I titled this essay "Cigna and the Homeless on Belmont" to forewarn of my attempt to link my reflections on these two subjects:
- Cigna, a major US health insurance company, and the issue of health insurance reform in general; and
- a small community of homeless people living on Belmont Avenue in Chicago, Illinois.
Cigna
I think you'll find my personal "Explanation of Benefits" provided by Cigna to be of more than passing interest. But first, a word about Cigna itself:
The following quote can be found on this link: http://health.usnews.com/health-plans/national-insurance-companies
QUOTE:
The largest U.S. health insurers collected some $650 billion in premiums in 2009, the latest year for which data were available in early 2011. The top 25, ranked below by market share, accounted for nearly two-thirds of the total.
:UNQUOTE.
The link cited above lists "Cigna Health Group" at #11 on its list of the top 25. Even though Cigna isn't listed in the top 10, I'm still getting a pretty good deal. This is important, at least to me, since I've been undergoing treatment for liver and colon cancer since early fall, 2012. My treatment consists solely of chemotherapy to which, I'm happy to report, I am responding favorably. However, my diagnosis hasn't change: I still have Stage IV liver cancer for which there is no cure.
I now cite two status reports (aka "Explanation of Benefits") sent to me by Cigna:
QUOTE # 1:
Amount billed: $5,485.00: This was the amount that was billed for your visit on 12/04/2012.
Discount: $5,142.17: You saved $5,142.17. CIGNA negotiates discounts with health care professionals and facilities to help you save money.
What your plan paid: $342.83
What I owe: $0.00: This is the amount you owe after your discount [and] your plan paid...
:UNQUOTE.
QUOTE # 2:
Amount billed: $6,360.00: This was the amount that was billed for your visit on 12/17/2012.
Discount: $5,888.52: You saved $5,888.52. CIGNA negotiates discounts with health care professionals and facilities to help you save money.
What your plan paid: $471.48
What I owe: $0.00: This is the amount you owe after your discount [and] your plan paid...
:UNQUOTE.
Bottom line:
I highlighted CIGNA negotiates discounts above to emphasize my huge savings. But of course I have a question: How could CIGNA have managed to negotiate a more than 90% discount in both cases, especially since their statements indicate "CIGNA received this claim [for $6,360] on December 21, 2012 and processed it on December 22, 2012?" [NOTE: The other claim [for $5,485] was "processed on December 12" after having been "received on December 10, 2012."]
Such a rapid turnaround (of one or two days!) doesn't suggest that CIGNA negotiated my particular claims but, rather, that CIGNA has a standing arrangement with my particular provider. I'm not complaining, mind you. But I have to wonder how my medical provider can make any money by having agreed in advance to accept a mere 10% of the amount claimed for their billable services.
Worthy of Note: I don't have any kind of cadillac insurance plan, since I'm only a low-level state civil service retiree covered under a State of Illinois plan provided by Cigna. My max annual income while working was about $40K per year.
Summary:
I don't know how medical providers make their money. I suspect, though, that if I am paying so little then someone else is paying much more. Or maybe my medical services professional is able to make up for his loss of income (from me) by some kind of government-sponsored subsidy? I really don't know, but (as the old saying goes) it's always worth one's while to follow the money... or to at least ponder the possibilities in the absence of someone who can explain these things in easy-to-understand layman's terms.
I still stand by my position in support of universal Single Payer health care as offered in my Electoral Contract to the American people on August 22, 2012, offered as part of my campaign to be elected US President last year, linked here:
http://ind4prez2012.blogspot.com/2012/08/the-electoral-contract-of-steven-searle.html
SIX: I will veto every single bill from Congress that comes my way until it passes:
- a Single Payer health care reform package, which will provide medical coverage to all US citizens free of charge - that is, without co-payments, deductibles, or any requirement to pay insurance premiums. This will also establish reasonable medical billing practices and rates.
- a nationwide cap of 18% on personal credit card interest rates.
The Homeless on Belmont Avenue
A few days ago (2/5/12), I was on the Belmont Avenue CTA bus en route to a friend's home that evening. I wanted to double-check something I'd seen about a month ago. As I approached the Kedzie Avenue bus stop, located under the section of the Kennedy Expressway that flies over Belmont, I saw what I'd seen before: On raised concrete platforms was a collection of bedding and baggage belonging to about a half-dozen homeless people.
The first time I saw this, I told my ex-wife I was amazed that thousands of commuters passing this encampment daily must have seen what I saw. She said there have been homeless people there for years, every winter sleeping in the cold in the midst of a relatively prosperous middle class residential and shopping area.
Apparently, this is okay with the local police. But it is not okay with me. Have you ever tried to sleep outdoors under a pile of blankets as a fierce Chicago winter rages about you? As pedestrians walk past you as they make their way to the various shops in the area? What's it like to wake up in the middle of the night because you have to take a crap? You maneuver yourself out of your blanket cocoon and start walking toward some hidden area where passersby won't see you. After you finish your business, you get to take some of it with you because you don't have toilet paper. Then you walk back to your cocoon of blankets, hoping they'll still be there - not having been ripped off by punks who don't like the homeless or by other homeless coveting your threadbare coverings.
And bathing is hit-or-miss because the managers of the local restaurants won't let you use their restrooms as a bathing option. They caught on to that years ago.
The cold is bad enough, but what about their health: "What happens when the down-and-out get sick?"
Suppose one of these souls, obviously lacking insurance, were to come down with the cancers I have. What would they do? Answer: They would die simply because they wouldn't be afforded the chemotherapy I am blessed with on a twice-every-three-week basis. My advantage might not really be so great since the doctors agree that I, too, shall die soon enough - that is, prematurely. But at least I am not (as of this writing) in pain. At least I don't sleep on concrete in the freezing cold while being witnessed by the too many who don't give a damn.
I wonder if any of the homeless dwelling under the Kennedy Expressway at Belmont Avenue wandered past storefronts with TVs showing Obama's inauguration. I wonder if they thought, "That shindig must have cost a fortune. Hey buddy, can you spare a quarter?" I wonder if any of them had any hope that Obama's buddy, the Golem of Chicago (aka Mayor Rahm Emanuel), has any plans to help them. Or if Rahm will make any moves toward at least spiritually integrating the most segregated city in the USA. Or if Rahm will, instead, make a smoke-filled room kind of deal with the gangbangers who are skyrocketing Chicago's murder rate - a deal kind of like this: "We'll take police pressure off your drug business if you stop embarrassing me with high profile shootings of innocents."
Sound far-fetched? Not for a Golem who wants to someday become President of the United States of America no matter what the cost. Far-fetched? Not to a sympathizer of a homeless person piled under blankets who keeps a wary eye on passersby. Not to me.
Baby, it's cold out there.
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Steven Searle, former candidate of US President (2008 and 2012)
Founder of the Independent Contractors' Party
"In case you're wondering, I shared my home with a homeless person - rent free with no strings attached - for four years."
Contact me at bpa_cinc@yahoo.com
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