Filed under The Public Square
Everything about receiving health care has become so complicated! Most of the time I just don’t get myself involved. Specialists for everything and I don’t know who does what. When hubby had his knees replaced last fall we went to a surgeon who only does hips and knees. Other joint replacements would require a different specialist. How do you determine whether your back pain should be addressed by a neurologist or an orthopedic doctor? I’m serious. Where do you start and if you begin in the wrong place how many doctors do you see before you find where you should be? Does your insurance require referrals? Is this doctor in ‘the network’ of providers? Onandonandon…
And then there is the confusing matter of tests. My Mom’s family doctor sent her for an MRI. The results of that sent her to the hospital for a needle-guided biopsy. The MRI was what was called an Open MRI and it wasn’t adequate so the hospital had to do a Closed MRI before they could do the biopsy. I know this all sounds fairly simple, but it wasn’t! All of this was leading to whether it was safe to do a hip replacement — at yet another doctor. Do all these doctors talk to one another? Not always. Maybe they send a report.
Again there is the consideration of whether the tests were completed within ‘the network’ your insurance ‘prefers’ or by an entity that participates. Don’t count on finding the ‘lists’ of who participates very easily! And, don’t count on a list being accurate!
Shortly after you’ve seen any doctor the bills and insurance papers (IF you’re insured) begin arriving. Sometimes you can match them up pretty easily, but, again, not always. Sometimes it’s very difficult!
And medications are another whole can of worms.
Often you’re dealing with all this confusion and complications when you’re ill!
I don’t know what the solution is, but I know somethings gotta give!
How many here know what the Affordable Care act means to YOU? How many know the timeline of implementation? How many know…
How many are confused? Count me here among the confused. Count me among those who wait. Could ‘something’ have been treated more effectively if ‘caught’ sooner? Who the hell knows what to do?! Who the hell has the money to begin what might be a long and very costly journey to find out?!
Great post, Fnord. All so horribly true.
The whole billing thing is a huge scam. When I had my knees replaced, And I was dealing with all this while sick, in pain, and taking massive pain killers.) the bills started flooding in. First, the insurance company sent me a $50,000k check instead of paying the bills at the hospital. WTF? I guess they thought they’d pay me a lump sum and let me go hang for any bills not covered by that amount. I couldn’t drive for six weeks, live alone in the country, and just held on to the check while I tried, through the drug fog, to figure out why they sent me that check.
Within a week of being home, I got served with papers for THEFT of the check they sent to me, in my name. WTH? The sheriff deputy who served me, after I hobbled to the door on my walker, said “well, do you have the uncashed, unendorsed check? Has anyone ever asked you that?” I said no one ever asked, and yes I had it since I couldn’t get to town to do anything with it. He took it with him and returned it to the insurance company along with the service papers. No further comment from anyone. Unbelievable.
I waited to see what the insurance would pay before shelling out. They took their time. Then my “unpaid” bills got sent to collection agencies, trashing my credit. However, eventually the insurance company paid, sometimes double paying what I had already paid for. Did I get all the refunds I was due? Hellifiknow. Probably not. BTW, this went on for over a year after the surgery.
And governor sam wants to put these jackasses in charge of Medicaid in Kansas.
LOL I have the greatest excuse for not dealling with the bill collectors. They call and I explain what happen to me and how my mind was effected. So they get where they are reacting much like I do when I reconized them “Sigh…. OK thank U!
I can so relate, I have lost count and accounting of which Doctor is who and what? To make it worse, they all have names it takes a computer to know how to pronounce and spell! Some I did know before from my mother or happenstance. One who is a very easy name to say happen to have a plane he uses at the little airport I was a line attendant at. He does not remind me I think but to be honest that is no surprise since he would come to fly to do some operation somewhere else in the this or surrounding states. Fast in and fast out..
Everyone seems to have an opinion about how SCOTUS will rule with regard to The Affordable Care Act, aka Obamacare. This is an interesting take from Slate, and I tend to agree with the author that the Conservative Justices will be anxious to deprive President Obama of a signature accomplishment and don’t care nearly as much about precedence or their own previous writings. I don’t have confidence in The Roberts Court and I don’t think they feel any need to follow the constitution or the law if it conflicts with what they want to do.
Ryan’s budget and the path to single-payer health care
Let’s play a game: I’ll describe a health-care bill to you. Then you tell me if I’m describing President Obama’s Affordable Care Act or the budget released this week by Rep. Paul Ryan.
The bill works like this: The federal government subsidizes Americans to participate in health-insurance markets known as “exchanges.” In the exchanges, insurers can’t discriminate based on pre-existing conditions. Individuals can choose to go without insurance, but if they do so, they pay a penalty. To keep premiums down, the government ties the size of the subsidy to the second-least-expensive plan in the market — a process known as “competitive bidding,” which encourages consumers to choose cheaper plans.
This is, of course, a trick question. That paragraph describes both the Affordable Care Act and Ryan’s proposed Medicare reforms. The insurance markets in both plans are essentially identical. And for good reason.
The Affordable Care Act was based on two decades of Republican thinking about health care. The basic structure was first proposed by the conservative Heritage Foundation in 1989, first written into a bill by Senate Republicans in 1993, and first passed into law by a Republican governor by the name of Mitt Romney in 2005.
Continue reading –http://www.washingtonpost.com/business/economy/ryans-budget-and-the-path-to-single-payer-health-care/2012/03/23/gIQAlnUmWS_story.html
Never should someone’s life be judge as whether it is worth saving or not based on whether they can afford to have their live’s saved. Stand of living is another thing that is never should be a judgement call.
I can totally related about the confusing world of health care – try going through the maze of Cancer treatments, CT testing, PET testing, lab testing and eveything else.
There has not been one spot on my body that has not been zapped with radiation.
The PET scan was a nuclear radiation test – I was injected with some neon-green colored dye – the technician had me sit in a small room behind a screen while his arms went through some holes and his gloved hands injected the dye into me.
I was then told to not move from that spot for 30 minutes and all of this was done in a mobile van outside the hospital.
And then when I asked about all the precautions, I was told – it’s for your safety, as well as ours.
MY SAFETY????? Hell, that neon-green-colored dye was in MY veins – NOT theirs.
And for the privilege of having this testing – I had to go round and round with the insurance company because a PET scan is only authorized in certain cases – and it seems my doctor’s office had sent some form twice – what was the big deal? I did noth have the f__g test done twice – the office simply faxed this one page twice – DUH……..
The frustration of dealing with our health care system is enough to want to make someone just say – nevermind, I would rather just take my chances and not see your ass anymore.
In fact, that is what I told my first oncologist (before I found the one that saved my life in the Yellow Pages).
That first oncologist (the best in this field) had a staff that was absolutely clueless. I’ve shared a small portion of the shit I went through with that damn bunch.
When I had my fill – I told his nurse that I would rather take my chances with the damn cancer in my body than to deal with her and that doctor’s ass anymore. That is how much I HATED their place.
Her reponse was – that’s so sad you feel that way. She took nothing of my complaints to heart – she only heard what she wanted to hear – that I was not coming back to their office, so there would be no further money coming from my insurance company.
And, sad to say, money is the only thing that matters to some of these doctors in our health care system today.
It’s sad – just damn sad.
But my current oncologist (not US born and a Muslim) is the doctor that took the time and compassion to get me to a place where I was even willing to fight for my life. My doctor routinely takes the patients that my first oncologist refuses to take if their insurance limit is met or they are on Medicaid.
That’s the difference between our homogenized health care and the health care of foreign doctors. At least, in my case, the foreign doctor was a doctor because he was doing what he was meant to do. The white doctor was doing it for the money – IMO.
Indy, I’m so sorry you had to endure all of that, but I’m really glad you did and made it. I can’t even imagine what it was like for your.
On another note, please don’t let the fundies win, at least without considerable trouble. We need you. Hell, I need you. LGBT people can’t do it alone. We need all our allies.
Speaking of bill collectors – the worst time I had was with the local Catholic hospital threatening me with weekly calls.
They had already been paid $168,000 from my insurance company. I owed $10,000 – my deductible and d/t some CT testing that I thought was covered, was not actually covered because their CT department was outsourced to another company and this company was NOT in my network – so therefore, my CT testing was not covered.
Anyway – I had to put up with some ditzy woman calling me weekly (now mind you, I had just been in the hospital for 29 days, had two drainage bags coming out of my side, had an surgical incision from my belly button to the furthest point a woman’s body can go. And, I had a colostomy to contend with.
AND this bitch kept threatening me with all kinds of crap. This is the woman that told me to divorce my husband, quit my part time job and go on Medicaid.
When I screamed at this woman – You’re the damn church that does not believe in divorce and you want ME to divorce my husband just so you’ll get your money?
She then replied – I was only joking.
No, folks, she was not joking. She was serious until I called her damn bluff and started demonizing her church.
THAT is the problem today – it is about money…….. Religious affiliated hospitals are offended? NO sir – I am offended by THEM.
Anymore either my wife or I make a point of asking the Doctor or the lab who is wanting or doing the test wheither it is covered by my insurance?
They all seem to know almost without looking into it or will call within minutes of asking.
The odd thing was – the same CT department took several CT scans while I was an inpatient. But since I had the same CT scans done while as an outpatient, the same insurance refused to cover them BECAUSE they were an out-of-network provider.
I never did understand that one….
But, you’re correct, one should always ask..
Of course, they are not bound by their answer. Get it in writing if possible, and even then, they are not bound by it.
Being an insurance company means never having to say you are sorry.
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