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affordable care act


Who deserves the Oscar for the Affordable Care Act?

Health insurance used to be simple when I was young. At least it seemed simple.

Mom and Dad took me to the doctor when things looked funky, like my collarbone.

Things break on kids, like bones when they fly through the air and land awkwardly.

Have you ever seen a video of someone launched over the handlebars of a speeding bike?

Or played a game of swinging statue?

Chalk up two broken clavicles for that.

Give an Oscar for the bike rider.

What if your arm feels like it’s about to drop off?

One football shoulder injury in high school, and one college wrestling injury later on the same shoulder?

Affordable Care Act Oscar worthy?

Or should it go to the doctor who looked at the shoulder in high school and also checked a once broken finger and said, “Well, we’ve never had much luck on the baseball finger.”

That’s a drooping last joint on a finger due to ligament damage.

My finger deserves an Oscar?

Or do we give the finger to the doctors too afraid of their own diagnostic skills to say the words?

How many times do medical professionals rely on their own network of trusted doctors to deal with their healthcare? It’s not about insurance, but deliverable medical opinions.

First of all, doctors are human. At least they seem human even with their god-like status.

Who wouldn’t believe them?

For instance, if you had radiation treatment for cancer thirty years ago, which is half a lifetime if you’re sixty and bad at math, you got blasted.

Today’s radiation treatment burns out cancer in specific areas with controlled bursts. Not so much thirty years back.

Then you got a general blast that includes everything surrounding the place, like using a lawn mower to trim on blade of grass.

The radiation oncologist at St. Vincent Hospital, Dr. Hansen, answered every question I had about cancer and his work.

“Will I get an associated cancer related to treatment?”

“Does the treatment open the door to more cancer?”

“How do you know this stuff works?”

Every question came with a crisp, reassuring answer. Not like they were dumb questions, but more like he’d heard them before.

The chances of related cancer, different cancer, are small. The proof it works shows in the CT scans and PET scans.

But what if you and your doctor have a professional relationship? And they refer you to someone else because they don’t want to give the bad news?

That is an Affordable Care Act Oscar worthy performance.

Dear Doctor, just give the results and let the patient and their care advocate decide on the next more. Don’t just kick them down the line.

My last nominee for best Affordable Care Act Oscar goes to the insurance lady who called with her best used car sales pitch.

Instead of, “What do I need to do to get you in this car today,” she said, “I see a new charge and I’m calling to clear this up today.”

It was funny if it weren’t so pathetic.

On the day of surgery I got the call. It was a few hours after I got back home.

“Hello, I’m calling to talk about clearing up a new charge. This phone call will be recorded for quality control.”

“Thank you for calling.”

“How would you like to handle this bill?”

“How do I know you are an insurance rep?”

“I have your birth date and name.”

“Do would every identity thief.”

“I’m not an identity thief.”

“Good to know. Here’s how I’d like to handle the bill. First I’d like to see an explanation of benefits. I appreciate the quick response to collect money, but the EOB comes first, right?”

And that ended the conversation right there. But why make the call to begin with?

This is a phone call that sends people into a tizzy. They answer thinking they owe thousands of dollars right now. Maybe I do, maybe I don’t, but let the process work.

When an insurance staffer makes that call and knows they’re jumping procedure for a fast cash infusion, they deserve an Affordable Care Act Oscar for a supporting role.

Do you have a candidate for an Affordable Care Act Oscar? Nominate them in comments.

About David Gillaspie
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