By Suzanne Gordon
Salt Lake Tribune
Progressive Media Project
01/15/2010
I’ve had enough of the derisive talk about “Cadillac” health insurance plans. They’re not all that they are cracked up to be, and they are not what is driving health-care costs skyward.
My husband has been a union member and staffer for many years, and his employer provided my family (as a hard-won benefit of union negotiating) with what is now considered an unnecessarily “luxurious,” “wasteful” insurance vehicle.
So let me tell you how we’ve used our insurance plan over the past few years and how, in turn, it has misused us.
Three and a half years ago, I had an emergency appendectomy. During the surgery, I suffered several preventable complications, one that has proved to be quite serious. As a result, I needed extra visits to multiple doctors and physical therapists, as well as MRIs, ultrasounds and a variety of painkillers and other medications.
My husband was bitten by a feral dog in El Salvador and had to get 10 rabies shots when he got home.
Our daughter needed a variety of pills and shots before going to Rwanda to work for a group that helps women who were raped and infected with HIV/AIDS.
How have we fared when we’ve taken the Cadillac for a ride? Not well.
For more than 25 years, I was on the rolls as Suzanne Gordon, but then the insurer suddenly renamed me Suzanne Early (giving me my husband’s last name) when I submitted bills for my emergency appendectomy. Since there is no Suzanne Early (at least
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not one who’s actually me), it was no surprise that they couldn’t identify me as an enrollee. Claim denied. That took months to sort out.
When my husband got his rabies shots, the insurer denied the $1,000 claim because somehow the services weren’t coded as “medically necessary.” In his lengthy conversations with the insurer, he reminded them that since rabies is invariably fatal, dying of the disease would cost the company a heck of a lot more than $1,000.
No matter. To get the bill paid, it took a year of haggling, including receipt of many threatening letters from not just one but three bill collectors. And for months after the problem was resolved and the bill paid, we still were receiving dunning notices from one bill collector.
When my daughter needed more than the formulary-allotted supply of malaria pills (you can’t easily get them in Rwanda), it took dozens of calls to pharmacists, doctors’ offices and the union’s human relations department to get them and renew them.
Driving a Cadillac, it turns out, is almost a full-time job.
Like so much else in our health care debate — “death panels,” “socialized medicine” — the depiction of the so-called Cadillac option is a scare tactic meant to deceive and derail.
The tragedy is that in this instance, the scaremongers and derailers include President Obama, some of his party and too many of the progressive policy commentators.
Instead of blaming unions for bargaining for better (but still insufficient) health benefits for their members, we should be clear on who is really to blame for the real cost escalators in health care: a for-profit private insurance and a pharmaceutical industry that puts us all at risk.
Suzanne Gordon is the co-editor of the “Culture and Politics of Health Care Work” series at Cornell University Press. She wrote this for Progressive Media Project, a source of liberal commentary on domestic and international issues; it is affiliated with The Progressive magazine. Readers may write to the author at: Progressive Media Project, 409 East Main Street, Madison, Wis. 53703; e-mail: pmprojprogressive.org.