Sunday, March 13, 2011

Adventures in Health Care

The future is now. At least the scary-socialized-medicine-the-pundits-warned-you-about future is already here. Or so it seems from my recent adventures in health care.

Call me a freak (it's ok, I've been called worse), but I've been fairly lucky, and fairly healthy for the past decade. Unless there is organ failure or bleeding from a major artery, I tend to take a less-is-more approach when treating any physical maladies I experience. No doubt this behavior was something I adopted during the years 1999-2006, when I was also without health insurance. Anyway, as a result of my relative good health, I don't have a "Primary Care Physician" but instead visit the nurse practitioners at the local one-stop medical center when suffering from something that Ibuprofen, rest, and the judicious consumption of whiskey won't cure.

When my knee recently decided to go rogue, however, I decided it was probably best to go shopping for a physician. I had run out of good knees. And I had turned 50. Probably time to let someone have a look under the hood, so to speak. After all, I have employer-paid health insurance now! Better use it or, the way budgets are being pruned these days, they might decide I don't "need" it! Anyway, finding a physician in Bubba County who would accept a new patient within the week - or the month - wasn't going to happen, but I was able to get an appointment with the nurse practitioner.

I arrived in plenty of time for my 1:30 appointment and took a seat among the dozen or so others waiting. I was thankful for the free flu shot I'd received, and hoped there were still antibodies swimming around my bloodstream from that upper-respiratory "thing" I had in February to protect me from the, er, mucousity of my fellow patients-in-waiting. I wished I had brought a book to pass the time -- there was no way I was touching any of the reading matter there! Instead, I memorized the fliers posted on the receptionist's window and practiced some slow breathing so as not to inhale too much of the unsavory ambience.

At about ten past 3 - that's no typo, folks - it was finally my turn to be seen. Various measurements were taken, my knees were poked & pushed, and it was determined that an MRI should be had to determine the extent of the damage. I was told that the my insurance company's approval was required and I would get a call when said approval was obtained (or not). Meanwhile, with continued self-care, my knee continued to feel and work better, but I don't feel I can "trust" it to do what I need it to do, consistently and reliably. It is my hope that I will get sent to a brawny physical therapist so I can properly and expeditiously rehabilitate this wayward joint, and hopefully avoid future injury, too. But first, they need to know what the heck is wrong with my knee.

At my follow-up appointment two days ago, the obviously overworked nurse pulled out my chart and found the insurance company's denial form. The MRI was not approved, they said, because there was no diagnosis code on the request. The nurse scanned the forms and said that yes, there was a diagnosis code, and they would resubmit the request. That makes a ten day wait - plus however much longer I'll have to wait while the forms are resubmitted and re-scrutinized. It's enough to make a person sick!

But after all, I am one of the "lucky" ones - my mostly sedentary job also permits me to work from home on occasion, and in addition to health insurance, I have paid sick leave. If it was the dead of winter and if I wasn't tired of spending so much quality time with the couch and "House" reruns on hulu, I'd say let 'em take their time. Still, I hope I never have to "test" the system while suffering from anything more serious. And I'm going to look for a physician in the town where I work, in NC, in hopes that someone there will accept a new patient sometime before I'm eligible for Medicare.

I've just learned, though, that if I do need to be hospitalized, at least at the same facility (not in Bubba County, TN but in Charlotte, NC) where my boss recently had surgery, I will be asked to bring my own towels and washcloths. I guess nobody told that facility that kind of thing only happens in Cuba, or so say opponents of health-care reform.

The health of our health care system is enough to make you sick. Just make sure you get pre-approved.


  1. Having been in the same leaky boat as you, we had no insurance up until my wife took her current job three years ago. Prior to that, we keep our income minimal so that we could keep the girls on medicaid. I will say, there was never a question, or hem haw when we had to take them to the doctor, or on a couple of occasions, the hospital...ever. We never paid one dime, or had a procedure questioned. Since getting BCBS, I am amazed at the way they dodge even procedures recommended by our doctors. The most blatant are blood draws and lung xrays...forget it. I can't imagine that a government run health care system could be much worse...keeping in mind that we pay out almost $500 month, plus co-pays that hurt. As far as I am concerned, the broken part of the system is the "for profit" side.

  2. Agreed, jaded. It is absolutely obscene that insurance company execs get bonuses based on denying people the treatments they need. How can they sleep at night?

  3. With the assisstance of insurance-approved sedatives, Intell.

  4. I can not believe Americans put up with this, living in Australia with our 'socialised medicine' I am amazed at the stories of your 'greatest health system in the world'. Whats also suprising is how much money is spent on health care in the US with such poor returns.

  5. My preference is for leaving wit bombs on people's posts, but this time I'll just say grab your nearest ten bucks and buy a copy of Pete Egoscue's "Pain Free: A Revolutionary Method for Stopping Chronic Pain." I did, twelve years ago, and systematically (and quickly) got rid of pains I'd put down to middle age and even some I'd had for forty years. Gone. Gone. I tend to go all evangelistic on this and scare people away so I'll go away quietly now.

  6. Barnesm, we put up with it because most of us don't have enough money to have a choice.

    Murr, thanks for the comment and the recommendation. I'll definitely check it out - today I especially feel like I need it!

  7. Jesus. Great country and all, but utterly barbaric in many ways.
    Tell the Republicans that if socialised healthcare is OK for Israel, it's OK for the US!

  8. Vole, indeed Jesus would provide better healthcare. And the Republicans in Congress forget that their own healthcare is paid for by the taxpayers. They can probably get essential procedures like facelifts and viagra prescriptions without requiring precertification, too.


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