STD and SSDI: Who designs these things?

December 7, 2011

I visited a friend yesterday who was recovering from surgery.  He had built up a lot of sick time at work over the years, since he is generally healthy, so he will use sick days to cover his month out of work.  He has an understanding boss, who knows that he may need to take off extra time.  His health insurance covered the majority of the costs of the surgery.

He asked me how I’m doing, and how I’m managing to be out of work.  He meant financially.  My friend is smart and well-educated, but he got a new kind of education from me yesterday.

First, we discussed how my short term disability (STD) works.  I’m lucky to have an especially good plan.  We talked about how poorly my boss handled my exit, which makes me wonder if my reentry will be difficult.  We talked about how I want to return to work part time because I’m worried that returning full time will lead to a quick relapse.  Unfortunately, it is up to my boss whether or not I can return part time.  If she allows it, then I will return to work a few days a week, and STD will cover part of my salary for the days I don’t work.  Of course, at some point STD will run out, at which point I’ll just earn a whole lot less.  I should be able to cover all of my bills, but I won’t be able to put any money into savings.  Of course, I need to put money into savings more than ever, as I’ve realized that my body will force “retirement” on me much earlier than I’ll be able to afford.

Then we talked about social security (SSDI.)  We discussed how I may not even be eligible for it.  If I am eligible, then the application process is long and arduous.  Most people are denied and then need to appeal.  If I were to get approved, it could take two years.  For those two years I wouldn’t be working, so I’d be draining my savings account.  The amount I would get would be just a bit less than what my rent is now.  It wouldn’t be enough for electricity, gas, or groceries.

Now, let’s say I did get SSDI.  I have a fluctuating illness.  I have weeks and months and years where I feel better, then I feel worse.  When I feel better I could work.  But I’d lose SSDI and if I needed it again, I’d have to start applying all over again.  That’s why many people are on SSDI even though they are well enough to work.  They know that getting off SSDI now would be devastating if they ever needed it again.  So they stay on it even though they are well enough to work.

My friend just shook his head in sadness, thinking of the many, many people caught up in this horrible system.  And I’m one of the lucky ones: I have STD, I have family to fall back on, I have good health insurance, and I have a little money in my savings account.  I could be so much worse off.  But I am wondering how to pay for the acupuncture treatments that I just started today.  My health insurance doesn’t cover those.

When when I consider all of this, the insurances and the government “help” and all the rest, I just have one question:

WHO ACTUALLY THINKS THIS IS A GOOD SYSTEM?

I don’t know who it is, but I’d be willing to bet that they don’t need to use the system themselves.  If they did, they’d be working to change it.

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Leave a Comment » | Educating, Expectations, Frustration, Isolation, Limitations, Medication, Politics, Rants | Permalink
Posted by chronicrants

Political interference

November 27, 2011

Politics affects all of us.  It has to.  Government builds and maintains infrastructure (roads, mass transit) and regulates taxes.  Government creates laws and enforces them.  Government controls the big picture and also a lot of minutiae.  It must play a role in our lives, but I question how big of a role.

Because of my illness, I rely on my government to create and enforce non-discrimination laws, to keep the roads and sidewalks passable, and to ensure that the medications I take are safe for consumption.  These are all important.  However, I feel that sometimes government goes too far in “protecting” its citizens.  I will write more later, but for now, think about medical marijuana and assisted suicide.  How involved should the government be?

In the United States, one big problem is that some states have legalized each of these, but the federal government does not recognize them as legal.  That sets patients and doctors up for potential problems, and that’s not fair.  It must be decided once and for all whether or not states can regulate either of these areas.

As far as marijuana goes, I won’t get into whether or not I think it should be legal for general use.  However, for medicinal purposes it should be treated like any other drug.  There should be studies to determine its efficacy, then it should be subjected to an FDA approval process to ensure it is safe for medicinal use.  Why not do this?  After all, it is no more harmful to a person than alcohol, cigarettes, or many prescription medications.  It is not dangerous to non-users as long as second-hand smoke is avoided (it could follow the same rules as cigarettes) and people do not drive under the influence (it should follow the same rules as alcohol.)  I would happily accept government regulation of medical marijuana so that I could trust that it came from good sources.  I can not accept, though, that the government will not even consider it.  Given the choice between the side effects from marijuana or the side effects from prednisone, I’ll choose pot, thank you very much.

Now, as for assisted suicide, the idea that suicide is illegal is ludicrous.  A person who wants to commit suicide should get proper counseling, of course, and be of sound mind.  But if a terminally ill person is in a lot of pain and wants to end their suffering a few weeks early, why shouldn’t they be allowed to make that choice?  And if they are going to end their suffering early, shouldn’t it be done with the aid of a doctor, so that it is done in the least painful way possible?  I simply can not imagine why people have a problem with this.  And I certainly can not see any reason why the government should be regulating it.

These are just my opinions, of course.  Everyone needs to do their own research and their own thinking.  For me, though, the answers seem very clear.  My opinions are strong, so I will definitely be elaborating on these in later posts.  For now, I just needed to vent a bit.

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6 Comments | Educating, Frustration, Healthcare, Intrusions, Medication, Politics, Rants | Permalink
Posted by chronicrants

Searching for fairness in healthcare

November 17, 2011

Continuing yesterday’s theme of the screwed up health care system, I just read this article about special medical services to give second opinions.  They reevaluate diagnoses and treatments and make changes as needed.

Now, doctors make mistakes.  They are human.  It happens.  I think it is responsible of patients to get second opinions.  So you may be wondering why I think this is a problem.  Here’s why: this service isn’t available to everyone!  I just looked at the Best Doctors web site, since they’re located near me, and I saw that the service is offered only through employers!  This is like the FSA situation, where only some people have access to a fantastic benefit.

Back in the day it made sense to tie health benefits to employment, but is that still really the case?  For those of you living outside of the United States you probably think this is completely nuts.  You’re right!  I’m certainly not about to defend this system.  Why should I get better health insurance now because of where I work than I had the last 10 years (my entire independent working life)?  If I change jobs, why should my benefits change?  If I get a new job that pays more or less or is located someplace else, those aspects will affect my life.  That makes sense.  What doesn’t make sense is that the amount I pay for medical costs will change.  What doesn’t make sense is that I may have to get new doctors.  What doesn’t make sense is that my medication may not longer be covered by health insurance.

Congress failed.  Yes, untangling health insurance from employment would be a huge undertaking, but wouldn’t it be worth it?  Mandating that employers provide health insurance sounds good, until you realize that many will provide only the minimum, and that this doesn’t help the unemployed at all.  We need a system is that is fair for everyone.  We should accept nothing less.

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Leave a Comment » | Educating, Expectations, Frustration, Limitations, Medication, Politics, Rants, Symptoms | Permalink
Posted by chronicrants

How broken is our health care system?

November 16, 2011

It is important for everyone to have doctors they feel comfortable with.  For those of us dealing with chronic conditions, it is especially important that we have a medical team we trust and who respects us.

Sometimes I think about leaving the Boston area (the climate here is horrible for me) and it saddens me to think about leaving my family and friends.  But then I think about having to get new doctors, and that terrifies me.  It took me many years to get doctors I like.  In the past year I have had to find a new PCP twice and that has been a horrible experience.  I can not imagine having to start over with a new rheumatologist, a new endocrinologist, etc.  Still, when/if I move, I know that I will have to build up a new medical team.  But that will be my choice, based on my actions.

What upsets me is being forced to change doctors!  To be clear, this is not happening to me personally, but it may be happening to a lot of people in my community soon, and that is very disturbing.

The current health care system is broken on many levels, in many ways.  I would like to say this is an isolated issue, but sadly, it’s not.  According to this article and other reports, a lot of people may have to find new doctors because of a breakdown of negotiations between an insurance company and a hospital.  Corporate negotiations will force people to get new doctors!  How horrible is that?  Now, to be fair, I’m sure patients will be more than welcome to stay with their current doctors if they pay for the costs themselves, but realistically, how many people can do that?

I’m not saying I have all the answers (though I certainly have a few suggestions), but I do know that the system needs to change so that when negotiations break down, patients aren’t the ones being harmed.  It is hard enough to be sick, then to find good doctors, and to negotiate the maze of insurance rules and medical terms and tests and procedures.  To then have that all taken away and be forced to start over, that is criminal.  The Blue Cross and Tufts Medical negotiators must work this out and they must do it now.  There is simply no excuse.

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Leave a Comment » | Educating, Expectations, Frustration, Healthcare, Intrusions, Politics, Rants | Permalink
Posted by chronicrants

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