pol 

Benefits rep for the parent company called me this morning to say "we're doing everything we can."

I asked if they were contracting a second insurance provider so we'd at least have a market from which to choose, or if they were lobbying for single-payer at the corporate level.

He said no.

I said, "then you're not doing everything you can. I expect better."

The conversation didn't really go anywhere after that, but it took him forty-five minutes to recognize that.

pol 

To be sure, at one point he did fully admit that our corporate benefits package sucks and he hates having his hands tied, and it was good to hear that acknowledgement, but learned helplessness doesn't move the needle. He did say by the end that he would ask about how long my spouse would have to be without treatment before they could apply for TNS as a "new depressive episode," and that might work. And he did say he'd tell me how to manage an external review. But none of that _fixes_ this.

pol 

THIS is why we need unions.
THIS is why we need collective action.
THIS is why we need solidarity.
THIS.
The benefits rep on the phone said flat-out he's having to tell a patient with breast cancer that she's exceeded her limits, and he "felt terrible" for having to do it. I about screamed on the bus, "your feelings won't pay for her cancer treatment."

pol 

He told me that he felt that every action the company took was to support as many employees as they could. I asked him how I was supposed to feel about the company if the actions they took to cover as many as possible left me in the cold and their answer to being confronted with that fact was "oops, sorry." He said he hoped I didn't feel like the company didn't care about me because of this. I said, "that's exactly how I feel, increasingly every time I talk about it."

pol 

Never assume your employer will have your back.
Never assume your employer will see you as a person.
Never assume your employer will reciprocate the time, the effort, or the mindpower you give them.
Never assume your employer will see you as anything other than a potentially fungible resource that will have to be replaced one day.
Build your care networks away from capitalism and its evils.
Find what comfort and solace you can in those who will see you as a person, not as food for Moloch.

pol 

@literorrery I don't know how I managed to miss this thread, but I'm caught up now.

*sends soft and gentle hugs* I'm so sorry you have to deal with this shit.

If anyone can change policy over these sorts of situations, you can.

Oh, fun question: Are they self-insured? Most companies offering heath insurance are. That means it's not Anthem making these decisions, it's the company board. Anthem's job for a self-insured company is to enforce the decisions of the company board.

pol 

@mawr I don't know. It's worth asking when next they contact me.

pol 

@literorrery It'd be worth knowing.

If they are self-insured, know that they literally set it up that way on purpose. The insurance provider is contractually unable to make exceptions without board approval and the board is intentionally unreachable by employees and gets to decide whether or not to even hear your case if the insurance provider even bothers to bring it to them.

I've yet to find a company in which anyone short of VP/Pres/CEO has the authority to force an exception through.

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