Just Health

NTTAWWT!

well, you found us out. I just like to call him Susie....

Glad to hear you are back home Phred.

Hang in there FLL

Glad and grateful to discovery that I still have sufficient dexterity and eyesight to change the RAM in a pre-unibody MacBook Pro.

Grats! That's always fraught with peril for me.

So, hijacking the thread slightly... if you all have time, let me know:

1. what your top frustrations are in dealing with medical bills

2. same for dealing with health care providers

3. same with dealing with health insurers

What do you spend most of your time doing? What records do you keep? What records do you most often access?

ddt

The most frustrating thing is that whenever I change my primary doctor, even within the same medical group, I have to fill out a complete medical history. I also wish there were more things that I could do without doctor intervention. For example, I need to call my doctor's office if I want to get blood test. If I want to know my cholesterol, why does my doctor get to say when I get the test and why do they deliver the results to them?

My main frustration with bills is never being entirely certain if this is a notice of charges for my records, a notice of charges paid to my provider by the insurer, a notice of a balance due after the insurance has paid as much as it intends to, an outright bill requesting payment, or some combination of the above. I am never sure what stage of the physician/insurer dance the paperwork is coming out of.

My main frustration with my health care provider is a complete lack of pro-active care. Aside from me periodically demanding an overall physical, they make no attempt to do anything other than treat whatever immediate issue drove me to go to my doctor. I am 50, I have never had a prostate exam, or been offered one. (Not that I am looking forward to one. NTTAWWT.) Oh, they did tell me to lose weight, so I did.

My main frustration with my insurer is getting repeated demands to explain how I came by an injury, an almost explicit demand to tell them who they can sue for payment, so that they don't have to pay for my health care. I have had to answer inquiries about how I came by calcium deposits in my shoulder ("I woke up at my home, in my bed, and my shoulder hurt."), my torn rotator cuff ("I woke up at my home, in my bed, and my shoulder hurt."), etc. My wife got quizzed about her broken thumb. I don't like to (apparently) be party to extortion-through-litigation. I don't like to write up essays on how I came by injuries. I have never had any problems with payment, nor have they disputed my claims.

Another (non-systemic) issue is that for my HMO I pay extra to cover my wife and children. It has a $1500 lifetime orthodonture level. My child needed orthodonture, it was November, and my company was changing HMO providers in December. "A perfect storm," thinks I, "I can get some work done now, on this policy's lifetime cap, and then start over with the new company in December, with a new cap!" We got the work done, and the HMO refused to pay, based on the fact that they were not going to have the contract going forward. WTF?! I paid for the coverage for years, and then when I finally needed it, I couldn't get it. Because they were not going to be covering me... in the future! Aaargh. I never got it straightened out and had to eat the expense.

DPBD. There is a hell of a lot of fraud going on in the medical industry. Not just patients defrauding physicians, but physicians (and chiropractors, and dentists) defrauding the government and the insurers. Most of it (at least, when I was involved in trying to fight it) was made possible by the AMA's refusal to tie doctors and practices to a single ID. This allowed physicians to submit multiple claims for a single procedure, or for more procedures than they physically had time to perform. I've ranted about this before, and the system has doubtless changed since I was involved, but there is a LOT of money being spent to preserve the loopholes to defraud insurers.

TPBD: Another issue with my provider: They changed record-keeping schemes, and suddenly they had no idea what my history WITH THEM was. They didn't know what they had prescribed me, what medicine I was allergic to, and... this really hurt... my high score on the office scale. They didn't even have access to the old data, or at least didn't want to admit that they did. I have no idea what blood pressure medicines I tried before we found one that worked. So if I ever have to switch, I have to cycle through them all again.

Also, I can fill prescriptions locally. Once. All refills have to be obtained online via an annoying, ever-changing, but not-to-hard-to-figure out process. For some reason, they renew a 90-day prescription about every 75 days. The medicine is starting to pile up. How the hell is this helping anybody? I guess that I could build a little fort with the bottles.

I don't have a lot to complain about. My only real beef is with the insurance company and the federal government.

I have ADD and because my medication is a controlled substance, refills aren't allowed. Each refill requires a new prescription and it must be a physical piece of paper. The doctor can't phone it in to the pharmacy.

That is the government's fault.

It wouldn't be so bad if the insurance company let me get more than 30 days worth of medication at a time. Instead, I have to get a new written prescription from my doctor EVERY MONTH.

Keep in mind, this is to treat a condition where patients are extremely likely to procrastinate or just forget about things until the last minute. It also sucked when I had to LEAVE THE COUNTRY for 6 months and could only return once every two months. Might have been easier if I could have had family members get the script filled and mail it to me but I think I explained before how unreliable package delivery was for me there... not to mention the fact that it would technically be illegal for them to mail that substance to me there anyway.

It sounds like our new plan may allow me to get a 90 day supply if I go through their mail-order provider. I have to look into that.

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ddt
1. what your top frustrations are in dealing with medical bills

2. same for dealing with health care providers

3. same with dealing with health insurers

What do you spend most of your time doing? What records do you keep? What records do you most often access?

1. None - Kaiser doesn't have bills.
2. Umm... I have to take time out of my day to see one?
3. None - provider & insurer are essentially the same thing at Kaiser.

I don't spend much time on healthcare. I don't keep records - Kaiser has everything stored electronically back to my birth, and lets me know when my next immunization (or whatever) is due. I could access everything online, but don't really have any reason to do so.

You're a lucky man, James. May it continue so.

I shred pretty much everything my doctor sends me that isn't a bill (or refund!)

most frustrating is that there are people that insert themselves in between me and the doctor. When I got out on my own, I paid my doctors bills AT THE DOCTOR. I quickly learned that cost me more, because the insurance would not refund all that I had paid. SCAM! Just let me pay my doctor, they can lower their prices or work pro bono (major crap) or take my daughter in payment.

There's been some interesting drama in Minnesota lately regarding health care. Read this:

http://goo.gl/vEZkS

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I have ADD and because my medication is a controlled substance, refills aren't allowed. Each refill requires a new prescription and it must be a physical piece of paper. The doctor can't phone it in to the pharmacy.

I have that problem because I take valium. I'm not addicted in the sense that I need it to "chill out", I'm on a small dose and only notice it when I don't take it for a day or two - my back seizes up like a rock. Because it's an addictive substance they don't can't give out repeats (fair enough). Luckily I have a GP that'll let me call the reception and they'll write out a repeat without the need for a pointless visit to the quack...

Reading through your dramas (with the exception of James who seems to have landed the uber-health benefits scheme) - why are your panties so twisted in a bunch about socialised medicine? There really aren't any "death squads"...

Even if you don't want that, every country should consider a scheme like this. Big Pharma HATES it, which is proof of what good social and economic policy it is.

My health care in Massachusetts was very nice. They booked me a cab to the MRI I didn't need without asking. Just went along and everyone made their money.

I haven't used health care in a while, though I probably should. I read http://blog.jayparkinsonmd.com for a great vision of how health care can be. His startup, Sherpaa, even addresses James' one complaint - the first step is online support from a doctor.

i can't remember, is it allowed to complain about a current, hopeful fleeting, mental state here?
I am a touch blue. Work has really sucked this week. I only compound the issue by sucking the most.
sigh.