Identify what is most important )0( Eliminate everything else
The idea that some lives matter less is the root of all that is wrong with the world. Dr. Paul Farmer
The suffering of others is not alleviated when no one knows about it.
There is no one right way to live. Daniel Quinn Ishmael
The only thing that you need to start an asylum is an empty room and the right sort of people.
We are what we pretend to be, so we must be careful about what we pretend to be. Kurt Vonnegut

Monday, March 23, 2015

finding medical care

I have an internist and am very satisfied with the care and resources.  Unfortunately, the world of medical insurance and care is so complicated and difficult to research. 

I have a computer, it is connected to the Internet and I know enough about both aspects to teach other people how to use both, heck, I can even write code, or I used to be able to do that.  I am too stressed from organizing my health care stuff to find out.

I am privileged.  It is important to stress how insanely privileged I am regarding medical care.  I am acutely aware of this because I work with people who are not so lucky.  And, it really is all about luck.  The luck of having the ability to wrestle through all of this mess.  Lucky to have sufficient resources to afford additional health coverage in addition to what Medicare provides. 

What I have in common with less lucky people is the nearly paralyzing stress and fatigue of trying to navigate this crap. 

It is like the complexity of taxes, of all kinds.  Get one system, simplify it and apply it to everyone.

It is like laws.  Go back to the time before laws and lawering and make everyone follow that if what you want to do or say does not cause harm to anyone or anything...including yourself in most instances, there certainly are exceptions...then go ahead and do or say whatever the heck you want to say or do.  If there is no harm, then, no foul.

There are lots of other ways to make life less stressful, and I know that the one most helpful to me is to make the payment systems at stores and clinics and wherever, one same process.  If I have to scan or swipe my information or membership card, if I have to swipe my payment method card, standardize all the damn machines for doing so into one universal machine.  Period.  I know that the clerks and sales people would like the same thing. 

But, this health stuff is horrible.  I know that I have decent access to care and that it will (most probably) will not impoverish me, or if it does, it will be relatively temporary.  I prepare for extra and/or medical expenses by saving anything I can.  Sometimes I have to delay medical care for a while if it is not an emergency, and I do my best to avoid any behaviors that would create an emergency situation.  Except for the falling, but I am working on that.

I arranged for and paid for the top tier of health benefits through my medical plan, for medical, dental and vision care.  The dental benefits alone will pay for the extra fees.

However, because our health care system is such a mess, many providers, clinics, hospitals and individual doctors are bailing out of some things. 

Medicare is one of them.  Complicated and inconvenient (and sometimes greedy)insurance companies and their procedures is another.  It once took my old insurance company nearly eight months to pay a simple office visit claim.  During those months, my doctor and clinic were waiting for claim payments from practically every insurance with which they work.  That is insane, and whilst I understand the desire to hold on to your money as long as possible, to cause problems for others who need their money is kind of disgusting. 

And, that causes all manner of difficulties for health consumers, me, you and everyone.  And, that means that I have spent two full days trying to find:
  • A pre-colonoscopy preparation thing that my insurance will cover.  It is in my best interest to do so because to pay for it myself will cost more than a hundred dollars/US.  My second call to my prescription service graced me with a person who was willing, unlike the first call just a minute earlier, to dig around and find a prep thing that would be covered.  A subsequent call with the gastro office was actually funny.  The prep thing that my insurance will cover is one of several dozen available, but which has not been used in several years...maybe longer.  The office person was familiar with it and will prescribe it, but it might not be available in a pharmacy; will have to be ordered.  However, it will save me me and will cost only $14.00/US.  So, I can schedule the colonoscopy.  Ultimately, two or three hours well spent.
  • Same thing for another prescription, one for my heart crap.  I have that settled, too.
  • Now that I have moved, I need a new therapist.  It would be best for me to have one with a couple of specialties or at least experience or interest in treating someone like me.  The one that my internist says is the best match for me no longer takes my insurance or is a Medicare provider, because of the issues I have already mentioned.  In fact, when I called the clinic, the woman who answered the phone was so cool and welcoming until I asked if they took my insurance.  My best guess is that she often experiences people who are upset and probably not nice about that.  So, she was immediately stressed and defensive.  I had to reassure her that I was not upset or challenging their policies before I could convince her to tell me what their customary session charges are.  
  • Another few hours were spent, nearly five, in searching for a female therapist who is part of my insurance providers and within driving distance that would not encourage an overnight stay, you know, just to be safe from all the driving.  I think I have found two possible therapists, but I am now too exhausted to try any contact with either of them today.
  • One of my anti-anxiety meds has gone from $26/US for three months to the same price, but for only one month, and I cannot express how unbelievably grateful I am that I will be able to afford this med, even though the first month will cost $130/US. A minor complication that I am not fussing about.  It took a long time to find this med.
  • The dentist I would like to use is within walking distance of my flat, is reasonably priced and is nice.  He is not on my provider list.  Huge surprise.  So, I am going to just stab a knife into the list of the ones I did find.  Too tired to do anything else but home for the best.
Those who do not have my resources do what I used to do and that is to seek medical service with anyone who will take them, not rip them off too much and not be too far away to reach.

Having what I have now is why I am so privileged and lucky and I have nothing that is worthy of complaint.  So, I am not really, but I am thinking about how if this is so difficult for me with every skill I have, what can be done for those around me who cannot navigate or even begin to understand this mess.

I was planning to visit the village's community center where there is a program for seniors.  I cannot just walk in and announce that, "Hey, I know that there are other old folk like me who have having conniptions about juggling all that health care jazz..."

Nope, cannot do that, although I am thinking that going there and meeting other old folk would be more than nice.  Maybe we can incorporate health care stuff into the employment stuff that I will be starting up again.  Soon, I hope. 

This mess is not our fault, unless you want to extrapolate it to how we vote for the people who are the chief messer-uppers.

Gooder-news is that I found a support group that is close enough to not require an overnight stay and I am going to it tomorrow.  Unfortunately, it cuts into my on-line and on-telephone research time, but there is a excellent chance that I will sort out all of this medical and insurance stuff before I die, but we have to wait until all of my test results are back from last week's bloodletting.

2 comments:

  1. Goodness your heath system over there is complicated, J. Hope you feel better soon.

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  2. I am hoping that, as well.

    Our health care system is complicated, baffling even, but it is better than it used to be. At least now, because of the affordable care act/Obamma care, millions of Americans who have never had any health insurance have some coverage now. It is still expensive for most of us, but at least we have some.

    ReplyDelete