Knit Sisters

Minimizing losses

Post by Ellen
Wednesday, January 23rd, 2008

Happy New Year everyone! A bit belatedly, I know, but you are now talking to someone with two completed dissertation chapters and a third in gestation, but who is now, I’m afraid, officially a “fallen-away blogger.”

Better blogging times are coming, Lord, we just don’t know quite when…

Meanwhile, my university welcomed me to 2008 with some warm, fuzzy, and deeply American news: they would be cutting off my health insurance, in spite of the fact that I am now, and have been for the past five and a half years, a graduate student in good standing at Berkeley who has always been judged by my department to be making what they call “good progress” (towards what exactly is a larger philosophical question that shall not be addressed here).

The precise details of this health insurance debacle are, as all things with this “industry,” byzantine, maddening, and very difficult to convey. I shall attempt, nonetheless, to summarize: in order to finish a Ph.D. at Berkeley in any field that requires research away from campus (and that would be, ahem, many), a student will—for bureaucratic purposes and to save her department big, big cashola—be placed on what is called “withdrawn” status for two semesters while she is away. During this time, she has to buy her health insurance through the university as a separate fee, which costs her approximately $3000 for the year.

Since her stipend is somewhere between $15,000 and $18,000 per year (pre-tax), this poses a serious financial “challenge,” but one that can be surmounted by eating nails for a couple of months and never turning the heat above 50 degrees.

So far, so good!

You with me? Now, right before the student gets her Ph.D., she spends ANOTHER semester on what is called “filing fee” status, another bureaucratic category into which she is placed, like it or not. Under this status, she is also required to buy her own health insurance.

Here’s where things go off the rails. The insurance company that “serves” the university has made a rule that a student may only buy into health insurance through the university for two semesters. But this is in the extremely fine print, of course.

Those of you keeping score at home may have already realized that to finish the program the student has to buy health insurance for three semesters.

Folks, with “service” like this, who needs enemies?

I noticed this rule on January 14th, one day before my health insurance from last semester ran out. So I gave the folks out in California a friendly call to investigate.

Me: So I read this rule about the two semesters on your website and I’m calling because I wondered if I was reading that right.

Insurance Elf: Yes, you are.

Me: Well, that’s funny because my program—and I’m guessing many others—puts a girl on this kind of status for THREE semesters, not two.

Insurance Elf: Well, I’m sorry, but we have been enforcing the two semester rule.

Me: May I ask why?

Insurance Elf: We did a study and we discovered that the group of students who buy insurance while they are on withdrawn or filing fee status is small, but it is a high claims group. We needed to minimize our losses.

Me: (Pause to take in the wildly inhumane magnitude of this statement and to tear out a chunk of my own hair) So what do you suggest I do for health insurance then, Insurance Elf?

Insurance Elf: There are plenty of outside plans you can buy as an individual.

Me: Dude, I have researched those “plans” in the past. They have terms like, say, $2000 deductibles. You take a financially marginal person and give her insurance with a $2000 deductible and you have given her nothing but disaster insurance. There isn’t any “health care” about it. That’s just insurance so that you won’t have to eat mealworms and live in a refrigerator box for the rest of your life if you fall on the ice and break your arm. You can’t go to the doctor unless it is clearly a matter of your imminent death. You got mild asthma? Go home and f*cking gasp, little friend.

Insurance Elf: Well, we do enforce the two semester rule.

Me: I think you’ll burn in hell for this.

Actually, I didn’t tell the Insurance Elf she’d burn in hell. But I think she will.

So at the moment I have the disaster-only insurance. There is a chance that the insurance elves will make an exception in my case, but while they deliberate, I have to have some kind of coverage. (Revisit specter of a lifelong diet of mealworms and a refrigerator box home.) And the coverage can’t lapse or the health “care” industry will shaft me on the old pre-existing condition clause.

Now, without boring you with all the ins-and-outs of this matter, I can assure you that one way or another this will be resolved by February 15th such that I can have usable health insurance. But only because I am married. That is, either Berkeley will relent, or I can get onto Alex’s insurance.

So this isn’t really about me, even though my situation is all, all, all wrong.

This is about a broken, inhumane, indecent health “care” system that has been turned over to rapacious businessmen who prey on people who need medical attention and take decisions about health, healing, and well-being out of the hands of doctors and nurses and place it into the hands of people who only want to make a buck.

This is wrong. It’s wrong that companies are “minimizing losses” by making it impossible in practice for people to go to the doctor when they are sick or to get their medical care covered if they do. It’s wrong that we have so many people who are completely uninsured and so many who are underinsured and therefore in constant danger of financial ruin.

It’s wrong in a country where we have so much money and so many resources that we would allow this to go on. If ever a thing were immoral, this is.

I’ve been in such a toot about this that I have contacted all the major Democratic presidential candidates to offer my services to help them sort out this health care nightmare. I have told them that I will get my Ph.D. in December and will be available—just in time!—in January.

Unaccountably, none of them have had their people get back to me.

Everybody must be at lunch.

Or on the phone. Arguing with their insurance companies.

This entry was posted on Wednesday, January 23rd, 2008 at 11:16 pm and is filed under Wool gathering. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

12 Responses to “Minimizing losses”

Alex Says:
January 23rd, 2008 at 11:35 pm
My favorite part of it is that they told you that they wanted to make sure students like that were “making progress with their degree.” Like that’s their business! Just what I need, an HMO that “cares” about my degree progress so much that they’ll drop me if I drop into a “suspect” category (from their point of view; perfectly normal from the university’s)!
Amy Says:
January 23rd, 2008 at 11:42 pm
I’m so glad to see you come out of oblivion to post. And you have my fullest, sympathy and understanding for the situation. Over the holidays my unemployed (at the time, no longer, thank god) fiancee had an emergency room trip and… yegods. My own insurance is laughable, and I cancelled the “disaster” insurance at my last job because it was truly, utterly pointless.
Diane Says:
January 23rd, 2008 at 11:45 pm
Glad to hear from you!

Yikes…been there, done that. The first option I was given after our health insurance ran out (after getting laid off) was $900/month, $10,800 for the year…excuse me, but what part of unemployed didn’t they get? Luckily, my pre-laid off income was low enough that I could qualify for disaster insurance from NYS at $360/month. Thank goodness I finally found a job, pay not so good, but they do pay health ins. in full!
Jolynn Says:
January 23rd, 2008 at 11:55 pm
Yeah… Insurance companies pretty much STINK!
Clumsy Knitter Says:
January 24th, 2008 at 3:32 am
Glad to see you back again! Sorry about the horrible insurance scam. My husband is Canadian and is quite fond of pointing out that if we had universal, tax-funded health care like they do up there, we would all actually be paying LESS than we do now with our fees and everyone would be covered. Shame on your school for not doing more to help the students out!
Mama Urchin Says:
January 24th, 2008 at 8:49 am
Oh health insurance, such a pain. Maybe you should knit them some socks to sway their decision.
Ellen Says:
January 24th, 2008 at 9:54 am
I so wish they would be swayed by a pair of socks. But somehow I think with this crew you’d have more luck with our friends Mr. Smith and Mr. Wesson.

Not that we’d ever advocate gun violence here on the blog. Although exceptional circumstances call for exceptional measures, I think we can all agree.
Helen Says:
January 24th, 2008 at 3:47 pm
And once you get that Ph.D. and land a teaching job, some tenure-track jobs, especially with state schools, require the new hire to pay for her health insurance for the first six months to one year.

Yeah, higher ed is all heart.

-Helen
elise Says:
January 24th, 2008 at 5:41 pm
Well you aren’t the only one with insurance issues. I need a medicine to curb some stomach issues that won’t go away, recently they can out with a generic. I was all happy and smilely until I got a notice from the insurance people that under my drug plan the generic was going to be MORE EXPENSIVE than the name brand. I called them yesterday and asked why and the only answer they would give me was that a cost effective study was done and they found the name brand to be less expensive for them. I was quite tempted to tell the poor phone lackey that it was less expensive becuase of the kickbacks that the insurance company is probably getting from the drug company. What is the point of even having a generic option if it is more expensive? Sigh. Someone needs to fix this industry, it has grown out of control.
Jennifer Says:
January 26th, 2008 at 12:52 am
Ugh, you have my sympathy. I’m actually enough of a capitalist that I understand the business need to make money, but what I don’t understand is why in this country health care is in the hands of business. There is no way to make it work in a way that’s effective for any but the most fortunate minority. Er, I’m in that minority. If you want to move to Seattle and become my domestic partner (they don’t need to know the details) you can be covered under my very nice plan.

Another idea is that you could channel your rage into knitting, somehow creating a giant building cover that could be dropped over the office complex that houses the heartless Insurance Elf, imprisoning her permanently with her charming and like minded Insurance Elf colleagues. When their health starts to fail due to confinement and overcrowding, you can help them find the clause in their personal insurance policy that precludes coverage for people imprisoned by giant knit building covers.
Jennifer Says:
January 26th, 2008 at 12:53 am
Congrats on the 2 completed dissertation chapters. It sounds like the ‘butt in chair’ method is paying off
Kate Says:
February 10th, 2008 at 7:02 am
Gah! Shades of when I was made redundant at work and didn’t have any health insurance and couldnt’ afford the astonishing fees asked. It was either get married and use my partner’s health insurance, get another job with insurance attached or go home. I went home. Not all bad but kinda difficult on the relationship at the time.

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Minimizing losses

12 Responses to “Minimizing losses”

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