Tag Archives: Medicaid

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.

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Filed under lifestyle, Personal finances, Personal health