My Awakening : My First Serious Look At America's Healthcare System 我在美國沒有健保的困局
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Yesterday, I discovered that I had officially joined the tens of millions of Americans who don't have health insurance, since 1/1/21018! I never imagined in a million years I could be one of the uninsured Americans. Now I'm one, I finally realize why healthcare is such a debated issue in this country. Having been an employee for many years, I used to have no idea what people were talking about when they talked about uninsured Americans. I had never lived one day in the USA without health insurance. When I was in college as a foreign student, I was covered by my university's group plan that had very affordable premiums. After I left the academic world, I was provided with health insurance by my employer. During the probation period at my first professional job, I was covered still by my university's group plan, which I only used for one doctor's visit due to a strap throat. Yes, there were the changes of jobs, and employers, but I was able to buy short-term private health insurance on my own, very easily, very quickly. It was easy like buying a book from Amazon.com. Those were the good old days.
Yesterday, I discovered that I had officially joined the tens of millions of Americans who don't have health insurance, since 1/1/21018! I never imagined in a million years I could be one of the uninsured Americans. Now I'm one, I finally realize why healthcare is such a debated issue in this country. Having been an employee for many years, I used to have no idea what people were talking about when they talked about uninsured Americans. I had never lived one day in the USA without health insurance. When I was in college as a foreign student, I was covered by my university's group plan that had very affordable premiums. After I left the academic world, I was provided with health insurance by my employer. During the probation period at my first professional job, I was covered still by my university's group plan, which I only used for one doctor's visit due to a strap throat. Yes, there were the changes of jobs, and employers, but I was able to buy short-term private health insurance on my own, very easily, very quickly. It was easy like buying a book from Amazon.com. Those were the good old days.
As the healthy perpetual employee who was always covered by my employers, I was oblivious to the plight of the imploding healthcare crisis in America. I only had my first hunch about it when auditing the employee benefits expenses in my corporate clients. I was shocked to see how much my clients were paying for healthcare insurance for the employees. The cost of health coverage for the older supervisors, managers and executives of my clients were even more jaw dropping. Even the doctors and nurses who worked for one of my healthcare provider clients cost a lot to insure as they grew out of their 30s and 40s. So for many years, I never dared to quit my job regardless of the very long hours and the lack of "work-life balance". Until one day I discovered, Cigna appeared to have some low cost plans for individuals at the low $300 per month. The plan had high deductible, carried very lousy drug coverage and had fewer doctors participation (just based on my knowledge that some of my physician friends refused to contract with the plan.) But I don't mind since I've been lucky to be healthy enough that I rarely saw a doctor. I don't even have a primary care doctor because I don't have any illness other than the colds that I got from my fellow colleagues who coughed on me when we were confined in our clients' conference rooms to get that 10-K filed with the SEC. I happily enrolled myself to become self-employed, when I saw such an affordable health plan offered by Cigna. Affordability is relative to the individual. To me, it was more affordable to pay a few hundred bucks per month to have some sort of coverage for the big unexpected sickness, than to risk my savings on the extremely high medical cost in the USA.
Since I setup auto pay and my monthly premium always went through to Cigna, I've always assumed everything was fine. I don't see a doctor much, except for using the free annual checkup so I never experienced billing issues. I wouldn't have found out that I lost my coverage with Cigna if I didn't try to get a new insurance card issued for 2018 before my upcoming trip to Macau. I just want to have a valid health insurance card with me, for the event when my Travel insurance needs to repatriate me back here to the USA for treatment if I accidentally falls ill in Macau, or if I get into an accident that requires medical attention back here in the USA. No, my family and I don't trust the doctors in Macau. It's a long-held family belief. So yes, I would very much like to be repatriated to my adopted home country, the USA, if I accidentally falls ill during my visit in Macau. After I logged on to mycigna.com, I was mortified to see my coverage period remained the same as 2017, even though it's now 2018. I had experienced the same situation in January 2017, and I was told that mycigna.com wasn't integrated with the benefit administration department that issued the policy so there was always a time lag for update in the online portal. That was the first time when I realized Cigna had a problem, because that phone call in January 2017 made me realize they mailed my insurance card to my old home causing me not getting my updated insurance card in January 2017! The address problem was not caused by me. I called to update them when I moved and I received the bills alright from them afterwards. They were able to charge me fine through billing. They had no problem in reaching me for money. They got my billing address right, but somehow it also wasn't integrated with benefits administration which was responsible for managing my benefits and to communicate with me regarding my coverage. So there were two disconnects back then in 2017 January, the disconnect between the web portal from anything, and the disconnect between billing and benefit administration. I finally got my insurance card at the end of January 2017 but with lots of time consuming phone calls and frustration. Still the web portal couldn't get my address correct, regardless of those phone calls. I gave up. I had no time to fix their IT problem which sadly is quite common in corporate America. As an auditor, I think that Cigna isn't the only company in the U.S. that has problems derived from the lack of integration among their piece-meals IT infrastructure, and it's probably not the only U.S. entity that pays for expensive software that has logical flaw that somehow the huge workforce and the fat management makes it even harder to fix. Seeing such issues in my clients, (not Cigna, which was never my audit client), as an auditor, it was really about writing up the potential IT weakness in my audit workpaper. But being a victim of such an issue really agonizes me since it's inflicting direct damage on me, that is, my loss of time in trying to get my mail, and to fix the higher premiums that I was charged (automatically) based on my old address.
Fast forward now to 2018, I suddenly became suspicious of Cigna based on my unpleasant experience last year. So I called, and as I expected, the customer reps told me it could just be the company was still busy in processing the new card since it was the first few days in the new year. But I just couldn't trust those reps anymore because my experience told me that they would say anything just to get me off the phone, and to sign off their system saying issue resolved and the customer call was handled. This isn't unusual and I'd seen this early on when I did a walk-thru during my understanding of my client's business in one of my early audit engagements. So I pressed on and after being bounced to different reps, one finally told me that my plan was actually discontinued. Demanding an answer, I was told they didn't know why and again I was redirected to yet another person who finally told me that Cigna pulled out of that market in California, and yes, I wasn't able to renew with Cigna but had to move on to another insurer. As much as I never liked Cigna from the beginning, I dread the hassle of changing plan and changing insurer, particularly now that I'm literally not covered! I blame Cigna. They said they sent me a termination notice months ago. Yeah? I didn't receive any such letter in my mail, or hardly any communication from them. The only communication I got from them was the clearance of my autopay to Cigna and it was reported to me not by them, but by my bank! "Deny any mistake and just stall the customer!" is what I've observed as very common practice in corporate America. This is often not due to any particular person's fault but just the business environment, culture within the corporation that relegates certain functions to somewhere or someone whom no one within the corporation knows what it is or who it is anymore. Such functions became detached and orphaned while everybody else in the corporation were too busy to cope with the day to day business to just survive another day. When another new regulation hits, let's just snap another expensive bandage and buy another expensive software to patch us into compliance. This is the business environment that I've witnessed in the USA. It's got to a point where corporations are so busy patching compliance with the latest regulation that, it's become removed from the actual line of business they are in, or they've just gotten more out of touch from their products and services. Overtime, the corporations would derail into bankruptcy and then be wiped off the map in the USA for good, other companies that are more monopolized, will carry on profiting while letting the customers suffer without any consequences.
Okay, after all these rantings, I finally feel less angry with Cigan now, because I suddenly remember how I was lost in the blackhole of corporate intranet trying to fix my paycheck problem with my former employer, and for a very long time, not my boss, not the human resource department at my office could do a thing about it. It took me a very long time to fix it. Yes, people got screwed along the way, but that's nothing abnormal in corporate America, particularly when there is no one on the wide corporate web for you to hold accountable for. It's only getting worse and worse as management engages in more overthinking to implement more theological and cumbersome business solutions from text books to be put on their reports, instead of rolling up the sleeves to actually solve any problem relevantly. Wherever people work these days, it's all about the look of paper work and there is so much politics. My sudden loss of health coverage reminds me this sad situation and before you ask why everything here in the U.S.A cost more, this is one of the reasons why. There is just too much focus on making the smoke than cooking the edible good steak. There is simply too much politics, too much cumbersome but irrelevant paperwork, everywhere.
Since I setup auto pay and my monthly premium always went through to Cigna, I've always assumed everything was fine. I don't see a doctor much, except for using the free annual checkup so I never experienced billing issues. I wouldn't have found out that I lost my coverage with Cigna if I didn't try to get a new insurance card issued for 2018 before my upcoming trip to Macau. I just want to have a valid health insurance card with me, for the event when my Travel insurance needs to repatriate me back here to the USA for treatment if I accidentally falls ill in Macau, or if I get into an accident that requires medical attention back here in the USA. No, my family and I don't trust the doctors in Macau. It's a long-held family belief. So yes, I would very much like to be repatriated to my adopted home country, the USA, if I accidentally falls ill during my visit in Macau. After I logged on to mycigna.com, I was mortified to see my coverage period remained the same as 2017, even though it's now 2018. I had experienced the same situation in January 2017, and I was told that mycigna.com wasn't integrated with the benefit administration department that issued the policy so there was always a time lag for update in the online portal. That was the first time when I realized Cigna had a problem, because that phone call in January 2017 made me realize they mailed my insurance card to my old home causing me not getting my updated insurance card in January 2017! The address problem was not caused by me. I called to update them when I moved and I received the bills alright from them afterwards. They were able to charge me fine through billing. They had no problem in reaching me for money. They got my billing address right, but somehow it also wasn't integrated with benefits administration which was responsible for managing my benefits and to communicate with me regarding my coverage. So there were two disconnects back then in 2017 January, the disconnect between the web portal from anything, and the disconnect between billing and benefit administration. I finally got my insurance card at the end of January 2017 but with lots of time consuming phone calls and frustration. Still the web portal couldn't get my address correct, regardless of those phone calls. I gave up. I had no time to fix their IT problem which sadly is quite common in corporate America. As an auditor, I think that Cigna isn't the only company in the U.S. that has problems derived from the lack of integration among their piece-meals IT infrastructure, and it's probably not the only U.S. entity that pays for expensive software that has logical flaw that somehow the huge workforce and the fat management makes it even harder to fix. Seeing such issues in my clients, (not Cigna, which was never my audit client), as an auditor, it was really about writing up the potential IT weakness in my audit workpaper. But being a victim of such an issue really agonizes me since it's inflicting direct damage on me, that is, my loss of time in trying to get my mail, and to fix the higher premiums that I was charged (automatically) based on my old address.
Fast forward now to 2018, I suddenly became suspicious of Cigna based on my unpleasant experience last year. So I called, and as I expected, the customer reps told me it could just be the company was still busy in processing the new card since it was the first few days in the new year. But I just couldn't trust those reps anymore because my experience told me that they would say anything just to get me off the phone, and to sign off their system saying issue resolved and the customer call was handled. This isn't unusual and I'd seen this early on when I did a walk-thru during my understanding of my client's business in one of my early audit engagements. So I pressed on and after being bounced to different reps, one finally told me that my plan was actually discontinued. Demanding an answer, I was told they didn't know why and again I was redirected to yet another person who finally told me that Cigna pulled out of that market in California, and yes, I wasn't able to renew with Cigna but had to move on to another insurer. As much as I never liked Cigna from the beginning, I dread the hassle of changing plan and changing insurer, particularly now that I'm literally not covered! I blame Cigna. They said they sent me a termination notice months ago. Yeah? I didn't receive any such letter in my mail, or hardly any communication from them. The only communication I got from them was the clearance of my autopay to Cigna and it was reported to me not by them, but by my bank! "Deny any mistake and just stall the customer!" is what I've observed as very common practice in corporate America. This is often not due to any particular person's fault but just the business environment, culture within the corporation that relegates certain functions to somewhere or someone whom no one within the corporation knows what it is or who it is anymore. Such functions became detached and orphaned while everybody else in the corporation were too busy to cope with the day to day business to just survive another day. When another new regulation hits, let's just snap another expensive bandage and buy another expensive software to patch us into compliance. This is the business environment that I've witnessed in the USA. It's got to a point where corporations are so busy patching compliance with the latest regulation that, it's become removed from the actual line of business they are in, or they've just gotten more out of touch from their products and services. Overtime, the corporations would derail into bankruptcy and then be wiped off the map in the USA for good, other companies that are more monopolized, will carry on profiting while letting the customers suffer without any consequences.
Okay, after all these rantings, I finally feel less angry with Cigan now, because I suddenly remember how I was lost in the blackhole of corporate intranet trying to fix my paycheck problem with my former employer, and for a very long time, not my boss, not the human resource department at my office could do a thing about it. It took me a very long time to fix it. Yes, people got screwed along the way, but that's nothing abnormal in corporate America, particularly when there is no one on the wide corporate web for you to hold accountable for. It's only getting worse and worse as management engages in more overthinking to implement more theological and cumbersome business solutions from text books to be put on their reports, instead of rolling up the sleeves to actually solve any problem relevantly. Wherever people work these days, it's all about the look of paper work and there is so much politics. My sudden loss of health coverage reminds me this sad situation and before you ask why everything here in the U.S.A cost more, this is one of the reasons why. There is just too much focus on making the smoke than cooking the edible good steak. There is simply too much politics, too much cumbersome but irrelevant paperwork, everywhere.
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