Why having insurance does not suck

Any of you who know me to any degree beyond just casual acquaintance will know that due to my profession, I have very strong opinions on the Affordable Care Act, and the health insurance industry (and what I see as it's general direction in this country).  This blog post is NOT meant to reiterate that, or change anyone's mind on their particular opinions on the subject.  I will simply leave it at the fact that I am truly glad that some of my friends are now able to have health insurance coverage now for the first time in forever, and I am very happy for them, but I still disagree with how the Act was created and implemented, and there is pretty much nothing anyone will be able to say to convince me that a government-run, single payer health care system is in any way a good idea in this country.  If that is your belief, I will let you keep it; I ask you to respect me enough to keep mine.

Okay, that said, I recently read a comment on a good friend's Facebook page that really set me off.  The friend was legitimately venting about an uncovered service on her insurance policy, and I had complete sympathy for her (I understood the rationale behind the exclusion, though I disagree with it). However, another friend of hers made a comment on said thread to the effect that all health insurance sucks and it is completely worthless and a huge racket.  To which, I pretty much lost it, and left a very snarky and sarcastic reply comment for which I am still not the least bit sorry.  Granted, I was still really sick with bronchitis at the time, and overstressed from work, and the show, and wedding planning and I recognize that I wasn't in the most forgiving frame of mind.  Still, I'm not at all sorry about saying what I did.

It just really gets me how little people understand what insurance is supposed to be.  I do, however, understand why they seem to think that a health insurance policy needs to cover every possible test, service and treatment with up front first-dollar coverage -- this is what our state and federal governments have forced the industry into doing.  But seriously, no one expects their car insurance policy to cover every oil change and maintenance service for free.  So why do we all expect that up front with our health insurance policy?  I really don't get it.

The other thing people really don't seem to get is how much work insurance companies work to get really amazing discounts from doctors, drug companies, and medical equipment/device providers.  Seriously, it is huge.  In fact, they will often do it for providers that aren't even in their network.  Just so that their members don't have to shell out huge sums of dough.  Does that sound like something an evil, greedy, money-grubbing corporation only concerned with profit and lining the pockets of their CEO would do? 

[Fact: Last year when Brian had his sinus surgery done by an out-of-network provider, his insurance company did, in fact, negotiate discounts and got the total surgery cost down to less than half of billed charges.]

In going over my statements of benefits for my diagnosis and treatment of Sleep Apnea, I was once again reminded of how much my insurance does not suck, and how grateful I am to have it.  Even though having to do so has caused me to reach my rather large medical deductible.  That too is a good thing, as any other services I get this year (including the recent Urgent Care visit) will now be covered at 80% by my insurance, in addition to the aforementioned discounts.  Silver lining, I suppose, to being unpleasantly sick for far too large a portion of this year?

A few non-hypothetical examples of how my insurance has made this a much less financially painful experience for me:

• Initial visit and consultation with Sleep Specialist: Billed $370, Discount $134.25 -- I paid $235.75
• Follow up visits with Sleep Specialist: Billed $165, Discount $63.64 -- I paid $101.36 (each)
• At-Home Sleep Study: Billed $600, Discount $283.94 -- I paid $316.06
• CPAP machine: Billed $2,052, Discount $1,599.57, portion paid by insurance after meeting deductible $157.59 -- I pay $294.84

Ability to sleep through the night and wake up feeling refreshed and able to get stuff done and enjoy my day and my life = PRICELESS!!!

CPAP and respiratory infections

Warning, whiney post ahead!

So my theater peeps will know what I'm talking about here.  You're in a show, and one cast member gets sick with some icky upper respiratory crud.  And then said icky respiratory crud starts making its way around the cast, especially among those who share a dressing room with the aforementioned "Patient Zero".  So you start popping Airborne, and washing your hands more often, and pray this one will pass you by.  But of course, it doesn't.  And you find yourself in the throes of said nasty viral illness during the next weekend of the show.  A show for which there are no understudies and no "backup plan". 

So you soldier on and give it 100% of the 40% or so you have left in you, meanwhile feeling guilty as hell because you are only working 9-10 hour work days in your day job (in addition to performances) because the rest of your team is working crazy stupid around-the-clock hours and you don't feel like you are justified in taking a sick day when you already work from home.  And you try to ignore the fact that you are asthmatic and have a propensity to develop bronchitis at the drop of a hat, and definitely as a result of any "common cold" that isn't immediately taken care of.  Thereby ending up completely useless and feeling like death after said weekend of performances.

Okay, maybe that last part only applies to me ...

Anyway ... You may be wondering what that has to do with my experiences with sleep apnea and CPAP therapy.  Well, honestly, nothing much except that I wanted to vent my frustrations about how much more using the CPAP makes being sick SUCK MAJOR DONKEY BALLS.

First of all, it is much more difficult to catch a quick nap, which is something I not only like to do but pretty much NEED to do when I'm fighting off a cold.  I can't just grab 30 minutes on the sofa, I have to go into the bedroom and hook myself up to the machine, and let myself get comfortable, etc, etc, etc.  I actually ended up giving up several naps for this reason, which was definitely to my detriment. 

Secondly, even with a full face mask, trying to breathe through one of those things with a stuffed up nose and major sinus pressure is pretty unpleasant.  Just makes all the pressure feel that much more enhanced when you have pressurized air blowing into your face every couple seconds.  Coughing into the mask is equally unpleasant.  And the feeling when you wake up and your ears are totally plugged up because of all that extra pressure and stuff, oh yeah, that's just tons of fun.

Then you get to add the extra special feeling of claustrophobia induced by having to wear a full face mask when you are struggling enough to breathe due to a full blown bronchial infection.  And again, waking up every few hours with a coughing fit into said mask, thereby further enhancing said claustrophobic feeling.

I can only hope that the drug combination the doctor prescribed (antibiotic for the infection, prednisone for the inflammation, and codeine cough syrup to help me sleep) will kick this to the curb so that I don't have to keep on feeling like something that came oozing out of a dog's rectum, and I can resume my more loving relationship with my CPAP machine.

Okay, end whining ranting uber discontented and rather emo blog post.

A little, unexpected benefit

So, you have all heard how much I'm liking the CPAP now, and how awesome it is that I can get a decent night's sleep again (that is, when I'm not in Tech Week).  But there is another small benefit to sleeping with the full face mask that I hadn't anticipated, which is quite nice.

Brian can let out the biggest, nastiest farts EVER in bed, and I don't smell them.

Woo hoo!!!

Also, I can let out the biggest nastiest farts EVER in bed, and I don't smell them.

But he does.

Tee hee!