Not Covered

We’re done for.  I’ve said it before and my position only grows stronger.  In a past post called Healthcare Will Kill Us All, I explained the process it took from telling my primary care physician that I felt I’d torn my biceps, to finally getting to the surgeon five months later who said, “There’s nothing I can do now.  Why did you wait so long to come and see me?”

Searching for Joy

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In my opinion, when it comes to healthcare, here’s the bottom line:  If your doctor says you need a certain medication or procedure, but your insurance company—a company created to make a profit—says you don’t, then guess what?  You don’t get it.  Your healthcare is in the hands of someone who weighs your needs based upon whether they will lose money on you or not.  It has nothing to do with your healthcare needs.

And the Affordable Care Act took that power and gave it to the Federal Government.  The same people who brought you the Internal Revenue Service.  Try going to them to appeal your need for a certain procedure.  The motto for the ACA should be:

The Affordable Care Act.
The efficiency of the DMV,
And the compassion of the IRS.

Here’s a personal example.  Last autumn, I had to have photographs of my retinas to see if I might have diabetes.  I was sent to a facility about 25 miles from my house.  (I later found out that there is a similar facility, covered by my plan, about three miles from my house.)  My doctor had told me to call to make an appointment for about four weeks following the photographs, so she could go over my results.

doctor-old timeI did.

Or, at least, I tried.

I called the toll-free “appointment line” for my plan.  First the recording said, “It’s flu season.  We are offering free flu shots to…” and then they blabbed on with details and instructions for at least a full minute.  When they were finished, I poised my finger to depress the soon-to-be-specified number.  Instead, I heard, “It’s el flu-o del season-o…” and then I got the entire speech in Spanish for more than a minute.  Once that was finished, I depressed the proper number and was informed by the automation that they were closed for Columbus Day.  I supposed it was too difficult for them to tell me that at the beginning.

I called back the following day, listened to the spiel about flu shots in two languages and (eventually) connected to the person who could schedule an appointment with my doctor.

Now available in Paperback and for Kindle!

Now available in Paperback and for Kindle!

“I’d like to schedule an appointment with Dr. Strangelove.”

“I’m sorry.  They haven’t released her schedule yet.  All we can do is suggest you call back tomorrow and try again.”

I did.

This time I remembered the specific number I needed to depress to schedule an appointment and immediately pressed it.  Of course, the automation wouldn’t accept it until I had listened to the two minutes about flu shots in two languages.  I then had a brief conversation with the scheduler who informed me that my doctor’s calendar was still not released.

I did this daily for two weeks.

By then it was six weeks since my original procedure and, though you may find it difficult to believe, I was growing frustrated.

doctor-old time 2I finally got the bright idea to search the web for the actual clinic where I receive my modern-day equivalent of healthcare to see if I could find a direct phone number; thereby bypassing my HMO and then, perhaps, discover why they weren’t releasing my doctor’s schedule.  Once I accomplished that, I waited through their recorded menu and depressed 4 for one of their helpful personnel.

“Thank you for calling the County Dungeon of Doom.  How may I help you?”

“Yes.  I’ve been trying for two weeks to schedule an appointment with Dr. Strangelove and they keep telling me her schedule has not been released yet.  When will that happen?”

“Oh. She doesn’t work here anymore…”

Bang-HeadWith my forehead, I made a minor depression—one might call it a hole—into the wall of my bedroom and then got the name of the new doctor.  The woman transferred me back to the main appointment line where I learned that it was flu season and they were offering free immunizations and el shot-o’s.  Once through to my scheduler, he was able to squeeze me into my new doc’s schedule in only three short weeks.

I arrived a bit ahead of my scheduled appointment time and waited only two-and-a-half brief hours to see the new doctor who glanced at my files and said, “There’s no problem with your retinas but your blood pressure appears to be elevated…”

Everything after that is kind of black.

Bill sig blue

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