Category Archives: Paffooney

There tends to be a good reason behind certain expressions.  Let me take a moment to explain it to you in the vaguest sort of way meant to protect the innocent, the privacy of the sufferer, and my privacy, and yet still get at that little old devil who is making my life a living hell.

The problem stems from factors beyond my control, and the mental health of a family member who is not me, but I am responsible for paying for, because I can clearly see what the problem is (as can doctors and licensed practitioners)  while other members of my family (mainly for religious reasons) can’t see.  And, of course, you can imagine who the insurance company, who is supposed to pay for at least part of it, wants to believe.  I am the one who sat through the day in the ER two years ago, giving the best support and care I could while footing the bill.  (The truth is, Jehovah’s Witnesses have a complicated time in the ER because they don’t accept blood transfusions, and they worry about the practice of Psychiatry leading to some kind of evil mind control.)  In the ER it was determined for the sake of safety and protection of the patient, we needed to be sent to a psychiatric hospital.  Of course, the insurance gets to tell you where and what doctors you can work with, so we were sent to University Behavioral Health Hospital in Denton, the one facility that my family has determined CANNOT perform any more services for my family on pain of religious condemnation and angry black stares that ripple through time from then to now.    A weeks’ worth of time in UBH, determined by UBH to maximize profits, led to a bill of over a thousand dollars payable by me.  That, added to my own medical bills (from six incurable diseases) and the bill from the ER that the insurance pays less than half of because of deductibles, added up to a debt that maxed out my credit cards and brought me to the brink of bankruptcy. (A thing I narrowly avoided by engaging a lawyer for debt-reduction services).   I was forced to retire from teaching at that point because the time away from my job for the family member’s illness, plus the work missed from my own illnesses, was reducing my income to the point that I might’ve owed the school money at the end of every working month otherwise.  I was fortunate to have enough years in service to have a good pension.

Now, of course you know that mental health conditions aren’t the kind of thing that goes away by taking a pill… or even a hundred different pills.  It requires constant monitoring, prescribing, and proper therapy.  UBH will not even release a patient unless you can prove that you have set up appointments with both a psychiatrist and a therapist.  We found excellent ones of each.  But, of course, along comes the insurance company to have their say.  (This insurance company shall remain nameless… but it rhymes with FAetna… and that is not a capitalization error, no matter what the spell-checker says.)  We lost the services of one of the best adolescent psychiatrists in North Texas because he refuses to take the crappy insurance.  I don’t blame him.  I blame him less now that I know so many more of the devilish details than I did then.  So, I tried to replace the good doctor.  I called the insurance provider for a list of doctors we could use.  I was given only two names.  The first doctor, a well-respected lady psychiatrist, let us make an appointment.  When I was filling out the required paperwork in the office on the day of the visit, we were informed that due to a technicality, the only way we could see that doctor would be to pay 100% 0f the bill.  The receptionist graciously let us end the appointment without charging us the late-cancellation fee.  We went to the other doctor, one that had unpleasant memories of my family from UBH, and were rejected by the doctor.  So… no psychiatrist anywhere in the State would treat my family ever again thanks to the crappy insurance.  (I tried to think of another adjective besides “crappy” to use here, but couldn’t think of any I could use that would not melt my keyboard.)

Now, recently, we have lost our only other professional help.  We had been seeing the excellent therapist weekly for over two years.  Previous insurance had no problem paying for the preventive services he provided.  I got by with a simple co-pay every week.  But when we had to transition to crappy FAetna, a stealth problem occurred.  Apparently there was a form that needed to be filled out to transfer the payment obligation from one provider to the next.  The form had an expiration date on it that absolved the crappy insurance from any payments at all once it was passed.  They, of course, did not tell the poor therapist about the existence of this critical document until long after the expiration date.  All claims during that time were recently nullified and payments denied.  We actually owe the doctor doing the therapy well over a thousand dollars. But he knows we can’t afford it, and he feels bad that it was caused by an error that was technically his.    We are still trying to dipsy-doodle through the nightmare health-care system to find needed services.  I have had my fill.  I don’t try to call Satan’s member-services department for the crappy insurance any more.  They won’t tell me the truth, and they won’t do anything helpful… only things that are harmful.

If I were to go to the main offices of FAetna Crappy Insurance Corporation, I would fully expect the front doors to be guarded by a massive three-headed dog-thingy.  The receptionists would all be red-skinned succubi with fangs and horns.  You would have to descend in an elevator to the Pit of Hell to see any of their superiors… You know, like Beelzebub, Asmodeus, and Lucifer.  Apparently all the premiums we pay to health insurance companies entitle us only to arguments with intractable employees who don’t even know what the word “approved” means.  So, the Devil is indeed using the details to rule in Hell… and he is doing a Helluvah job.