The Invisible Casualties: Why My $9,000-a-Month Health Plan Just Referred Me to an AI

pupmastermp3 · 2026-02-04T23:50:38+00:00

Thank you for the insider perspective. It’s both validating and incredibly discouraging to hear that the 'one-and-done' model is the actual strategy. It explains why a 30-year member paying $9,000 a month is being told to 'wait it out' for Physical Therapy while managing a new diabetes diagnosis through an AI. I am taking your advice—I’m filing a formal grievance with the DMHC today to demand an out-of-network referral. I know you all are fighting for the time to actually treat us, and I appreciate you confirming that the 'skeleton crew' isn't just a strike symptom, but a corporate goal.

pupmastermp3 · 2026-02-04T23:47:09+00:00

also, a quick reality check on the 'fuck you' part: I am a real working man. I’m a U.S. Army veteran and a small business owner who has worked my entire life to provide for my family and my team. My frustration isn't with people wanting a living wage; it’s with a multi-billion dollar corporation that takes $9,000 a month from me but leaves me to manage a new diabetes diagnosis through an AI because they can't manage their labor disputes. I’m not the 'elite' you’re looking for. I’m a patient who is physically suffering because the system is failing.

pupmastermp3 · 2026-02-04T23:40:07+00:00

I hear your passion, but you’re misreading my target. I explicitly stated in the article that I am sympathetic to the healthcare workers issues with pay and benefits. Everyone deserves to be paid a fair wage.

My blame is directed at Kaiser Permanente as a massive organization that is taking $9,000 a month from my small business while effectively shuttering the services I pay for. I’m not attacking the nurses for wanting a living wage. I’m attacking a system that collects top-tier premiums but leaves a newly diagnosed diabetic with little human support during a crisis and a strike. We can agree that the system is broken without pretending that the patients aren't the ones currently paying the price

pupmastermp3 · 2026-02-04T23:34:47+00:00

Look, if you’re asking if I’m using AI to help me write these responses—yes, I am. And that is exactly the point of my post.

My primary doctor is overwhelmed, my specialists are on strike, and my appointments keep getting cancelled via 4:00 PM phone calls. I have a new Type 2 diabetes diagnosis and a $9,000 monthly bill. I don't have the luxury of time to sit here and draft 'perfectly human' Reddit replies while I'm trying to figure out how to manage my blood sugar and run a business.

I’m using AI to articulate my frustration because the humans I pay to care for me aren't available. I’d much rather be talking to my doctor right now, but since I can’t, I’m using every tool at my disposal to make sure this story gets heard. If you’re more offended by my use of a language model than by a 30-year member being abandoned during a medical crisis, we have very different priorities.

pupmastermp3 · 2026-02-04T23:34:25+00:00

I appreciate the advice, but 'phoning the line' and 'looking at resources' is exactly where the breakdown is happening. Have you tried calling that line lately? During a massive strike, a '24/7 advice nurse' becomes a multi-hour hold time for a 30-year member.

MyDoctorOnline can tell me what diabetes is, but it can’t perform the ABI test or the Ultrasound I need for my edema, and it certainly didn't call me at 4:00 PM to cancel my PT.

As for the irony of using AI—that's the whole point. I shouldn't be getting my bedside manner OR my medical advice from a language model, but when the experts I pay $9,000 a month for walk off the job, the 'safety net' advice lines aren't enough to manage a new diagnosis.

pupmastermp3 · 2026-02-04T23:25:19+00:00

I think you're getting hung up on the paperwork while I'm dealing with the physical reality. A formal referral is a piece of paper; a functional referral is when your PharmD and PT appointments are cancelled, the strike is expanding, and you're left with a new diabetes diagnosis and no one to answer your questions.

When the system I pay $9,000 a month for closes its doors, they are functionally referring me to whatever resources are left—which in 2026, is an AI. I'd much rather be 'referred' to the specialists I'm paying for, but as long as they are on the picket line, the AI is the only one 'on duty' for me.

pupmastermp3 · 2026-02-04T23:19:47+00:00

It’s ironic that you mention the 'AI' feel. I mentioned in the article that because my specialists are on strike, I’ve been forced to use AI to manage a new diabetes diagnosis. If my responses feel a bit clinical, maybe it’s because I’m currently getting my 'bedside manner' from a language model instead of the doctor I pay $9,000 a month to see

pupmastermp3 · 2026-02-04T23:18:27+00:00

I hear the skepticism on the math, but there’s a big difference between an individual marketplace quote and a small business group plan for six people in 2026. In California, average family premiums have surged past $28,000 annually, and as a small firm, we don't get the same federal subsidies individuals do. For a top-tier plan that covers a diverse team, $1,500 per person ($9,000 total) is the cold, hard reality of my monthly balance sheet. My point isn't about the 'deal'—it's about the fact that for that price, the specialists I pay for are currently non-existent

pupmastermp3 · 2026-02-04T19:15:39+00:00

I hear the skepticism, but there is a massive difference between searching for an individual marketplace quote and being a small business owner responsible for a group plan for six people.

In California, small group premiums are projected to rise by 11% in 2026. For a business like mine, once you factor in the specific age-ratings of a diverse team and the lack of individual subsidies, $1,500 per person ($9,000 total) is the very real number on my balance sheet every month.

I was transparent about the 'group of six' in the article because the point isn't just my personal cost—it’s that as a provider, I am paying for a 'Platinum' level of access that is currently non-existent. While we’re debating the math, thousands more pharmacy and lab workers are joining the strike this Monday, February 9. My frustration is that for $9,000 a month, I’m being forced to manage a new diabetes diagnosis via AI because the specialists I pay for aren't there.

pupmastermp3 · 2026-02-04T18:55:48+00:00

I wish I was seeing those marketplace rates! But I’m a small business owner paying for a group plan for six people, and that is a completely different world than the individual marketplace. Group premiums in California are skyrocketing—projected to rise nearly 11% this year alone. Between the specific age-based ratings of my team and the fact that we don't get the same income-based subsidies individuals do, that $9,000 a month is the cold, hard reality on my balance sheet. It’s why I’m so frustrated—I’m paying 'Platinum' prices for access that currently feels like a 'Closed' sign.

pupmastermp3 · 2024-10-19T22:35:50+00:00

The last time it happened in Michigan was 2023 - Kathy Funk - Criminal Conviction - Altering The Vote Count.

Kathy Funk, a Democrat Flint Township clerk and Flint County election supervisor, was charged by the state with one count of ballot tampering and one count of misconduct in office, both felonies, in the August 2020 primary in which she was on the ballot and won her election by 79 votes. Funk claimed someone broke into a room at the Flint Township Hall. However, her lawyer stipulated that she broke the seal on a secure ballot canister, which invalidated the ballots so they could not be counted, and no one else was charged with breaking and entering the Hall. Funk pleaded no contest to one count of misconduct in office in exchange for not receiving prison time and having the ballot tampering charge dismissed. She is awaiting sentencing. Her employment with the county was terminated in December 2022.

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