The Personal Becoming the Political

On October 27th of this year, I was struck with Bell's Palsy.

This isn't normally a big deal.  People get it.  They look ugly for a while and have some other deficits.  In my case, these included being unable to close my left eye, loss of my full swallow reflex, loss of taste and smell, and a sensitivity to loud noises including voices in a certain pitch range in my left ear.

I saw a neurologist. I saw an ophthalmologist.  I had a whole series of blood work and tests done.  I severely cut back on my smoking and drinking, and brought my diet back to a very healthy state.  I became more proactive about stress reduction and I got the sleep my body required of me.  I waited to do the exercises that would help until I saw a Physical Therapist because that was what was recommended.  I even left my house wearing an eye-patch, because even though it looked ridiculous, I didn't want to have any complications and I wanted to give me the best shot for an one hundred percent recovery.

The only thing that is attractive about my physically is my slightly off-center and goofy grin.  That's all I have going for me.

I started PT yesterday and was slated for eight more visits over the next three and a half weeks. 

Now, I only have three visits left.

Why?

Because my insurance company believes they understand my situation better than the physical therapist who I saw AND better than the neurologist who I have seen a number of times.

Because my ability to eat "really" is not impaired, they are not going to cover any more than three additional visits.

Not because the PT recognized that I was developing TMJ (which means a whole lot more in coverable expenses) and not because everyone (personally, professionally, medically, and psychiatricly) understands that this paralysis of my face is exacerbating my already considerable self-esteem issues.

I can always appeal (which I will) however, does it not strike you absurd that this organization can without informing the patient deny coverage for something that was recommended by their personal medical professional?  Did they speak to me regarding this?  No.  Did they speak to my neurologist regarding this?  No.  The called the PT to inform her that I was only getting three more visits, not to discuss with her, to inform her.

Up to this point, I was fairly neutral when it came to the health care wars, but now, I am for any plan, by any one, that eliminates (and hopefully punishes the executives of) the insurance industry from American health care, with the ulitmate goal being to eliminate the insurance industry from American life.

What helped cause the current trainwreck of the world economy?  The insurance industry. (Look at what AIG did)

Just sayin'...is all...

I am angry now.  I am saddened too.  I know how much my company and I pay for my insurance.  I have a fairly good idea of the payments that they make to my medical providers (because I ask) and I know how much I have used medical services in the five years I have been with this plan.

Based on my math, which is more than fairly accuarte, my company and I have paid roughly $15,000.00 more in payments than I have received in services.  Does this seem fair?  Does this seem right?