Chris and I are among the new Blue Shield of Californa victims, some of whom have seen their premiums increase by 59% in the last 3 months. Our premiums have gone from $540 to $860 in 3 months. Correct me, math whizzes, but I believe that’s an increase of more than 30%. Way to go, Blue Shield. Way to go, government health insurance reform!
So on Saturday, I received a letter from Blue Shield of California, terminating my coverage for “non-payment of dues/premiums.” I was wondering what the hell they were talking about–I paid $900 on Oct. 29th for the month of November, which was partly making up for October’s payment since we added a baby to our plan, and $585 for the month of December. I had just spoken at length with a Blue Shield of California representative on Thursday about some claims and another issue I had with Blue Shield (they weren’t applying any of my son’s pediatrician visits to our annual deductible because they were claiming he wasn’t “covered” in October and I wanted to know why I paid the additional premium for him in November if he wasn’t “covered”). This representative had said nothing about my coverage being terminated. So what was going on?
I called today and after literally 30 minutes on the phone, the representative was finally able to figure out that I owed an additional $10.96 cents on my November dues.
So Blue Shield of California TERMINATED my plan because of a measly $10.96.
Unbelievable. And totally, completely absurd. Come on, Blue Shield of California. REALLY? You really would terminate somebody’s health coverage because, in the confusion of adding a baby to my plan, I wasn’t exactly sure how much I owed and I accidentally failed to pay ten dollars and ninety-six cents? Have you no SHAME?
Yes, I paid the eleven bucks over the phone and the representative reinstated me and my family. I did it but resentfully. I often feel like we would be better off putting that money in a savings account rather than forking it over to health insurance company for a plan that covers nothing until we’ve paid $3500/per person or $7000 for a family annually. If you add up our monthly premium and the annual deductible, we basically must pay $14,000 before health insurance makes a difference. That’s a lot of money every year. Of course, it’s not a lot of money if you have cancer or some other catastrophic illness and your bills suddenly total hundreds of thousands of dollars. And that’s why I sucked it up and paid the $10.96 instead of demanding my November $900 and my December $585 payments back and saying, “See you later.”
The truth is, any other health insurance company is no different. And the other truth is, my parents, self-employed, also deal with private health insurance and they’ve been around the block with just about every insurance company you can possibly name. They’ve said Blue Shield has treated them better than most.
Okay. Fine. But Blue Cross/Blue Shield of California’s complaints department is still going to hear from me.
Yesterday as I walked to my doctor’s appointment, some random dude leaned out of his car and screeched something at me that I couldn’t understand.
But I definitely understood his final epithet: “BITCH!!!”
His scream startled me so badly, I jumped and tensed, the pain from a day of hunching over my computer shooting through my shoulder blades and one sudden, hot tear smarting my right eye.
It’s a small thing, really, that some stranger would get their rocks off calling you a bitch as they fly by in their small white car, insulated from any real retaliation, probably horsing it up with their buddies, not really meaning it in a personal way. For that guy, I’m a bitch for reasons that have no real bearing on who I am. Maybe, to him, I’m a bitch because I’m a woman, or because I was walking down Portola Avenue at 4:15 in the afternoon, or because I was wearing jeans and a sweater, or because I have long brown hair that reminds him of his ex-girlfriend.
And while I know that, like gays with the word “queer,” some feminists have reclaimed the word “BITCH” as part of their self-description, I also know that when someone hurls it at you as an invective, it’s a violation. A small one, but a violation nonetheless. You can reclaim terms for personal use, but you can’t dictate how others use those terms.
It got me thinking about other times I’ve experienced small, but important, violations with complete strangers. One of those moments came to mind right away and it’s amazing how much it smarted to remember it several years later. Unlike the stranger calling me “bitch,” this one seemed more personal, even though I had never met the woman who violated me.
I was a graduate student at Stanford at the time, and I had recently come to the conclusion that I no longer wanted to use the Mirena IUD as my form of birth control. The conclusion had come pretty quickly after it was inserted, for a variety of reasons. 1) The way my uterus cramped and bled for two days after it was inserted convinced me that it’s not a good idea to have a foreign object camping out and having a party in your uterus. 2) I suddenly started having skin problems that hadn’t bothered me for years, skin problems that started occurring within two days of the insertion. 3) While I’m pro-keeping-abortion-legal due to some complicated reasons that don’t belong in this post, I am not pro-abortion, and the realization that the IUD is, essentially, an abortifacient was keeping me awake at nights. 4) My sister-in-law, who had never had a miscarriage in her life and had already had two healthy children, suffered 3 miscarriages after using the Mirena IUD for only a few months. Coincidence? Perhaps. Worth the risk to my personal health? Absolutely not.
Anyway, the point was, I wanted the IUD out. And I wanted it out now.
So I went to my friendly Student Health Center on the Stanford campus, Vaden Health Clinic, where I know many of the staff by name (and they recognize me by sight as well) because I spent so much time going there after that truck hit me while I was crossing a street in downtown El Paso. They were all very good to me and I love them very much.
My nurse practitioner at Vaden, Carolyn, is a wonderful, kindly, caring woman, in her fifties I think, who teaches yoga on the side. She reminds me of one of my sisters-in-law who is a medical doctor. She takes her time with her patients and always listened to what I had to say and, the next visit, would remember it. I felt well cared for her in her hands.
I dressed in that little flimsy cotton gown that opens in the back (or the front, if you put it on wrong, as I have on occasion) and she did my pap smear and we chatted about this and that, joking about how I was getting wrinkles and acne at the same time, which somehow seemed really wrong and unfair to me. She needed help to remove the Mirena IUD, so she left the room to fetch another nurse.
The other nurse came marching in to the room, Carolyn on her heels. “Now, exactly why do you want to remove the Mirena?” she asked, her voice busy and important.
“Well, I’ve been having some skin problems ever since it was inserted and I’m not convinced it’s entirely healthy for the body,” I said vaguely.
She peered at my face, one of her hands on her hip. “Your skin problems don’t look bad to me,” she announced.
“Well, they’re bad for me,” I said. “For what I’m used to.”
“Well,” she said, “a lot of women in their thirties start having skin problems.”
“Okay,” I said.
“You might regret having the Mirena taken out,” she said.
Carolyn interrupted. “Jessica and her husband are talking about starting a family,” she said.
“But you’re going to Africa next week,” the nurse said. Everything she said came out forceful, almost like an accusation.
“Yes,” I said, wondering what her point was. I was, in fact, leaving for South Africa a few days later.
“You don’t want to get pregnant when there’s a chance you could get malaria,” she said.
“There isn’t any malaria in South Africa,” I said, beginning to feel frustrated and defensive about wanting to remove the Mirena IUD, “at least, not the areas I’m going to. And my husband won’t even be with me while I’m gone.”
“Still, that’s a risk you don’t want to take,” she said, the little wagging finger in her voice. “It would be very very bad for your baby if you got malaria.” She stared at me, strongly concerned, and waited for me to agree with her.
“I’m not in danger of contracting malaria,” I repeated. “And, anyway, I’m not in danger of getting pregnant while I’m there either because my husband won’t be with me.”
Did she think I was a floozy and would be getting it on with a bunch of strangers while I was overseas?
“It’s not a good idea to remove it right now,” she said.
I don’t even remember what else she said, I just remember that I was holding my tears back as she talked me out of removing an IUD that I no longer wanted inside me just in case it was fucking up my reproductive system.
And Carolyn pressed forward and said to me, looking me directly in the eyes, “If you want the IUD taken out, we will take it out, right now.”
She was trying to repair the damage that the other nurse was creating. She was, subtly and kindly, reminding me that this was my body and my choice.
This was precisely why I always chose Carolyn as my primary health provider. And I was glad in that instant—and ever since then—that I had never before or since encountered that other nurse in my many trips to the health clinic.
Nevertheless, as I write this, my throat aches with unshed tears. Why? Because despite Carolyn’s reminder that this was my body, the pressure from the other nurse—a perfect stranger, but one who had some power over me—was so great that I backed down and decided against removing the Mirena that day.
Later, it made me angry. Later, I wished I’d made a scene and told that nurse to shove off. Later, I wish I’d asked her, “Why do you have such a personal investment in preventing me from getting pregnant right now? What fucking business is it of yours?”
Later. Later. Later.
But at the time, I let myself be violated.
A small violation? Sure, small, though it won’t seem so small in ten years when a group of women come together in a class-action suit against the makers of IUDs because of some health problem that’s occurred—like they’re doing with Yaz and Yasmine right now.
A small violation? Sure, small. I went to another doctor a few months later and, two seconds later, it was out. “Do you want to see it?” he asked, and I said, “Yes,” and the reason I said yes was borne out of that encounter with that nurse, with the sudden fearful stabbing thought that a doctor could say he’d removed something like an IUD from your uterus but, in fact, leave it in. That’s a paranoid thought, I know, but not so paranoid after my encounter with that nurse who really really really wanted me to leave mine in, wanted it so badly that she applied considerable pressure and used manipulation, even to go so far as to suggest that I’d be putting my as-yet-unconceived-child in danger if I didn’t leave the IUD in. And not so paranoid when you consider all the violations of human rights that have occurred in the medical profession since the profession was created.
I love doctors and nurses, I do, and this is not an invective against them, though it does point out the ways they have power over their patients in ways both large and small, and the very fact of that power makes violations so easy to occur. The jerk that yelled “bitch” at me as he passed didn’t have any power over me because there was no relationship but he managed to violate me anyway.
The only thing that connects these small violations is the fact that both of the people who initiated them were perfect strangers. I’ll never see either one of them again. And I suspect that the other thing that connects them is that I’m a woman. I’m not saying that perfect strangers don’t try to do these kinds of things to men, but I suspect they occur less frequently, and that most men respond differently (both at the time and after the fact) because they’ve been socialized differently. I could be wrong. I’m curious to hear from men about it.
Why do perfect strangers have such an investment in us that they would behave in these ways? And how should we deal with these kinds of small violations, when they happen so often?
I don’t really know how to end this blog post except to invite you to give your thoughts.
Well, color me pink or something like that. I just got a phone call from a Blue Shield of California representative because somebody apparently monitors the blogosphere, came across my blog posting, and wanted to make sure my questions were thoroughly answered. I even got a phone number that I can call if I have further questions.
That was totally unexpected and, well, I guess it did what it’s supposed to do. Makes me feel a little more loved and warm and tingly or something. So. Good customer service but…I still think everything I thought in the last posting. It doesn’t change anything about the power imbalance, the fact that the system is rigged, or anything else.
But I know health insurance is necessary the way the medical system operates these days. I posted my earlier comment on Facebook and got a number of comments from disgruntled people. A parent told me how it took 15 months to get Cigna to cover a new wheelchair for his severely disabled son. A mother told me how much her daughter owes the hospital ($15,000) for a minor thing–a gallstone–and that’s after the health insurance paid their part. Another person said that he had cancer and one test alone, a diagnostic test using dye, cost $115,000. He cautioned me not to go off health insurance. But, he added, many Americans are stuck in low-paying jobs simply because they’re afraid to lose their health insurance benefits. I know how true that is. For a long time, I wondered if I could leave grad school at Stanford–simply because of the health insurance. And then I realized there was no point in being miserable simply because I had good health insurance.
Anyway, regardless, before the phone call, I did decide to stick it out with Blue Shield. I cancelled the application with Mega Life last Friday, and over the weekend, talked with at least three self-employed people who have all felt reasonably satisfied with Blue Shield (or one of its variations, such as my parents, in Texas). My parents were able to compare their Blue Cross/Blue Shield coverage with coverage they’ve had from just about every other plan out there, and my dad’s take on it was essentially, “Yeah, the premiums are a little higher but it’s a better policy than most of the others. They haven’t raised the premiums on us the way otherl companies have.” My dad gets frustrated with policies that start out low and, within three years, have doubled or tripled the monthly premiums you have to pay.
The cautionary satisfaction with Blue Shield is about as good as it gets. So I’m sticking with it and hoping that, when or if the time comes, they end up coming through for us. But I’m not forgetting the point my little brother made yesterday when we talked about it: “Health insurance companies are out to make money. That profit motive is incompatible with paying for your medical costs.”
Yup.




