• rant: state of american health care


    while i'm not an entirely michael moore theorists, i do like that he makes me think.  sicko, his recent movie, made me think.  it was hard to listen to peoples' stories because i've always worked for a company that has had great health coverage and made it a priority benefit for their employees -- for that i'm entirely grateful after countless emergency room visits, 2 children, a few surgeries, and tons of medications.

    well this weekend, i'm starting to even hate how i'm being treated even though i still do have great coverage.  on saturday, the day of festivus for our family, i awoke to a kidney stone.  i went with my daughter to the grocery store in the QC for our weekly donut treat in the morning.  before i left i noted to my wife 'i feel like someone kicked me in the <nuts/family jewels/gonads/groin/pick-your-word>' and i left.  honestly i barely felt like i was going to make it home.  i came in, buckled in pain and went to my secret stash of demoral (after 2 previous incidents it is my new american express card).  it wasn't working (probably because it was 3 years old...yeah, i know...lecture me later).  after a few minutes of trying to deal with the pain, i called out to lisa and said 'find someone to watch the kids, we need to go to the er, like 10 minutes ago.'  in my neighborhood we have a private hospital (gilbert hospital) which promises to get you seen in less than 31 minutes.  since it is a private hospital, it isn't usually covered by health plans.  who cared, i needed to get some IV meds ASAP.  i went in and was immediately placed in a wheel chair and brought to a room -- before they even asked my name -- they let my wife deal with stuff.  48 minutes later i was discharged.  in that span of time i did:

      • brought in immediately, placed in a hosp gown
      • vitals taken
      • iv w/saline put in
      • morphine injected...oh sweet morphine
      • taken for a CT scan
      • saw the actual doctor 3 times
      • full explanation of details
      • received prescriptions and discharged

    booya.  i say.  sweet.

    but this rant is not about my problem.  not more than 2 days later we were back in the emergency room.  on monday, my wife (a cyclist) was out for a ride with her friend.  at about 10 minutes until the end of their ride, she was struck by a car.  (note: i was in los angeles.)  because of where we live, she was air-evac'd to a trauma center in scottsdale (about an hour drive from our home).  they took great care of her.  the aftercare...hmmm...this is where i start getting pissed.

    today i start making calls to meet with an orthopedic surgeon for her.  *every* doctor i called, their first question had nothing to do with the injury, how my wife was doing, etc. -- their first question was "what level of insurance do you have?"  argh.  even when we were calling dr. offices to find out who they normally refer, they asked what our insurance was.  i said 'pretend we're paying cash in a briefcase, it doesn't matter...the health of my wife does.'  they just didn't get it.  one dr. we called, their second question was 'were you in an accident and is insurance involved?' -- technically yes and no.  our claim stuff hasn't made it's way through obviously.  but when we explained the accident they refused to make an appointment and said they don't help those situations.  un-friggin-believable.

    i guess america is such a litigous society that people don't care anymore really...and i mean in the sense of *care* about people.  medicine has turned too much into business, not health.  which is a sad state of affairs.

    oh well, needed to get this off my chest.  the medical industry is weird.  if you go in for something and they don't diagnose anything because they can't figure it out -- don't you think you shouldn't have to pay?  i mean in the tech industry if you don't deliver the answer, you are expected to compensate accordingly (or not bill).  i think i'm in the wrong industry.  "doctor" is quickly approaching my list of easiest jobs in some regard (although meteorologist for a news station is still #1).

    thanks for being a soundboard internet.  you are too cool.

    Thursday, December 06, 2007 4:52 PM

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Comments.

  • Gravatar
    # re: rant: state of american health care


    Tim,
    That's terrible! I've been blessed with good health but I am also an avid cyclist and know i'm in danger every time I strap on my shoes and clip in. I hope all turns out OK with you and your wife and thanks for filling us in. I'm ashamed of our medical situation here as well. I'm extra scared now as we're on deck for our first baby due in January. Rudeness and general idiocracy directed at me I can handle....wife and kids? not so much.

    Kurt

    12/6/2007 5:35 PM
  • Gravatar
    # re: rant: state of american health care


    Tim, I am sorry to hear about the kidney stone and the accident. I can't help much, but I can totally sympathize. This kind of situation is why it took from July to September for me to get in for my latest knee surgery.

    There is one thing I can do to help: Call me/email me - I can get you the name and contact information for my ortho. They may be more willing to work with you than others, especially if you are coming from a known patient.

    You are both in our prayers.

    12/6/2007 5:53 PM
  • Gravatar
    # re: rant: state of american health care


    My Dad had kidney stones once, and the doctor said it was "the closest a man could get to the pain of childbirth". Wow. Hope you and your wife are doing better, sounds like a really tough week.

    PS. Having lived under both the national health thing in canada, and in California insured, I have to say national health care hands down. Who needs someone trying to weasel out of helping you when you are sick?

    PPS - I think there have been instances in the past of software not working and money still changing hands ; ).

    12/6/2007 7:50 PM
  • Roy said:
    Gravatar
    # re: rant: state of american health care


    Tim,
    Hope you all are doing well. I really enjoy your blog... it is uber informative.

    As far as health care goes, I am unsure what you would be advocating but if you think things are bad now... just let the government run the program. The first question will be the same as before except you just replace the new government plan lingo. The only way for a government plan to reduce cost will be to deny service. Except now the scale is gigantic with a government plan that serves and entire population. I would agree that the healthcare in the US can be improved but government run care is not the solution. Just my opinion.

    12/7/2007 9:00 AM
  • Guy said:
    Gravatar
    # re: rant: state of american health care


    Hey Tim - sorry to hear about what happened. Coming from Blighty it's easy to understand your point of view. I hope that things sort themselves out for you.

    12/7/2007 9:19 AM
  • Dave said:
    Gravatar
    # re: rant: state of american health care


    Tim...

    Glad you and your wife are ok, that's always good!

    With regard to health care, two of the Doctors I see are just barely hanging onto their practice because even with the money WE have to pay, they can't make it because of all the barriers put up for them. I think the only ones getting anything out of the whole deal is the insurance companies.

    Long story short: My wife was in the ER from 5pm to 11pm then in a room until 11am. I got billed for 2 days. Their answer: "this isn't a hotel, she was in the room part of 2 days". This was Saturday/Sunday, so the 'precert' was done long after she was home and billing was complete. My bill was $1500, and my portion at that time was 20 or 30%. The insurance company paid their percentage of the $1500, and then paid $1700 in full. When I questioned the insurance company, they said it was precertified as type xyz which was $3200, so the hospital gets the balance... remember, precert was done AFTER she was home. Oh and since I figured this out all by myself, the hospital never came after me for my percentage!

    12/7/2007 9:40 AM
  • Steve said:
    Gravatar
    # re: rant: state of american health care


    I hope you and your wife get well soon. All the best. BTW In Australia we have a Dr who we are trying to extradite back here as it is alleged he killed a large number of patience. I belie
    ve he is practising in the USA. http://en.wikipedia.org/wiki/Jayant_Patel

    once again get well soon

    12/10/2007 2:41 PM
  • Gravatar
    # re: rant: state of american health care


    Sorry about your wife. When I read the part about her getting hit by a car I was scared. Despite all this she is ok?
    I had a weird incident recently which I don't understand. I read a couple of the claims from some a test I got done and oral surgery. It looks like the people that did the test deliberately claimed more than the bill really was, so the insurance company would give them more money and I ended up paying $20. When they said at first I was going to need to pay $200. Then on my oral surgery they tell me I only need to pay $394, then I get sent another bill for $576. I looked over all the insurance information for the pre-claim information and it really looked like I was supposed to pay $576. So I get ready and call them up to hand over the money, but they tell me my insurance company paid it out in full. Overall a very odd few situations. I've had this issue before where the insurance company sends me one number and does another thing or doesn't do what they told me in the first place. None of it makes sense.

    12/14/2007 7:52 AM

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