<— Part 1

There are two types of medical insurances: government and private. With government insurance such as Medi-cal and Medicaid it’s easier to get medication and equipment that you need. Don’t take this to mean that it’s easy, it’s just easier than private insurance. Because private insurances are for profit they have to think about money before health. This is the fundamental problem with for profit insurance companies.

The biggest for profit insurance company right now is Molina Healthcare. They have managed to finnagle their way into Medicaid and Medi-Cal. They sued the government in every single state and forced them to hand them the contract to those programs.

Molina is the company that has taken over my healthcare. They seem innocent enough. When you go to their website you’re confronted with the image of a smiling mother and child. However, not one week after being switched over to them, I’m already receiving phone calls asking for me to change my doctor. Of course, I told them no. They would like to switch everyone to their doctors and their pharmacies. There are two issues with that:

1. The doctors that I have right now are some of the very best in San Diego. I already have an established relationship with them and they know my needs. Changing doctors would mean starting over with someone that is already overworked and extremely stressed out. The quality of my care would inevitably go down until I built that relationship with the new doctors.
2. They just don’t care. The doctors that they want me to have just plain don’t care. It’s not because they’re bad people or anything like that, but they see so many patients a day that it’s impossible for them to care anymore. No human being has the capacity to see so many people and still give them the care that they need. There are exceptions, of course, but by and large this is true for most of the medical field.

When they switch people from one doctor to another they are, inevitably, lowering their quality of care, whether they want to admit it or not. Most people don’t have the time or energy to stop them from changing their doctors. They will do what they say because of some perceived notion that Molina has their best interest in mind or that it’s useless to resist because it’s going to happen anyway. The people at the top know this and use it to get what they want and that’s my core problem with Molina.

When you are entrusted with people’s health you need to make sure that that is your number one priority. The fact is that Molina doesn’t have health as its number one priority and that is something that eventually will get people killed.

In January, I received a package from the State of California. It was addressed to me and it looked rather important, but my mom gave it to me right as we were going to a meeting about how I owed my nursing company $8,000. My private insurance, Anthem/Blue Cross, so that big important package didn’t seem so important at the time.

“I’ll put it in the car and you can open it later.” said my mom as she slammed the door shut. It sat there for a few hours as we met with my nursing company. They explained to us how Anthem/Blue Cross had stopped paying them months ago, they could write off half of what we owed them, but we still had to pay them $8,000. That package drifted further and further out of my mind with each passing minute.

Nevertheless, I still had to look at it. My nurse opened it and showed it to me.

IMPORTANT INFORMATION ABOUT YOUR HEALTH PLAN!

“Just leave it over there on the table” I told my nurse. The nursing company had just told me that they would have to cut my nursing hours and I was not in the right mindset to deal with paperwork. This is not an excuse or justification for not looking at it, I should have looked at it. But, at the time, I was more worried about how I was going to pay my nursing company In the end, they put me on an 8 month payment plan (for which I am eternally grateful) and I started thinking about what I was going to do to make sure it didn’t happen again. I couldn’t deal with another large bill and figuring out how it happened and how not to let it happen again was my main priority at the time. I got distracted and didn’t really think about the paperwork until a few months later.

YOU HAVEN’T FILLED OUT OUR PACKET IF YOU DON’T FILL IT OUT NOW, YOUR HEALTH PLAN WILL BE CHOSEN FOR YOU. PLEASE GET BACK TO US BY THIS DATE!

I looked at the date. Then at the calendar. Back at the date. Fuck.

Now, to understand why that was the first thought that came to my mind, you first have to understand one thing: My things never stay where I tell people to put them. It doesn’t matter how much I stress that that one thing stays in that one place, it will always disappear. It’s like the Bermuda triangle has manifested itself right in my house. I’m not completely sure how it happens, though numerous studies point to evil garden gnomes that come to life when I’m sleeping.

It had been over a month since we put that packet on the table. It was long gone.

IF YOU LOST YOUR PACKET YOU MAY REQUEST ANOTHER ONE.

“Oh, look we can just order another one!” I told my nurse.

PLEASE ALLOW FOR 7-10 BUSINESS DAYS TO RECEIVE YOUR PACKET

“When’s the cutoff date?” she asked.

IF YOU DON’T CHOOSE YOUR HEALTH PLAN BY THIS DATE, YOUR PLAN WILL BE CHOSEN FOR YOU

The date was a few days away. “Just send it anyway, maybe we’ll get the packet before then?” I said in a half hopeful manner. I knew that it was unlikely, but I figured it was worth a shot. The cut-off date came and went with no packet. Just like they promised, they chose my health plan for me..

I started receiving more and more paperwork from the state. After actually reading it, it turned out that this was the paperwork for the infamous managed care pilot program. I had been hearing so much about. The state of California wants to implement it because they think that it will save money. San Diego county has been chosen as one of the cities that it will be tested in.

It’s my belief that there’s no point in dwelling on something that already happened, it’s much more productive to learn from it and move on. So that’s what I did, but the fact is that I made a mistake and now I have to deal with the consequences. There’s not much I can do about being enrolled in the managed care program, but I figured that since I’m already on it I might as well tell everyone what it’s like. The state has billed this program as something that would be beneficial for both them and the consumers. This will be a weekly series showing what the program is like and how it measures up to what I had before, which was not “managed care”.

Stay tuned.