148 – I Learn How to Keep Margaret
Alive: 16 January 2025
I learned on 3 December 2021 how to keep Margaret alive.
To keep Margaret alive, I only needed to force the health insurers to
obey the law.
No matter what happened after then, I knew I would make the health
insurers obey the law.
Margaret and me on 19 November 2020 at Loveon Cafe.
****
In Blog 39, I wrote this.
|
Throughout Friday 3 December 2021, I worked frantically on letters of
complaint to our health insurer HCF and to the Commonwealth
Ombudsman. In theory, the Ombudsman was the government agency
which, in conjunction with the Australian Health Department, enforced the
laws governing private health insurance. At about 4.30 in the afternoon, I emailed this letter of complaint to
HCF. |
****
I have now had the opportunity to check my records of that frantic day
of work and worry. The computer tells me
that at 12.51 pm on 3 December 2021, I sent an email to HCF. The following documents were attached to that
email.
·
Copy of letter of complaint dated
3 December 2021 sent to the Commonwealth Ombudsman on 3 December 2021.
·
Table 1: Itemisation of 32
Separate complaints by Margaret Redden Re HCF.
·
Table 2: Itemisation of Claims
Accepted by HCF.
The computer also tells me that at 12.54 pm on Friday 3 December 2021, I
sent an email to the Commonwealth Ombudsman.
Attached the email to the Commonwealth Ombudsman were the same documents
that I had sent to HCF:
·
Letter of complaint to Commonwealth
Ombudsman dated 3 December 2021 about the refusal of HCF
to pay claims for treatments provide to Margaret by Lift Cancer Care Services.
·
Copy of letter of complaint dated
3 December 2021 sent to HCF on 3 December 2021.
·
Table 1: Itemisation of 32
Separate complaints by Margaret Redden Re HCF.
·
Table 2: Itemisation of Claims
Accepted by HCF.
****
I had been awake since 3.00 am on the day before Margaret’s operation on
3 December.
I had also been awake since 3.00 am on the day of the operation.
I was physically and mentally exhausted.
I was worried sick about Margaret’s upcoming death. Like Margaret, I expected the operation
scheduled for the evening of that day would simply confirm what the surgeon had
already told Margaret after the operation on the 1st of December –
Margaret’s cancer was thriving, Margaret was dying and Margaret would be dead
in the near future.
I typed the Tables I sent with my letters of complaint in the morning of
Friday 3 December before I wrote the letters themselves. I needed to know the detail of exactly what
had happened. Had HCF refused to pay all
of the claims or only some of them? Had
HCF explained why it had refused to pay the claims?
Back then in December 2021, I was reluctant to make any assumptions of
illegality. My starting point was that surely
HCF would never intentionally disobey the law.
This meant the refusal to pay the Lift Cancer Care claims must have been
the result of a misunderstanding. It was
weeks before I realised that HCF had not made some innocent mistake. It was weeks before I realised that HCF did
not give a flying fart about what the law required it to do.
It was months before I realised that the government enforcement agency –
the Commonwealth Ombudsman – knew exactly what HCF had been doing and had made
a decision to refuse taking any action to enforce the law.
****
On 3 December 2021, I was naïve.
My wife was dying.
I knew other patients of Lift Cancer Care Services were grievously ill.
I knew HCF, NIB and Teachers’ Health were refusing to pay what the law
required them to pay for treatments provided by Lift Cancer Care.
I thought the refusal of the three health insurers to pay for the Lift
services must have been the result of some simple mistake.
Once I pointed out that the health insurers had made a mistake, the
health insurers would promptly fix the mistake – and if they did not fix the mistake,
the Commonwealth Ombudsman would force them to fix the mistake.
****
The surgeon was commencing his list of operations at 6.00 pm that
evening. Margaret did not know where she
was on the list. If she was
first, her operation would happen shortly after 6.00 pm and she would be
awakened no earlier than about 30 minutes after the operation finished. If she was further down the operations list,
it would be later in the evening before she was awakened.
Once the operation was finished, Margaret would be taken back to the
ward and the surgeon would visit when he had finished his list of operations. Margaret would ring me only after the surgeon
had seen her and told her what he had found during the operation.
I expected Margaret to ring me no earlier than 8.00 pm. I was certain the surgeon would insist that
she stay in hospital – at the very least – until the next morning.
****
I was shocked when Margaret rang me at about 7.30 that evening.
I was even more shocked at what she told me.
“Come and take me home! The
surgeon says he has never seen the cancer look so small! He says I can go home!”
I immediately drove to the hospital and brought Margaret home.
I had written letters of complaint to HCF and to the Ombudsman.
The result of me writing my two letters was immediate. Without any additional treatment between Wednesday
1st December and the operation on Friday 3rd December, the
cancer had shrunk dramatically and Margaret was able to come home.
****
I had learned how to keep Margaret
alive.
To keep Margaret alive, all I had
to do was force the health insurers to obey the law.
I knew I would do what I had to do
to keep Margaret alive.
I would force the health insurers
to obey the law.
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