Brace Yourself

Caitlyn has an overbite, pretty normal stuff for an eleven year old.  The dentist recommended that we take her to an orthodontist.  Both Michele and I wore braces and various pieces of plastic apparatus when we were kids to straighten out our teeth, so it seemed like a pretty normal idea.  We have dental coverage through the Presbyterian Church (USA) Board of Pensions, run through Aetna.  The coverage pays for cleanings and fillings and the like, and it is supposed to pay for orthodontics for kids under the age of 22.  So we find an orthodontist that works with our DMO coverage (not easy for some reason), and finally we get her checked out and find out that she has to wear one of those headgear things at night for about a year.  This involves a fitting, some bands on her back teeth and the wire and elastic thingy that she wears in the evenings.  The total bill for this high tech piece of head-reshaping is over $1400, spread out over about a year.  Insurance, so we think, is supposed to pay half, except they don't.  The orthodontist thinks they will, but our plan doesn't cover this specific thing, and nobody seems to know that.
So, a sort of terse phone call later, I come away with the unpleasant reality that, in this day and age, whenever you interface with the healthcare system, you need a freaking lawyer.  We, or the orthodontist, or someone, was supposed to check to see if this specific thing is part of what is covered by our dental benefit.  How we were supposed to imagine that something as straightforward as a big rubber band that corrects something as common as a mild overbite would not be in the realm of covered procedures, I do not know.
Insurance companies are minions of Satan.
I don't mean the people that work for them on the ground, the lady that I called and spoke with this morning was quite nice and sympathetic, but she really can't do anything about the fact that the system is set up to regularly and arbitrarily screw average people over.  Do you want to know why I think the Affordable Care Act is a good thing overall?  Well, I'm going to tell you anyway: because it set some limits on the kinds of shenanigans that companies like Aetna and US Healthcare and Blue Cross, Blue Shield can play on people.  Here in Maryland Aetna and US Healthcare decided they really didn't want to play by those rules.
Do you want to know what the biggest problem with ACA actually is?  Well, I'm going to tell you anyway: it's that they didn't come down anywhere near hard enough on these insurance providers.  The CEO of Care First (a Blue Cross Blue Shield provider) made $66 million dollars last year.  He did so because he ran a company that maximized profits.  Do you know how they do that? By tightening the screws on what sorts of care you are allowed to receive from your doctor. And once they became the most competitive provider in the market, consequently driving away most of the competition, they are then free to jack up their premiums, making things decidedly not affordable any more.
Why is it this way? Was it a terrible plan? A catastrophe from the get go?  Nope, it was made this way by the tortuous political process it had to go through to become a law, and the unavoidable consequences of human greed and sin. The health insurance lobby is powerful and they have senators and legislators in their pocket, they really didn't want too many rules governing how much money they were allowed to make off of people getting sick and needing healthcare. And there is an unfathomable amount of money being made, but generally not by the people who really should be making it.
Doctors and nurses get shafted in this deal too, because they want to treat their patients as thoroughly and as well as they possibly can.  Uninsured people, who were much more prevalent before the ACA, often could not, or would not pay their medical expenses, leaving hospitals and doctors in the lurch and causing a massive inflation of the "going rates" for various sorts of medical care.  I have very little doubt that, in a world where insurance was not a factor, Caitlyn's head gear would probably cost a few hundred dollars and involve a few paid visits to the doctor for adjustments, but not almost $1500.  They charge what the insurance will pay, and if your insurance decides they're not going to pay anything, tough cookies.
This system is broken in ways that the ACA didn't even touch, and it didn't touch them because some people with the power to stop it decided that their cash cow was sacred.
The thing that drives me nuts is not the cost of this little snafu.  As annoying as it is, we will be able to afford to pay for our little girl to have her jaws all lined up right.  An extra $700 or so is not going to kill us, but for many people who find themselves in the teeth of this system, it is absolutely life and death.
The only thing I know for sure about this is that you cannot trust corporations.  If it is your health against a massive, billion dollar industry's profit margin, you are going to die.  I do not like the removal of regulations being contemplated by the current administration.  Do I want them to fix the problems that the ACA has?  Absolutely.  Do I want them to take away the slim protections it actually affords? No way.