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December 17th, 2008

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07:25 am - The Best Christmas Present Ever: The Stunning Conclusion!
(Continued from here)

I was in the office one Wednesday after giving Jim a ride to pick up some prescriptions and then taking him home. Apparently, they'd had to cancel his chemotherapy and made him stay home from work for a few days because his white-cell count was too low. He was feeling sick and miserable. He could barely speak, and had a radiation burn/rash on his back from the treatments. You could tell he was trying to keep his spirits up, but the whole thing was getting to him. After all, the first of the year was only a few weeks away, and he was pretty sure that when it came, he'd be out of medical insurance.

I was still outraged on his behalf, and more than a little despondent since my plethora of phone calls really hadn't turned up much, but I was still hoping that someone would find out that Anthem couldn't do this after all. I mean, come on! It was the same company! The same exact damn company that covered him now -- how could they possibly get away with calling something a non-coverable condition when they were already covering it?

Of course, all this outrage was in vain. In the loophole vs. loophole battle, the insurance companies have got it down. They probably have teams of attorneys for each state whose sole purpose in life is to find just where the gaps are in the laws to make sure they can deny coverage to as many people as possible.

No, I'm not bitter.

Well, okay, yes, I'm fucking bitter. What's it to ya? Huh? You wanna piece of me?

Er ... sorry, where was I? Oh, yes. The office.

That afternoon, the company management met with the head of the PEO to discuss the situation. I didn't really think much about it, although I noticed that they all looked a bit grim.

If this were a Doctor Seuss story, right around now there'd be a clever turn of phrase about how the Grinch's heart grew three sizes that day, and about how we weren't sad at all, we were singing, we were singing!

Of course, this is real life, where companies need to make decisions based on business and profit margins and not such things as the medical care provided to the Whos down in Whoville. Which made what happened next entirely unexpected.

Jim called me up to tell me that he was going to get to keep his insurance.

"They're not going to switch," he said, in an incredulous tone of voice.

"What are you saying?" I asked him, not quite following.

"They're not going to go with that PEO thing," he repeated. "They decided they're going to stay with what we've got for now."

"You're kidding me!" I exclaimed. "That's great news!"

"Yeah, I couldn't believe they would do this for me," he said, still with a voice filled with disbelief.

We chatted a bit, then hung up. He was still pretty ill, but he sounded truly amazed that the company would chuck this plan because of how it would affect him, and it made a world of difference in how he talked. To tell the truth, I was amazed as well.

I know what you're thinking, but you read it right. Despite the economic downturn, and the amount of money that switching would save the company, the management decided that it wasn't worth the human cost to employees like Jim and the few others who also had what would suddenly become "pre-existing conditions."

Of course, Anthem still gets to continue doing business the same way they have been, and chances are that they'll hit other unsuspecting people with this in the future. (Although the PEO people are on guard for that now, and maybe forewarned is forearmed, as they say.)

But just once, amidst all the problems and annoyances and everything that goes on in the business world, amidst all the cutthroat deals and lobbying and backstabbing and scrabbling to squeeze out one more dime, one company chose compassion over profit so that a decent, hard-working guy could continue to get the medical care he needed.

And if that's not one of the best Christmas presents ever, I don't know what is.

The End

(19 comments | Leave a comment)


[User Picture]
Date:December 17th, 2008 03:37 pm (UTC)
that's great, and really impressive
[User Picture]
Date:December 17th, 2008 03:41 pm (UTC)
That is an amazing story. Thanks.
(Deleted comment)
[User Picture]
Date:December 17th, 2008 06:11 pm (UTC)
I would, except that I don't think the company would approve, much less "Jim." :-) I think it would be an invasion of privacy, which is why I didn't use real names (except for Anthem, which is evil and should be known).

But I really thought the story needed to be told, so you guys are the sole beneficiaries of it.

Unless you link it around, and feel free to do so. :-) I don't have a problem with anyone reading this, as long as the anonymity of the company and "Jim" are preserved.
[User Picture]
Date:December 17th, 2008 04:02 pm (UTC)
That is an absolutely fantastic story. And, I agree, I think you should alert the local media. Hell, tell the national media. Maybe tell your congress people and senators. Maybe then the insurance companies won't be able to pull that shit.
[User Picture]
Date:December 17th, 2008 06:01 pm (UTC)
Ditto on this.

I am so relieved this had a happy ending. What a great Christmas present!
[User Picture]
Date:December 17th, 2008 05:02 pm (UTC)
I love your company. Thank you for posting this. It is indeed the best present ever.

Date:December 17th, 2008 05:09 pm (UTC)

Be the miracle

Thanks for your heart warming story.

Hopefully, we will finally see an end to a system and a government that allows what your husband and millions of Americans endure every year.
We need Medicare for all - we can call it Ameri-care.

Wishing you all the best - good health, happiness, love, peace and prosperity in the New Year.
[User Picture]
Date:December 17th, 2008 06:07 pm (UTC)

Re: Be the miracle



A small clarification ... I'm actually not married, and my (ex)-husband does not appear in this story. "Jim" is a co-worker. :-)

And you're absolutely right about the need for change in health care in this country.
[User Picture]
Date:December 20th, 2008 07:19 am (UTC)

I'm actually not married,

You are a veteran of being a Mrs. In an ideal republic that would get you two votes.
[User Picture]
Date:December 20th, 2008 07:33 am (UTC)

Oh, excellent, thanks! I'm going to remember that one.
Date:December 17th, 2008 06:12 pm (UTC)
What a great happy ending. But everyone is right - in a civilized country, this kind of thing should never be allowed to happen.
[User Picture]
Date:December 17th, 2008 06:20 pm (UTC)
This is amazing and wonderful! I'm so glad the humans won over the dollars!!

I don't know about others but to me, that would be another really good reason to support this company if I can.

Hopefully this situation teaches the business involved something. The health care system in this country needs so much reform its not even funny.
[User Picture]
Date:December 17th, 2008 06:38 pm (UTC)
That is awesome. I hope "Jim" will not have to suffer too much in his treatments, and that he gets well soon.


Thanks for posting this. I think I needed a little more holiday cheer.
[User Picture]
Date:December 17th, 2008 08:16 pm (UTC)
Date:December 17th, 2008 09:11 pm (UTC)
I wish that more companies would choose to do the moral & compassionate over the profitable and expedient...
[User Picture]
Date:December 17th, 2008 11:09 pm (UTC)
Fucking awesome. The people who did the cost analysis that prompted them to almost-switch should send it to Anthem with a letter to show them how much money their policies have just lost them. And copy the media. :D
[User Picture]
Date:December 17th, 2008 11:12 pm (UTC)
Er, wait. Perhaps I should have reviewed the details of this story before commenting. Durr.
[User Picture]
Date:December 18th, 2008 04:31 am (UTC)
That's great news amid the black cloud of what he must be going through. Give him my best, and *hugs* to you.
[User Picture]
Date:December 18th, 2008 08:42 pm (UTC)
A real-life saga with a heartwarming ending. We need more like this. WE NEED SOCIALIZED HEALTHCARE YESTERDAY, DAMMIT.

This was indeed a terrific Xmas present.

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