As most of you know, I manage a low-income apartment building for seniors. This is a 41 unit building, subsidized by HUD. The rents are based on 30% of a person's net income. The tenants in my building pay from $2.00 per month - yes, you read that right, TWO DOLLARS - to a max of $400.
The rent is figured on a calculation of the total income, minus any out-of-pocket medical expenses over the last year, including any drug costs, supplemental insurance cost, dental or vision expenses. Plus travel expenses to doctors, hospitals, therapists. There is also a $63 utility allowance taken off the calculated monthly rent figure.
However, in the case of management - me - the same cannot be said. I receive my housing plus $600 per month gross. There are no benefits. Since I am not old enough for Medicare, that leaves me in the same boat as 59 million other people in this country.
In July, I fell while doing work in a unit. Naturally, I reported this as a Workman's Comp claim. I dislocated my shoulder 4 inches. A dislocation of that extent tore everything there is to tear - nerves, 3 of 4 rotator cuffs, the cartilage between the shoulder bone and the socket, and the tip of the shoulder bone shattered when the shoulder was put back in place.
Since July, I have been taking pain pills, coping with weekly physical therapy, and waiting for the nerves to heal. Surgery on the tears could not be done until the nerves healed to a degree whereby I was able to do the therapy required immediately after the surgery.
Finally, that magical day appeared. Surgery was scheduled last month for tomorrow, Dec. 2nd. A great relief for me to have this come to a conclusion. A great relief also for my attorney. What does an attorney have to do with this, you ask? Well, I guess I forgot the part about the Workman's Comp claim being denied. Oh yes, denied. Why? Per the insurance company, EVERY claim is denied as standard operating procedure. My employer encouraged me to get an attorney, as he was/is fully in favor of this claim being covered.
Obviously, my attorney has been not-so-patiently waiting for the bills to be finalized so he could get on with this case. Today he gets his wish.
Prior to surgery, you are required to get a pre-Op physical. As an uninsured, this is not something I have had done in decades. I just saw my Family Care Physician this morning - another laughable moment, as my surgeon didn't seem to understand the fact that when you don't have insurance, you DON'T HAVE a family care physician. Seems the results of my EKG are quite abnormal. My FCP seems to think I have at least one blocked artery, probably more. He is recommending this surgery not take place until I have further tests and/or heart surgery.
Now, that brings us back to the "no insurance" thing. These tests will NOT be done, hence, the surgery will also not be done. Ever. I must now hope I do not have a heart attack for ten years until I am 65 and on Medicare, if it still exists. Since my attorney will now be settling this claim with the WC insurance company, the shoulder surgery will also not be done now, if ever.
For those who may wonder, other than this totally surprising news and my shoulder, I am in perfect health. No family history of heart disease, no family history of diabetes, cholesterol problems, obesity, etc. I am fit and well-conditioned.
This is the lovely system we have in this country. Once again, an insurance company took $5000/year in premiums from a small business, with no intention of ever giving anything back. Once again, an uninsured person waits to die from something quite treatable.
God bless America.
PS. Sara R, bless her heart, had posted a diary last week for messages for a quilt for me. She wanted to have it finished prior to my surgery. I am more sorry than I could ever say for this waste of time, effort, and money. I apologize with every fiber of my being to Sara and all the wonderful folks on Daily Kos who wrote the most wonderful, heart-warming messages. Please forgive me.
Update: I have changed the title to reflect my biggest concern at the moment. I take these quilts very seriously and have been a supporter from day one. I feel absolutely horrible that this time was wasted.
Update: Thank you to all who have given me such great advice, hugs, and VERY informative links. If there are folks out there from the Mequon, WI area who know of any agencies that could be helpful, your advice is very welcome.
MAJOR UPDATE: The anesthesiologist just called. The surgery is ON. She stressed the need for me to get this heart thing taken care of, but said the stress on my body from this shoulder surgery would be no more than if I carried a load of laundry up a flight of stairs. Since I am able to do that with ease, she is willing to proceed. One problem taken care of! And it is because of you guys, I just know it. Make fun it you will, but the power of Kossacks never ceases to amaze me.
Final Update: So sorry, but I had to be gone for awhile to get some things in order before this surgery. I have gone back and read any comments I missed. Have I mentioned you guys are the bees' knees? the cat's meow? the whole enchilada? I have never, never, never seen a community such as this one. I have spent my life in the horse industry. I thought we were a community who helped our own, but we've got nothing on the members of this site. There is more knowledge here than I'd find on a 100 Googles. The generosity is 10X that amount. Signing up here was the smartest thing I ever did in my life.