Saturday, February 16, 2013

Here's my big but...

I know using the word "but" tends to negate everything that game before it, but...
Oh well, here I go.  There are a lot of people without health insurance or who have insurance but have dismal problems with coverage, such as the people who are in need of life saving procedures or drugs and their insurance won't pay for it.  This is tragic - and as having once been uninsured, I know the nightmare that healthcare can be.  I know there are people who are in much worse health pickles than I, BUT... We changed insurance in July and it was all pretty confusing to me.  Blue Cross wouldn't issue a card until we had a doctor (of course the doctors we had been seeing weren't in our 'group') and it was pretty much a crap shoot of look at a bunch of doctors on the computer and then declare them as one's physician.  That was weird and depressing.  But I noticed the rheumatologist I had been seeing for about five years was also included in the doctors offered since he also sees some patients as their primary physician.  So I picked his number, just so I could keep seeing him and get on the Blue Cross rolls.  We found other physicians ASAP - the rheumatologist is OK but I wouldn't want him as an internist.  And when I found an internist, I made sure I paid the higher copay to the rheumatoligist when I saw him.

Here's the meltdown....I saw him yesterday for my usual every 6-8 week check-in.  After the usual back and forth, "how are you?" "about the same, maybe a little worse", I mentioned the viral plague I had come down with last week.  I only thought it worth mentioning since the fever and chills had really messed with my joint pain, and the chills I woke up with on Wednesday night had me shaking so badly that I awoke thinking I was in the throes of some sort of seizure.  As I mentioned I had had a flu shot, the doc asked who gave it to me, and I said my internist and he asked who that was.  When I mentioned the name of the new internist he asked where my referral was.  I confess I was totally oblivious to the fact that I needed a referral for a doctor who I had already been seeing for about half a decade.  Dear doctor's immediate concern was to ruffle through my chart and try to calculate all of the appointments that I now would have to pay for since I didn't get a referral as soon as I had moved to my internist.  (Not that it's the doctor's obligation to explain the details of all this $#!+ to me, but the internist was told I was seeing a rheumatologist and she didn't mention that she would have to give me a referral)  For all these simple medical things, the amount of bureaucratic details involved in who is in a group with whom etc. is just depressing and mind boggling.  And I pity the doctors who have to deal with it.  So....my real gripe, besides having to contact Blue Cross and try to untangle all this since the doctor walked out to the front desk and declared me a "SELF PAY" with great gusto, is that the doctor never returned to the discussion of how crappy I was feeling, i.e. my health, which is why I was there.

I know doctors have rent, salaries, insurance etc. to pay.  I know business it difficult.  But, holy cow, couldn't he have just pretended for a minute to remember why I was there.  For health care.  For a modicum of concern.  I should have been the one with the will to redirect the conversation, but my mind went immediately to calculating how I would pay for the uncovered appointments and how difficult this whole referral business would be.  I stayed calm and businesslike, while my mind was spinning with despair over details.  The doctor told me he wanted to see me in four weeks - but to make sure I got that referral first.  WTF.  I told the secretary that I couldn't pay anything beyond the copay (which was the truth) I went home feeling worse than I did when I went in. 

As I said, a lot of people are worse of than I am, but....

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