have an assistance program and if all else fails to call the county assistance office to apply for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). We called the manufacturer and they had no program. So I called the county assistance office and they said that I should apply for Medical Assistance for Baby and then if she gets that she will automatically qualify for WIC based on medical need even though we don't qualify financially. So I filled out the application online and dropped off a stack of documents. They called me back a few days later and said that Baby qualified for Medicaid and that we should call the WIC office to set up an appointment. A few days later Baby got her gold card in the mail and we have an appointment with WIC in a few weeks.
I think it is a crime that insurance companies get away with this crap. We pay about $1,000 a month for health insurance and they won't cover something that my baby needs to to survive. I was hoping that they would at least cover some of the cost since the Neocate costs two or three times the cost of regular formula. Baby has multiple food allergies (including cow's milk and soy) and that was causing colitis and keeping her from gaining weight. She also has Gastro Esophageal Reflux and she was in terrible pain during and after eating. Shortly after she started on Neocate she gained weight and the colitis went away.
Insurance companies in the United States cover only healthy people. Old people, poor people, and people with health problems have to get health insurance from the government. If it were up to me I would like to see everyone in the US covered by a national health plan and do away with private, for-profit health plans. Right now these for-profit plans collect thousands of dollars in premiums for people who are basically healthy and then when they incur healthcare expenses the insurance company does everything in its power to deny coverage.
So now I have to swallow my pride and take my daughter in to the WIC office so she can get her monthly supply of formula. But she is now thriving and we won't have to go into debt to feed her.
Baby was breastfed for the first few weeks, but she lost nearly a pound and she had blood in her stool so her pediatrician recommended stopping the breastfeeding and put her on a hypoallergenic formula at about $25 per 16 oz. can. She gained some weight but she was still in terrible pain with each feeding so after a few weeks her pediatric gastroenterologist changed her formula to Neocate which costs $135 for a case of four 14 oz. cans. Right now we are using a can of Neocate every two and a half days.
We tried to get our insurance company to help with the cost of the formula. I called the insurance company and they told me that infant formula is not covered. I called Health Advocate the next day and they talked to the insurance company and again they told me that infant formula is not covered unless the baby has one of four conditions that they are required by state law to pay for formula--she does not have one of the four--and they told me to have her primary care physician (PCP) put through a pre-authorization request for the formula. The PCP's nurse called me back the next day and told me that they got a fax from the insurance company saying that infant formula is not covered. I called my wife's employer's benefits office who called the insurance company and got the same response.
Next, I called my state representative. His office took the information and contacted the state insurance department and they got back to me and said that there is nothing they could do to help. The representative's office suggested calling the manufacturer to see if they have an assistance program and if all else fails to call the county assistance office to apply for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). We called the manufacturer and they had no program. So I called the county assistance office and they said that I should apply for Medical Assistance for Baby and then if she gets that she will automatically qualify for WIC based on medical need even though we don't qualify financially. So I filled out the application online and dropped off a stack of documents. They called me back a few days later and said that Baby qualified for Medicaid and that we should call the WIC office to set up an appointment. A few days later Baby got her gold card in the mail and we have an appointment with WIC in a few weeks.
I think it is a crime that insurance companies get away with this crap. We pay about $1,000 a month for health insurance and they won't cover something that my baby needs to to survive. I was hoping that they would at least cover some of the cost since the Neocate costs two or three times the cost of regular formula. Baby has multiple food allergies (including cow's milk and soy) and that was causing colitis and keeping her from gaining weight. She also has Gastro Esophageal Reflux and she was in terrible pain during and after eating. Shortly after she started on Neocate she gained weight and the colitis went away.
Insurance companies in the United States cover only healthy people. Old people, poor people, and people with health problems have to get health insurance from the government. If it were up to me I would like to see everyone in the US covered by a national health plan and do away with private, for-profit health plans. Right now these for-profit plans collect thousands of dollars in premiums for people who are basically healthy and then when they incur healthcare expenses the insurance company does everything in its power to deny coverage.
So now I have to swallow my pride and take my daughter in to the WIC office so she can get her monthly supply of formula. But she is now thriving and we won't have to go into debt to feed her.
Friday, October 19, 2007
Birth Story II
Baby number two came on Wednesday. This time was so much easier than the last one. It is still scary and the most exciting thing I have ever witnessed.
This time we went in around 9:00 am with regular contractions. The doctor examined Mom and she was dilated to 3 cm. So doctor told her to go for a walk and to come back in about two hours and they would check her again.
At about 1pm we went back. Her contractions were getting stronger and now she was dilated to 4cm. The doctor said with her Russian accent, "I think we'll have a birthday party before midnight."
They took us to a room and we got settled in. The nurses were in and out for the next few hours monitoring the fetal heart rate and contractions. And everything was going smoothly.
A little after 6pm the nurse came in and said that she was going to have the doctor examine Mom again and see how she was progressing. By this time the shift was changing and a new doctor came in. He didn't introduce himself he just said that he was going to check her and then he said that she was still about the same and sent the nurse for something. She handed it to him and as he is inserting this thing he said that he was going to break her water and get things moving. Then he told the nurse to get some Pitosin and he left.
Now Mom was in tears. This whole pregnancy had been very good until this point. She had seen the same two midwives for all her regular exams. Now, on the day that she goes into labor there is no midwife on call. So not only is she stuck with a doctor that she has never seen before, but he is also a jerk.
I got the nurse and told her that Mom was very upset about that doctor and asked if there was any way to get a midwife, since that was the plan from the beginning. She said that she understood and she would see what she could do to help.
A few minutes later she came in and said that she could not get one of the midwives to come in and Mom was sobbing by this point. I asked if there was any way that the Russian doctor could do it because she was very nice and took the time to explain things and listen. The nurse went to check. Within seconds the Russian doctor and another female doctor, Dr. B, came in. The Russian explained that her shift was ending in a few minutes but Dr. B would be there and she could do the delivery so that we did not have to see Dr. Jerk again.
Dr. B introduced herself and said that she had trained with the midwives and would do everything possible to have the same type of delivery as we would have with a midwife. Then the Russian said that she would be only a few minutes away and would come in assist as long as the attending allowed her to come in. But, after checking with him she came back and said the she was not allowed and she assured us that Dr. B was very good and that she would do a great job.
At about 8:30 pm, Dr B. came in and examined Mom. She was completely dilated and +1. "It's time to have a baby," she told us. She predicted that that baby would come in 10 to 15 minutes.
Mom started pushing and by the second push I could see the baby's hair. Thirty minutes into pushing Dr. B said that the baby will come with one or two more pushes. They brought in the pediatrics team and the attending physician and she pushed one more time and out came baby's head. Dr. B suctioned the mouth and Baby screamed. One more push and we had a baby girl--a beautiful pink, screaming baby girl. Dr. B cut the cord and handed her to the pediatrics team. They checked her out and she was fine.
This was not as scary as Baby One's birth. He was blue when he came out and it took a while for him to cry, but he is now a very healthy two year old.
Baby Two and Mom get to come home tomorrow.
This time we went in around 9:00 am with regular contractions. The doctor examined Mom and she was dilated to 3 cm. So doctor told her to go for a walk and to come back in about two hours and they would check her again.
At about 1pm we went back. Her contractions were getting stronger and now she was dilated to 4cm. The doctor said with her Russian accent, "I think we'll have a birthday party before midnight."
They took us to a room and we got settled in. The nurses were in and out for the next few hours monitoring the fetal heart rate and contractions. And everything was going smoothly.
A little after 6pm the nurse came in and said that she was going to have the doctor examine Mom again and see how she was progressing. By this time the shift was changing and a new doctor came in. He didn't introduce himself he just said that he was going to check her and then he said that she was still about the same and sent the nurse for something. She handed it to him and as he is inserting this thing he said that he was going to break her water and get things moving. Then he told the nurse to get some Pitosin and he left.
Now Mom was in tears. This whole pregnancy had been very good until this point. She had seen the same two midwives for all her regular exams. Now, on the day that she goes into labor there is no midwife on call. So not only is she stuck with a doctor that she has never seen before, but he is also a jerk.
I got the nurse and told her that Mom was very upset about that doctor and asked if there was any way to get a midwife, since that was the plan from the beginning. She said that she understood and she would see what she could do to help.
A few minutes later she came in and said that she could not get one of the midwives to come in and Mom was sobbing by this point. I asked if there was any way that the Russian doctor could do it because she was very nice and took the time to explain things and listen. The nurse went to check. Within seconds the Russian doctor and another female doctor, Dr. B, came in. The Russian explained that her shift was ending in a few minutes but Dr. B would be there and she could do the delivery so that we did not have to see Dr. Jerk again.
Dr. B introduced herself and said that she had trained with the midwives and would do everything possible to have the same type of delivery as we would have with a midwife. Then the Russian said that she would be only a few minutes away and would come in assist as long as the attending allowed her to come in. But, after checking with him she came back and said the she was not allowed and she assured us that Dr. B was very good and that she would do a great job.
At about 8:30 pm, Dr B. came in and examined Mom. She was completely dilated and +1. "It's time to have a baby," she told us. She predicted that that baby would come in 10 to 15 minutes.
Mom started pushing and by the second push I could see the baby's hair. Thirty minutes into pushing Dr. B said that the baby will come with one or two more pushes. They brought in the pediatrics team and the attending physician and she pushed one more time and out came baby's head. Dr. B suctioned the mouth and Baby screamed. One more push and we had a baby girl--a beautiful pink, screaming baby girl. Dr. B cut the cord and handed her to the pediatrics team. They checked her out and she was fine.
This was not as scary as Baby One's birth. He was blue when he came out and it took a while for him to cry, but he is now a very healthy two year old.
Baby Two and Mom get to come home tomorrow.
Sunday, October 14, 2007
Smokers stink
Last week I was driving with my son to the hospital to visit my mother. On the way there I was behind a car driven by a woman who was smoking. We would stop at a traffic light and then start up again and I would have to drive through the cigarette smoke. At the third stop I noticed something move in the back of her car. I got a closer look and saw that there was a baby in a car seat in the back of her car.
This got me extremely angry. I was thinking that it should be illegal to smoke in a car with a child. It's not--but it should be. There was a police car stopped at the light on the other side of the intersection and I wanted to stop and ask if there is anything that he can do about this woman forcing cigarette smoke into her child's lungs, but I knew there wasn't anything he could do.
Then we arrived at the hospital. With my 2 1/2 year old son holding my hand, I approached the entrance which was surrounded by people smoking. By the time we reached the door we smelled like an ashtray. And right there on the door was a big sign which read, "smoking prohibited within 50 feet of this entrance." Yet, there they were just 10 to 15 feet from the door.
I don't care if these people smoke and kill themselves. Smoke in your car or home (with the windows closed and no children present). I do care that I have to breathe their disgusting smoke and that they force there children to breathe cigarette smoke. We should not even need a law, people should just know better.
This got me extremely angry. I was thinking that it should be illegal to smoke in a car with a child. It's not--but it should be. There was a police car stopped at the light on the other side of the intersection and I wanted to stop and ask if there is anything that he can do about this woman forcing cigarette smoke into her child's lungs, but I knew there wasn't anything he could do.
Then we arrived at the hospital. With my 2 1/2 year old son holding my hand, I approached the entrance which was surrounded by people smoking. By the time we reached the door we smelled like an ashtray. And right there on the door was a big sign which read, "smoking prohibited within 50 feet of this entrance." Yet, there they were just 10 to 15 feet from the door.
I don't care if these people smoke and kill themselves. Smoke in your car or home (with the windows closed and no children present). I do care that I have to breathe their disgusting smoke and that they force there children to breathe cigarette smoke. We should not even need a law, people should just know better.
Wednesday, October 03, 2007
Update
OK, so I wasn't really in jail. I just needed some reality.
So here's what's been going on:
I have a happy, healthy 2 1/2 year old who keeps me busy and entertained. We are doing Kindermusik right now. I'm not a big fan. I've done several of these music classes for babies and toddlers and this is my least favorite one. It could be because it is sponsored by a church and they throw in a few Jesus songs. It could also be that there are about twice as many kids in the class than there should be.
Oh, and we are expecting baby number two in a few weeks!
What else? Well, I am still running my own business. It is going pretty well. The best thing is that I can pretty much work as much or as little as I want.
We joined an organic community supported agriculture (CSA) farm. It is great! I highly recommend it if you can find one in your area. We get a big box of fresh organic vegetables every week. It is fun to see what's in the box and then trying to put together a menu for the week based on the box.
That's all I have time for right now. More later.
So here's what's been going on:
I have a happy, healthy 2 1/2 year old who keeps me busy and entertained. We are doing Kindermusik right now. I'm not a big fan. I've done several of these music classes for babies and toddlers and this is my least favorite one. It could be because it is sponsored by a church and they throw in a few Jesus songs. It could also be that there are about twice as many kids in the class than there should be.
Oh, and we are expecting baby number two in a few weeks!
What else? Well, I am still running my own business. It is going pretty well. The best thing is that I can pretty much work as much or as little as I want.
We joined an organic community supported agriculture (CSA) farm. It is great! I highly recommend it if you can find one in your area. We get a big box of fresh organic vegetables every week. It is fun to see what's in the box and then trying to put together a menu for the week based on the box.
That's all I have time for right now. More later.
Monday, October 01, 2007
Back from the dead
I just got out of prison and I am back online. I look forward to seeing my online friends again.
Tuesday, January 10, 2006
Last entry
This is it--the last entry on this blog.
I no longer have the time necessary to devote to this blog or even to this online persona. Rob will now fade away. I will likely be back in some form in the future but ConNiPtioNs is going away.
In August 2002 I started blogging. I never intended to make it a long term project but I soon found that there was something cathartic about posting--even when there was almost nobody reading what I wrote. I did not know what to expect or what direction this blog would take. I soon found that this was a pretty safe place to vent my frustrations with the US government and the idiots who voted them into office.
Here it is over three years later and until a couple of months ago I was posting pretty regularly. Now I think that the time is right to close this door and move on.
Thanks to everyone who has commented here over the years. I've enjoyed "knowing" most of you--even those of you who disagreed with me. I have learned something from each of you. Au revoir.
--Rob
I no longer have the time necessary to devote to this blog or even to this online persona. Rob will now fade away. I will likely be back in some form in the future but ConNiPtioNs is going away.
In August 2002 I started blogging. I never intended to make it a long term project but I soon found that there was something cathartic about posting--even when there was almost nobody reading what I wrote. I did not know what to expect or what direction this blog would take. I soon found that this was a pretty safe place to vent my frustrations with the US government and the idiots who voted them into office.
Here it is over three years later and until a couple of months ago I was posting pretty regularly. Now I think that the time is right to close this door and move on.
Thanks to everyone who has commented here over the years. I've enjoyed "knowing" most of you--even those of you who disagreed with me. I have learned something from each of you. Au revoir.
--Rob
“The world is full of wonders, special radiance, and marvelous secrets, but all it takes is a small hand held over the eye to hide it all.”
--Abraham Joshua Heschel, God in Search of Man, 1955
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