Doctor, Doctor

There are, no doubt, a whole host of blogs and podcasts about the American healthcare system.  All of them well researched, insightful, educational and investigative. This is not one of them. As you know, access to healthcare in this country is determined not by need, but by employment. Without a job, people are forced to rely on the massively underfunded and difficult to navigate Medicare and Medicaid systems, both of which refuse treatment, exclude payment for certain procedures and indeed make it as difficult as possible for people to obtain timely, appropriate and effective treatment. Or indeed, simply go without coverage at all and go untreated, or find some type of Obamacare programme they can afford.

Most, but by no means all employers provide access to health insurance, but even so, the cost of providing coverage for a family of four can be eye wateringly high. And even so, there’s no guarantee that certain procedures or medications will be covered, nor that some services such as cancer treatment will not have lifetime payment caps. I’m not too badly off in that my job is unionised and as I’m single, my coverage is very affordable. I pay in the low double figures every month for coverage and I get three month’s worth of medication for less than the cost of a night out with the lads. So far, so good.

Late last year I received a letter informing me that my physician of many years was retiring, no doubt to give himself more time to hit golf balls off the back of his yacht, or whatever it is that retired doctors do. Of course, this saddened me as he’s a really nice guy, very thoughtful and he hadn’t killed me. As part of my ongoing programme to wean myself off my former place of residence I contacted a clinic that is on my route to work and by coincidence is run by the same company that provides my coverage. I won’t give too much away, but suffice it to say that their name rhymes with Scheisse Permanente. Not wanting to waste time, I simply asked if any of their doctors was accepting new patients and took the one offered.

As I would need a medication refill soon after, I set up an appointment to see my new doc. as a way to prove that I exist and preclude the need to see him at short notice should there be any pushback from my refill request. Everything was as you’d expect, with the M.A. doing most of the work before the star of the show arrived. We chatted for about ten minutes and then I headed off to work.

Imagine my surprise when about six weeks ago I received a form from them in the mail bearing the phrase “This is not a bill”. It certainly looked like one to me, but what confused me was the impression that I was being billed nearly $300 for a routine IN NETWORK  office visit. I tried not to perseverate on this until a couple of weeks later I received a very similar looking form that most certainly WAS  a bill.

There was absolutely no way I could afford to pay a bill like that out of the blue, so I called them to find out WTF was going on. You are all no doubt aware of the horrors associated with calling any form of customer (dis) service, so take that part as read. To cut to the chase I was told that I have an $800 deductible to meet before the insurance company would pay a penny. I also found out that had I not had not taken advantage of the  flu shot programme at work, the bill would have been $100 higher! I was passed on to another section and was told that any payment programme could only go out four months, so I hung up and pondered.

The thing is, I rarely go to the doctors’ more than once a year, if even that, so there was no way I would meet my deductible. In fact the cost of this visit would have covered two and a half year’s worth of medication refills. So effectively, I don’t have insurance I can use unless I have something major happen to me, and even then, I’m on the hook  for what is effectively two weeks’ wages. As you can imagine, I was not a happy camper.

I tried to find a way to work this new expense into my, I’m going to say “Budget?” Despite my best efforts the only way to do this would have been to invent an entirely new branch of mathematics. However, in an act of what I can only call true love, my sweetheart offered to pay the entire bill for me. See ” I Don’t Owe You Anything” for details of a similar event. I was truly humbled. At that point we had only been together for two months, so she was in no way obligated to bail me out, yet she did so anyway.

Thankfully, I’m in pretty good health, although I could do with losing some weight, but what’s new? With one less millstone around my neck I can breathe a little easier, but it has given me pause for thought regarding any kind of medical appointment. One decision I did make was to put aside a little cash every week just in case I need to see my doctor at short notice. Even so, I’m not shelling out that kind of cash just to walk through the door unless I have something terminal.

Under My Thumb.

“Under my thumb is a broken bone and a stretched tendon”.  Hmm. Somehow I can’t see Mick strutting around the stage to that lyric, and probably nor can you. This summer I took a tumble whilst walking round on the boat, jamming my thumb into the steel plate deck. Just to quash any rumours, no, I wasn’t drunk. It was 6:45 am, although that is never proof of sobriety in itself, but this time it was.  After some initial swearing and dusting off I picked myself up and headed to work. By the time I reached my desk, the pain had not subsided and the right half of my left hand had swollen considerably, but was not bruised.

This lead to an experience that happens daily in the part of town where I work; namely, being ripped off in a drug deal. This occurred not in some evil smelling back alley by a character of dubious intent, but in a clean and brightly lit store by an ageing, balding, well presented store clerk who had the decency to wish me a speedy recovery.  There is a convenience store across the street whose business model is based on the concept of a captive audience, hence my being forced to pay $1 a pop for Aleve. Humph!

Eventually the swelling went away, but the pain never did, which is why in early December I made an appointment to see my doctor who told me that I had indeed broken a bone and stretched the tendon in my thumb and would need a cast. Again, humph! I’m right handed, so I didn’t think it would cause too much inconvenience, but I was wrong. One never thinks of how having one’s non-dominant hand hors de combat, but it turns out that it is almost as bad as breaking the dominant one.  I was unable to hold a knife, and so for three weeks ate a diet based on using only a fork, which was a cakewalk compared to dressing. My first day at work after the cast was a nightmare as I was unable to button my trousers after taking a comfort stop due to my inability to grip, so I was forced to rely on zip and belt alone to prevent me from a citation for public indecency. In fact, a large portion of my wardrobe was off limits to me for this reason and I was forced to rely on my older, and somewhat looser fitting clothes for three weeks.

Work was no easier than home. Have you ever tried to hit Control Alt Delete with the fingers of one hand immobilised, or opened mail with no grip? What a pain. Of course, I had no support but I managed although it did slow me down considerably.

I realise I’m making something of a meal of this, as many millions of people deal with far worse  permanent issues on a daily basis, but as someone who has passed his half century without ever having a cast, it came as something of a shock to be faced with the realisation that one handed life is harder than imagined. One thing I had anticipated, though was the fact that by the half way stage, my unwashed paw began to smell like a three day festival, but a search of the darkest recesses of my bathroom cabinet produced some old  aftershave which at least hid the truth from all within noseshot.

You can imagine my relief when the cast was removed. Despite washing it twice immediately after release, it still stunk of the cast, and my thumb, immobile for three weeks ached like the devil and it wasn’t until three days later that I could move it without discomfort. Thankfully, the rest gave the tendon time to return to normal, precluding the need for surgery.

This may all seem to be much ado about nothing, but given that it could have been much worse, for instance a broken wrist or arm. it was yet another indication of my mortality and how easily one’s condition can change in an instant. I know of one person who hit a traffic cone whilst cycling, was thrown over the handlebars, landed on her head and was dead before her body came to a full stop. An extreme example for sure, but still, had I been walking down the stairs instead of up, things could have been much, much worse.

My Death.

Lest you all start popping champagne corks and bursting into spontaneous renditions of “Happy Days Are Here Again”, let me assure you that I am in excellent health. Having turned 50 I recently underwent a  couple of medical tests and whilst they were both positive in their findings, they resulted in me spending more time than usual contemplating my mortality. Most people my age have college age kids, and most people with kids the ages of mine are a good ten to fifteen years younger than me, so this leaves me in a sort of generational netherworld.

I’m being purely selfish here, in that I often wonder if I will live long enough to see my grandchildren. Yes, I know how petty that sounds, but I see how much my dad enjoys spending time with my kids, and my mother just adored my daughter so it makes me jealous to some extent. My son is twelve and if things pan out as I hope, he will go on to get some sort of engineering PhD after graduation. He may well have to invent the particular branch of engineering in question, so at best, it may be 20 years before he starts a family. My daughter is only 9, so twenty years doesn’t seem unreasonable for her either, seeing as she is as needle-sharp as her brother. I hope that I will be a hale and hearty seventy year old, but one never knows what will happen. There is an old joke that goes: “How do you make God laugh? – tell him your plans”.

Whilst unpacking in my new home ( see “Space Oddity” – coming soon) I found a couple of old photographs: one was of my son when he was not yet two years old, the other of him and his sister taken a little over a year later. Not to get maudlin, but both pictures showed two adorable, sweet, happy and contented children and I couldn’t help but think about their development over the intervening years and how much wonder, joy, satisfaction and pride I’ve enjoyed in seeing them flourish. That sweet little round cheeked boy has now turned into a sensitive, intelligent, handsome young man and his sister is an insightful thinker, artist, soccer player and equestrian who is, I am sure, bound for greatness in at least one of those fields.

It breaks my spirit to think that I may not live long enough to see my putative grandchildren reach the age my children are at now. I’m pretty sure I won’t be around for their college graduations unless medical science makes some significant advances in the next two decades. Grandchildren are the payback generation, in that we put in immense amounts of physical, emotional and financial resources to ensure that our kids have as fulfilling a childhood as possible in the knowledge that when they themselves become parents we can sit back, reminisce about the early years and dote on our grandchildren who will never know what it was like to be a parent at the start of the century.

I think also that grandchildren are the ultimate validation of our parenting skills in that they are proof that we raised well rounded human beings who were fully aware of, and integrated into the world so that they had the skills to raise children who would be better human beings than their parents, as their parents were compared to their own parents. I know I should be living in the moment and enjoying seeing my kids turn into young adults, and I do, but there is part of my brain that just can’t let go of the thought of all that I will be missing.

Doctor Doctor.

I’ve always been in pretty good health. I’ve never been hospitalised, only had one surgery, and that was as an out patient, and have never broken anything except wind, although there are some who would say that I need to see a physician about that. Not that I’m blase about my health, far from it, but apart from the occasional visit, I never give my well being  second thought.

All this changed recently though. Whilst dropping the kids off for their weekend with me, my ex handed me a letter from the insurance company that informed me that I had been dropped from her plan as of Halloween. This did not exactly come as a shock to me, as I knew that she would be dropping me from the plan at some point after the divorce. At least it took her this long, so I have been able to build up a stockpile of my meds. All this means that for the past 2 weeks I have been flying without a parachute when it comes to healthcare. Yes, I know that the ACA has kicked in, despite all the haters have done, and are trying to do in order to to stop it, but here’s the thing. I can’t afford to sign up, and can’t afford to pay the fine for not signing up. Joseph Heller, where are you when we need you?

There is an upside, though. After my next birthday I am supposed to have the check most likely to induce discomfort and indeed jokes  in men. Yep, that one. If I’m not covered by then, it won’t be an issue, and it will avoid a potentially awkward moment. What if, whilst he’s performing the exam, I call out the name of another doctor by mistake? How embarrassing would that be? Although it would give me another excuse not to shake his hand afterwards, I suppose.