Thursday, June 16, 2022

Over-prosecuting the Poor & Disabled

 Handicapped guy 'actively' ADA'ing his RV...

...is told by the City of Muenster that the RV is a "Junked Vehicle" and will soon be towed and crushed, and I'll be charged $500 a day for the violation!
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Backstory: After 25 years in a wheelchair, I could not lift myself and my chair in and out of my Z28, so I decided that it was time to graduate to a vehicle with a lift or ramp. The other problem I have is increasingly less bladder control. This world simply does not guarantee me a bathroom I can fit into, so I decided that an RV with a bathroom and shower made the most sense. This way I'd always have a bathroom and if not, a shower, and change of clothes.  

I found a 1979 Class C with only 67,000 miles and no visible exterior damage. The owner said "it has a little water damage behind the passenger seat. All I would need to do is remove the carpet, cut out the bad spot, and replace part of the plywood. So, I bought "Peaches"...

I took all of my money and invested in the engine, brakes, and transmission. I saved a few hundred for minimal materials.

After spending close to $5,000 on repairs, new fuel tanks, wires, and hoses, she purrs like a kitten. Before bringing her back to my trailer house, I phoned the park manager and the city manager, to make sure my planned activities would not break any rules or codes. At this time, I had no idea how bad the water damage really was and I received the okay to begin my work.

I drove "Peaches" home and began demolition only to find Titanic water damage. EVERY board along every seam was rotten, from the front to the back... My project that was going to take a few months, turned into two years, as COVID price hikes slowed my progress. One piece of Red Cedar (chosen for water and bug resistance) is almost $100! While I am very paralyzed, I can still do some work, and every day I'm either buying materials and equipment, or installing it, but $937 a month does not go far.

Medicaid covers necessary patient lifts, so long as your Doctor signs off. However, under managed care, my medically necessary lift was determined to actually be a convenience elevator, which isn't covered. So, I found a used one for $1250, AND the Knights of Columbus even donated $500 to help me buy it, but I still owe $250. Even if I had the lift, I still need another $200 in wood, so I have something to mount it to.  

Meanwhile ONE neighbor thinks I should be STOPPED and that I should NOT be allowed to continue to build...
Here's my question, "How is this not an inspirational story?"

Hey, look at that quadriplegic, he's not sitting there doing nothing with his life, watching TV...he is building his dream, with his own hands!!!

How do we live in a country where that is illegal??

Dumbfounded by Recent Events,

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*That guy clearly needs help accomplishing his dream, in a reasonable amount of time...Let's HELP him...NOPE, CRUSH IT, ...and his dreams, Oh, AND charge him $500 a day...??? Really?

Thursday, May 19, 2022

How to Steal from the Poor and Disabled

United Healthcare Corporation does NOT provide services, they process your request, which is a denial.

Managed care means less care.  

I have been disabled since 1994, when a drunk driver ended my basketball career, and left me in a wheelchair, labeled a quadriplegic.  After my parents' insurance made private insurance unaffordable, at the age of 21, I had no choice but to apply for Medicaid.

Then, on my Blue Cross Blue Shield plan I received Doctor visits, three prescriptions a month, and either eye care or dental care, whichever I needed.  About 8 years ago my father was diagnosed with cancer and applied for his disability support services.  Once he received them, this changed my status.  Instead of being a disabled person myself, I was re-catagorized as the survivor of a disabled person, with a different benefits package, and now qualified for Medicare...which only pays 80%.  So I magically became more capable, and less in need of benefits, because my dad got cancer!?  

Now, each year I must re-qualify for benefits, and have my means tested.  If I make more than $5k annually, I am no longer qualified for benefits.  This same year saw the expansion of managed care services.  Private companies began subcontracting out health care services from both Medicare and Medicaid.

Companies Like United Healthcare are paid billions of dollars by Federal and State governments, to 'process medical requests.'  I am not allowed to seek gainful employment, and make more than that $5k a year, or I lose my benefits permanently.  Meanwhile, a lift to access my vehicle costs $6900, this same lift United Healthcare denied as a medical equipment request, because they ignored my Doctor's notes about it being medically necessary.  Instead, they categorized it as a convenience elevator, which is not covered.  

My wheelchair is now 6 years old, and currently held together with a zip tie.  I was due a new one at 5 years, and United Healthcare has not only failed to pay for it, but they did not pay for the physical therapy services, to fit me for the chair, and a bill for $30 was sent to collections.  So I took a financial ding, because United Healthcare failed to pay a $30 bill!

This company also moved my local hospital and doctor out of my coverage area, then said they would give me a ride, but no such ride services actually exist.  They merely process ride requests, and when a ride cannot be found, you just don't make it to your appointment.  I have missed three appointments, two last week, and have been asked to use ride services that injured me, by not providing a lift or a needed ramp.

The latest most blatant form of "Theft, Fraud and Abuse" is the subcontracted use of Solutran, to deliver an over the counter benefits card, and a $65 monthly allowance.  I was due one and these funds since last December.  I have received other benefits cards from United Healthcare, but they were only for a mere $15.  The brilliance of this program is that neither Solutran nor United Healthcare sent notice of this benefit, and the benefits 'expire' each month...rather than roll over.   I would argue that Solutran never sent the card, so that they could just keep $65 each month, and are doing so right now, to the tune of $6.5 million a month from their half a million members/subscribers, in Texas alone, by simply not telling ANYONE these benefits actually exist!

Today the United Healthcare Corporation has over $300 BILLION in holdings...

Go into business to steal from the poor and disabled, by simply NOT doing anything...and you too can become a billionaire! 

*There are no Legal Services available for poor disabled people being stolen from.  No Legal Aid, no Erin Brockovich...

We are failing to hold corruption to account.

Wednesday, February 16, 2022

Non-Profit Medical Insurance

 "Death panels are bad."

Be they employed by private insurance companies, Medicare, or Medicaid - all seek to deny care, medicine, and medical equipment in the name of protecting services to all.  

Private Insurance companies have infiltrated Medicare and Medicaid under the guises of companies like Humana, Health Springs, Amerigroup, United, Aetna, and new 'providers' join every day.  Their 'job' is to send me a "THIS IS NOT A BILL" statement every month, printed in three colors in an envelope also printed in three colors, informing me as to what they paid for my care.  Every nine to eighteen months, this provider care group 'changes' its coverage area.  When this happens, my Doctors, Hospitals, and Specialists all change, to further away.  It takes several months for my Doctors and Facilities to re-align themselves so that I can return to people I know and trust.  

As for my own care, I have a Bachelor's degree, and I'm one paper away from completing my Master's, but I am not 'allowed' to make more than $5k a year, or I lose my medical benefits, forever.  Yet, I was just denied a lift for my vehicle, so that I can get into and out of it without further injuring myself.  A new lift is $6k...so I am in every way prevented or denied ANY "pursuit of happiness."  Our system is broken, in that it in no way functions to protect health, or provide accessible services.

The solution lies in the utilization of Non-Profit or 501c3 organizations to perform the duties of a medical insurance plan, because is free from the need to advertise, litigate, pay employees, or make a profit.  ALL of those resources can be funneled into actual care, therapy, pre-screening, meaning zero claim denials!

The group or organization need only be +35k or larger to prevent a catastrophic loss, or about the size of the average Texas County.  For the first year, the applicant pays the average premium leveraged by the private market upon that individual's demographic.  Given this figure include care and advertising, profit, and employee payment, it will easily create a cash pool large enough to provide complete care.  Moreover, any monies a Non-Profit spends on services can be itemized as a deduction when IRS filings occur.  After the introductory subscription of one year, the applicant becomes a full member, owing only an equal share of all of the medical services paid for the previous month.  There is simply no need for, for-profit insurance companies to exist, if communities would realize the strength in their numbers.

Now, what good does it do, to give your countrymen the tools to fix what ails them, if they do not see each other as brothers, sisters, cousins, and neighbors...?

The state of our nation is divided, and until we stop calling other Americans the enemy, solutions like this one can never happen.