I learned the hard way that “having health insurance” does not mean having access to care. My loved one needed surgery—real surgery, not optional, not cosmetic, not something that could be delayed indefinitely. The first facility that could actually perform the procedure had the right equipment, the right surgical team, and the experience required. The surgeon was in network, but the facility was out of network. Coverage was approved and then 13 hours before the surgery, was denied. Full stop. This wasn’t health care. It wasn’t even sick care. It was no care.
Every facility within our insurance network lacked the surgical instruments required for his procedure—including the hospital where I work, which was technically approved, but physically incapable of doing the surgery. We weren’t being difficult; we were being factual. In the meantime, his surgeon instructed him to manage debilitating pain with ibuprofen and Tylenol taken around the clock, for months, while we waited in approval limbo. Not surprisingly, recent bloodwork now shows declining kidney function and anemia—collateral damage from being told to “manage” instead of being treated.
To add insult to injury, the insurance itself feels like a closed-loop experiment. My plan is the Employer Paid Option—the only one we can afford on my low hospital salary. The insurance company was created specifically for employees of the corporation that owns 11 hospitals up and down the California coast. Outside of this system, no one has heard of it. It’s a network designed to look comprehensive on paper while quietly limiting real-world access. The result? Patients and families trapped in a maze of yeses and nos, approvals and denials, referrals to surgeons who don’t even perform the specialty needed. (Read that last sentence again.)
The irony deepens when I think of my supervisor, who had eye surgery years ago—robotic, high-tech, performed at an out-of-network facility and preapproved. For three years afterward, she received bills. Collection agencies got involved. She made monthly phone calls, pulled in HR, and eventually even the CEO. She told me later it wasn’t about the money—it was the principle. That’s the part that lingers. When people who work inside hospitals have to fight this hard for care they were promised, the system isn’t broken—it’s functioning exactly as designed. And the cost isn’t just financial. It’s trust, health, and the quiet understanding that too often, care depends less on need and more on financial contracts.
So, what do we do now? How can we receive the true health care we humans deserve? I feel that we should first let the general public know, as in writing to the editors of newspapers, writing blogs like this one, and put your experiences on social media. Knowledge is power. Vote health care into action, real health care, preventive measures being rewarded, and then those in urgent need of sick care get their needs supplied, immediately. This, in my opinion, will improve accuracy, efficiency, and actually save the systems in place money, which can be used for true health education for the public.
Thank you,
KJ Landis
@superiorself on Instagram and X
@SuperiorSelf channel on YouTube
@superiorselfwithkjlandis on TikTok
[email protected]
Books available everywhere!
Every facility within our insurance network lacked the surgical instruments required for his procedure—including the hospital where I work, which was technically approved, but physically incapable of doing the surgery. We weren’t being difficult; we were being factual. In the meantime, his surgeon instructed him to manage debilitating pain with ibuprofen and Tylenol taken around the clock, for months, while we waited in approval limbo. Not surprisingly, recent bloodwork now shows declining kidney function and anemia—collateral damage from being told to “manage” instead of being treated.
To add insult to injury, the insurance itself feels like a closed-loop experiment. My plan is the Employer Paid Option—the only one we can afford on my low hospital salary. The insurance company was created specifically for employees of the corporation that owns 11 hospitals up and down the California coast. Outside of this system, no one has heard of it. It’s a network designed to look comprehensive on paper while quietly limiting real-world access. The result? Patients and families trapped in a maze of yeses and nos, approvals and denials, referrals to surgeons who don’t even perform the specialty needed. (Read that last sentence again.)
The irony deepens when I think of my supervisor, who had eye surgery years ago—robotic, high-tech, performed at an out-of-network facility and preapproved. For three years afterward, she received bills. Collection agencies got involved. She made monthly phone calls, pulled in HR, and eventually even the CEO. She told me later it wasn’t about the money—it was the principle. That’s the part that lingers. When people who work inside hospitals have to fight this hard for care they were promised, the system isn’t broken—it’s functioning exactly as designed. And the cost isn’t just financial. It’s trust, health, and the quiet understanding that too often, care depends less on need and more on financial contracts.
So, what do we do now? How can we receive the true health care we humans deserve? I feel that we should first let the general public know, as in writing to the editors of newspapers, writing blogs like this one, and put your experiences on social media. Knowledge is power. Vote health care into action, real health care, preventive measures being rewarded, and then those in urgent need of sick care get their needs supplied, immediately. This, in my opinion, will improve accuracy, efficiency, and actually save the systems in place money, which can be used for true health education for the public.
Thank you,
KJ Landis
@superiorself on Instagram and X
@SuperiorSelf channel on YouTube
@superiorselfwithkjlandis on TikTok
[email protected]
Books available everywhere!
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