Limpets and Octopods, Civilization, Health Insurance, and the Loss of Common Sense

This is a tale of how a singular event can lead to two simultaneous outcomes, one absurd and one enlightening. Recently, I’ve needed to have a medical procedure to keep my body functioning. The first procedure over two years ago worked great till last fall. In December, I needed to have this procedure again.

The enlightening part: Kevin was nice enough to send a copy of the Civilization and the Limpet by Martin Wells. Although aware of Well’s research, I was wholly unaware of this book. I triumphantly finished it yesterday and am admittedly impressed. The book is unabashedly Mollusc as Well’s research is largely on Cephalopods. Much of the book also centers on physiology again because of Well’s background. Each chapter is a stand alone narrative utilizing Well’s experience to discuss adaptations in marine organisms and instill passion for the ocean. The book geared for the public possess nuggets of wisdom even for well-read experts. One of my favorite chapters discusses the rise and fall of cephalopod rule of the oceans. Additional favorite passage is

Neither biological research nor college administration pays very handsomely, but when you come down to it, it is very marvelous thing that the world is prepared to pay at all for the like of us to spend so much of our lives in the study of anything so inherently interesting and outright beautiful as animals. In the bad times, I try to reflect on that. And there are bad times, just as in any other creative activity. Research is like painting pictures. The product hardly ever turns out quite as well as one might have hoped; it can be maddeningly frustrating; and one spends a lot of time simply cleaning up the equipment. But once in a long while everything goes really well, and this euphoric. And even in the bad time one is adding something, however slight, to the sum of human knowledge. Some poor people work just as hard and all they make is money.

Definitely a recommended read.

The absurd part:

I received a bill from the doctor who performed the procedure. Apparently, my insurance did not cover the full doctor’s cost, bewildering since the exact same procedure was covered in total by the same insurance company not more than two years ago. Note both procedures were pre-approved by said insurance company. One difference was the doctor who performed the procedure. One minute before the doctor entered the room…two minutes before the procedure was done…five minutes after I was given a cocktail of pain relievers, muscle relaxants and happy drugs…I was told by the nurse the doctor who performed the procedure last time would not be performing this one. Enter “new doctor” with no bedside manner and even worse technique. Jump to the future and last week I call my insurance to find out why they did not cover the full cost. The “helpful” insurance rep informs me that “new doctor” is not within my network. I explain that I did not know that “new doctor” was to perform the surgery until a minute before the surgery and that in my happy drug state I wasn’t thinking to ask “new doctor” if he was networked. My wife suggests that doctors need to wear patches with insurance logos so you know which networks they belong to. Kind of like stores with those stickers on the windows letting you know what credit cards they take. I guess I just need to ask everyone if they are in my “network”. “Excuse me sir, I noticed you mopping the floors of this hospital and I need to ask if you are in my network.”

The “helpful” rep states I can file a appeal. I will need a cover letter and (now brace yourself because it is about to get really retarded) a copy of my benefits. I thought I heard wrong so I asked “Did you say a copy of my benefits?”. “Helpful” rep replies yes. “So I need to send in a copy of my insurance benefits to the insurance company that gives me those benefits.” Rep notes that I can go to the insurance company’s website and download them if I need to. “So I can go to your website, print out my benefits, and send them to you?” The “helpful” rep never seemed to get it.

7 Replies to “Limpets and Octopods, Civilization, Health Insurance, and the Loss of Common Sense”

  1. LMAO, I can’t believe the insurance rep. The irony of it all… Thats pretty shitty though craig. I fail to see how this is your fault for the last minute change up. I foresee you winning this one, but its such a pain to have to go through all this just to get the medical care you need and pre-paid for!

    Excellent passage you quoted, btw. I’m glad you liked the book. I figured it was up your alley.

  2. Oh dear. Those circular conversations with some people that make me swear I have no need of recreational drugs..been there.

    I hope you have a speedy recovery and a fast resolution to insurance silliness.

  3. Sometimes I really wonder whether those companies do such things in the hope (an actual business plan?) that their customers simply don’t follow up and end up paying the full cost — they are, after all, trying to make a profit. Regardless, my condolences with your coverage troubles, and best wishes on your recovery.

  4. Craig – that’s truly awful. Unfortunately though not unusual. My wife’s a physician and complains constantly about the absurdity of insurance companies. Actual medicine these days is really secondary to the insurance companies bottom line.

    Your interaction with “helpful” rep must have been mind-numbingly frustrating. But it’s really funny. Thanks for sharing. I once had a similar encounter trying to activate a new bank card. To prove I was the card holder I was told I needed to list some recent purchases on the card. It was a new card. There were no purchases. “I’m sorry sir, I am unable to activate your card at this time”. Like I said, mind-numbing.

    Hope the procedure went well and that it won’t interfere with out plans to take over an oil rig.

  5. We had to defend each and every medical cost for kidney surgery on our one year old daughter, even the ones that saved the insurance companies money.

    I agree with Dave they want to see if you’re willing to fight for your benefits. The sad thing is, you don’t get reimbursed for all the time you spend haggling with these people, and faxing them their own paperwork. Aside from being frustrating, it’s very time consuming.

    Hope you’re feeling better, Craig.

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