The Medical System

Recently, I have been able to experience healthcare first hand here in the United States, and I have a few complaints about it.

First and foremost, I despise the policies of the insurance companies.  I currently have a healthcare plan that is based out of the state I am currently living in, and that has created all kinds of nightmares for me.  Perhaps let me start at the beginning so I can catch you up to speed on why my insurance company’s policies are atrocious.

I lived for two years in Kenya, and arrived back in the U.S. about a year ago.  Recently, it became apparent to me that I had a worm infection (don’t ask how I found that out, but needless to say, I was absolutely sure that I had worms living in my intestines).  As any logical person would do, I made a trip to the emergency room. That is all fine and dandy, because my insurance covers “emergency medical treatment” so there was no problem in getting them to cover a trip to the ER. (Although it was a hassle to try and get the company to actually pay for the visit. but that is another story for another day).  While I am in the ER, the doctor asks me the details of what happened, and I give him as much information as I can.  He then goes into his office to study a bit more on the treatment options I have.  When he comes back, he prescribes a certain drug. When I informed him that I had already been treated with that medication 5 times, his response was, “Well, that’s what the computer say to do, so let’s try it and I will refer you to a specialist.” That gave me some doubts about the ability of this doctor to treat diseases (And I will get to that more later).  So he refers me to a specialist. I gave the specialist a call the next Monday, and his secretary informs me that I would have to have the E.R. doctor call the Specialist, and then they can accept me as a patient.  A little frustrating, but not that big of a deal.  So I call the E.R. and politely ask if they could inform the doctor that treated me to call the specialist.  But evidently, that is against hospital policy for some unknown reason.  Instead I have to call my Primary Care Physician (who is out of state) and ask him to call the emergency room where I was treated to get the details of my treatment, and then he has to call the specialist that I was referred to so set up an appointment for me to meet with him.

Unfortunately, I am informed that I must receive preauthorization in order to see the doctor I need to see to be treated. So I call the insurance company. After being on hold for upwards of half an hour I finally get to talk to a real person who informed me that I had called the wrong number (because a batch of their insurance cards had been misprinted) and I had to call a different number. So I called again, and spent another eternity on hold.  FINALLY, I talk to someone to get preauthorization. But at the end of the conversation, the representative I am talking to informs me that “preauthorization does not guarantee coverage or payment on the part of the insurance company, only that the doctor that I am going to see accepts the insurance I am paying for.” Again, another story for another day.  But when I get in to see the Doctor, and we discuss treatment plans, it becomes clear to me that I will have to make several visits to the emergency room to be treated for this.  Unfortunately I also found out that my insurance only covers the first visit I make to a specialist after an emergency room visit while I am out of state.  So every time I want to see this doctor, I have to go to the emergency room, have my primary care physician call that emergency room, then call my insurance company and explain to them why I need to see this specialist.  Then he needs to call the specialist, and tell him to call me to set up an appointment. Frustrating to say the very least!!!! What was even more frustrating is that although the doctor that is treating me accepts my insurance, the Lab at the hospital he works at does not, and therefore I have to involve a whole other hospital in this proverbial tango. And that is where I stand at this point. Every time I need a check up, I have to jump through more hoops than a dolphin at Sea World.

Anyway, moving on to the second complaint I have.  Dr. Google.  My emergency room doctor essentially googled my sickness, and prescribed drugs (which I had had 5 times previously) to treat my illness because the computer told him to.  When did the requirements to be a doctor no longer include common sense and education?  Could I not have treated myself the same way? Why do I have to pay him hundreds of dollars to do a google search for me?  Am I paying for the bed I had to take a nap in at 2 AM while waiting for hours while the google results came in?  If so, you think they could try and make it a bit more comfortable! But it makes me nervous to be treated by any doctor who has less expertise on the kind of sickness I have than I do.

Finally, my last complaint (that I will write about before my head explodes with frustration) is the bloat in the medical system.  There are simply too many rules, regulations, and otherwise inefficient ways that we are managing the medical system it sickens me (which makes me have to take ANOTHER trip to the hospital!). Why can’t we simplify the process and make it cheaper? All I want is to be treated in a timely manner, without having to spend thousands of dollars to get the right kind of pills to make me better. Is that too much to ask? I doubt the founding fathers would be very happy to see the proverbial fine print we have added to the Declaration of Independence. Who would have known that in order to pursue life in this country it would take hundreds of hours and thousands of dollars, and dozens of corporations working in tandem with each other?


One thought on “The Medical System

  1. Pingback: Picasso and Einstein: Modern Communists « Hakuna Matata

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