Something that I never really understood, in all my years of working in health care, is the patients with serious illnesses that couldn’t stop talking about how lucky they were. Couldn’t wrap my head around it. How can people consider themselves “lucky” when they also have advanced heart failure, or some kind of progressive neurological disease? Or cancer. Someone who was really lucky wouldn’t be sick in the first place, right?
What I think I am beginning to understand is that I’ve been looking at it from the wrong perspective. This is not “lucky” in the sense of “I just won the lottery” this is “lucky” in the sense of “the building I was in exploded and collapsed around me but I didn’t die”.
So with that out of the way, I am exceptionally lucky. This whole thing could be so much worse.
I have a support system of friends and family without which my current situation would have gone from difficult and unpleasant to catastrophic. The material and mental support I have received has made it possible to navigate this whole thing with at least some sense, somewhere in the back of my mind, that things were going to be okay eventually. The loudest part of my brain is still saying that things are terrible now and the whole thing is so unmanageable that things are going to be terrible forever, but the actually smart part of my brain knows that even though I have fallen out of an airplane, I have a parachute. Lucky.
On the other end of the spectrum is the American health care system and everything surrounding it.
I have been missing a lot of work. Like I think I’ve probably only worked maybe 5 or 6 days in the last several weeks. When this whole thing started I tried to get a medical leave from work. The Family and Medical Leave Act of 1993 (FMLA) requires employers to provide employees with job-protected and unpaid leave for qualified medical and family reasons. It also set up a federal system for managing leave granted under the law but said that employers could set up their own system as long as it was substantially similar to the federal program and provided substantially similar benefits. I knew going in that, one way or another, I should be able to get some kind of approved leave.
I feel like I should say, at this point, that I am not an expert at navigating the consumer side of health care. Far from it. There are almost certainly easier and better ways to attempt what I have been attempting but they certainly aren’t obvious.
Anyway, so I contact my primary care doctor, human resources at work and the third-party company that manages medical leave and related things for my employer. Got paperwork rolling and things were looking okay. Then I find out that I don’t qualify for medical leave through my employer because I haven’t worked there long enough. I can’t remember what the requirement was exactly but I wasn’t even close. Fine, if I can’t get this through my employer I’ll just dive into the state and federal systems. Except I don’t qualify for those either because my employer has their own system set up and I have to go through that.
So I gave up on the idea of medical leave and some time passed. As it became more and more apparent that I was not going to be working full time through this I started looking in to the short term disability insurance that I pay for as part of my health benefits at work. This seems, on the face of it, to be a perfect fit for short term disability. I am, to a greater or lesser extent, kind of disabled right now but, because I am very lucky (see above), it should be pretty short term. Great, lets get this going.
Step One: You must be on approved medical leave to access your short term disability benefits.
Well shit.
So there it is, the Greatest Health Care System In the World™ – pay a lot, get a little.
Edited to add; This is how dumb I am – The whole time I was dealing with this whole question of leave and benefits and insurance I was thinking that what I really needed was a social worker. Many astute readers will immediately pick up on the fact that I know a social worker, and a really good social worker at that.
I still think it is extremely unlikely that I will be able to get any kind of coverage for the time I missed but at least I have a couple new leads to follow.
About ten years ago, my brother, racked with unrelenting pain from a catastrophic motorcycle accident (complete with attendant catastrophic opiate addiction in lieu of comprehensive pain management) and stuck in a job where his boss wouldn’t so much as allow him to sit on a stool for his 8-hour shift in front of a computer terminal, faced a very black-and-white choice: find some way to stop working and survive, or stop surviving. He and our Dad came to an agreement where David could move back to Hawaii to live in our family’s large-but-run-down ancestral home. But that wasn’t going to be enough. Dave needed to jump onboard Hawaii’s fairly decent Medicaid system, a process that normally takes years to wade through the interminable paperwork. Starting as a non-resident, the prospects were even worse. We racked our brains trying to find the solution, until someone thought to ask my father: since he was until recently a professor in the field of Public Health at the University of Hawaii of many decades’ standing—in fact going so far as to pretty much *build* the University’s School of Public Health from the ground up—might he not have many, many, MANY contacts in the state healthcare system? A plurality of whom might actually have been students of his? Why yes, as it turns out; something like 30% of the management structure in the State’s entire healthcare system turned out to have passed through his classroom at one time or another. He did some nosing around, found the appropriate contact, and after catching up with her many adventures since graduating, she got David fast-tracked into the system in a matter of a couple of months. So don’t feel particularly dumb about this oversight; apparently it’s more common than one would think. 😛