Vent about health insurance and how screwed up it is

[bjl584]

I'm wondering what's going to happen when Obamacare fully kicks in. Will these problems go away, get worse, or won't much change?

The government doesn't exactly have a good track record of making things better and more efficient, so I'd suspect that the things that Steve described would become even more commonplace. I guess we'll see.

[Joan.of.the.Arch]

Exactly. They have low copays or no copays (Medicaid). It is actually cheaper for them to come see me and get a prescription than it is to go to the store and buy a bottle of generic cough syrup or a bottle of ibuprofen. But those visits aren't free. The insurance company is paying their share of the charges.

Errg. I got dragged into the silliness of a doctor visit for a reason like that. An acquaintence called me from across the metro area to help her get her child to a hospital clinic because the child's school said he could not come back until a skin issue was addressed.

So I drove the 20 miles to get them, about 18 miles to the hospital, 18 miles back to their apartment, and 20 miles back home. All the kid needed was a flippin' tube of clotrimasol (antifungal). $1 at the dollar store she could have walked to.

Instead-- it took my time, my car and gasoline, her time, the kid missing school, the school nurse and secretary to make the phone call to the Mom, the clinic staff, the doctor, the pharamcist at the hospital, and the Medicaid payments! She even already knew what the infection was. Just wanted to not spend a dollar for the treatment.

Thank goodness parking at the hospital was free.

[Baby_nurse]

To be fair, I've had to take my daughter to the blasted doctor's office and pay my co-pay because the school wants a note from them saying my daughter has a fever before they will excuse her absence.

[disneysteve]

the child's school said he could not come back until a skin issue was addressed.

To be fair, I've had to take my daughter to the blasted doctor's office and pay my co-pay because the school wants a note from them saying my daughter has a fever before they will excuse her absence.

Yep. That's a problem too, when schools or workplaces insist on a doctor's note before someone can return. I'm sorry but if you have a cold and you miss a day of work, you don't need to be seen by a doctor. If you go out and pull weeds and get some poison ivy, you don't need to see a doctor. If you get a stomach virus and miss a day because you were home being sick, you don't need to see a doctor. But if your school or job requires a note, you're stuck going to the doctor. It's a waste of your time and the doctor's time and insurance money. It drives up healthcare costs for absolutely no reason.

[JoeP]

Yep. That's a problem too, when schools or workplaces insist on a doctor's note before someone can return. I'm sorry but if you have a cold and you miss a day of work, you don't need to be seen by a doctor. If you go out and pull weeds and get some poison ivy, you don't need to see a doctor. If you get a stomach virus and miss a day because you were home being sick, you don't need to see a doctor. But if your school or job requires a note, you're stuck going to the doctor. It's a waste of your time and the doctor's time and insurance money. It drives up healthcare costs for absolutely no reason.

When I get poison ivy, it takes a very long time (sometimes over a month) for it to go away, and the continual applications of calamine, the non-stop itching, and ingestion of benadryl makes me crabby. For me, the $30 co-pay and $4 rx for prednisone is money well-spent; I get cured within 3-4 days.

If only this was available OTC! Maybe there could be an option where I can pay a non-doctor person $10 cash to verify that I actually have poison ivy in order to get Official Authority Clearance to get the rx.

[disneysteve]

When I get poison ivy, it takes a very long time (sometimes over a month) for it to go away

Certainly there are times when "minor" illnesses require professional care. I was just making the point that many people go to the doctor without even attempting any self care or trying to wait something out. I'll often joke with someone that if they do nothing, they'll be better in a week but if I treat them it will take 7 days. It always takes them a moment to figure that out.

[hamchan]

There are a lot of skinny people with diabetes and healing wounds is a huge issue for people with diabetes.

I realize that. But it was only a couple of weeks after the surgery and as I said it was a minor infection that cleared up quickly once it was drained and cleaned. If it had not gotten better in a few days or if I had other symptoms, OK I would see the point of running my blood sugar. But under those circumstances it was just a waste of my time and money.

[disneysteve]

I realize that. But it was only a couple of weeks after the surgery and as I said it was a minor infection that cleared up quickly once it was drained and cleaned. If it had not gotten better in a few days or if I had other symptoms, OK I would see the point of running my blood sugar. But under those circumstances it was just a waste of my time and money.

There are about 26 million Americans with diabetes. There are another 80 million with pre-diabetes. That's 106 million people total, about 1/3 of the population. Screening EVERYONE for diabetes is well worth the cost. You don't need to have symptoms. Most patients who I diagnose get picked up on routine labwork. They feel perfectly fine - no signs or symptoms of the disease, which is exactly when we want to catch it and start treating it, not after they already have problems due to untreated disease. So I'll have to respectfully disagree about diabetes testing being a waste of time and money. It wouldn't have been such a waste had it come back positive (which there is a roughly 1 in 3 chance of).

[hamchan]

When it's my money paying for all these test I'd prefer to take a more conservative approach. If it walks like a duck and talks like a duck it's probably just a duck. Let's just say that I had been diabetic. And let's say the doctor had just cleaned it up and told me to call her in a few days if the infection didn't improve or right away if it got worse. I'd have still found out very quickly.

[Baby_nurse]

You got lucky it was a duck. Not everyone is so lucky, which is why most of us tend to seek out people who are trained to tell a duck from a zebra.

It's always your choice to decide whether or not to follow recommendations. No one can force a test on you. You also have the right to tell your doc that you need to check with your insurance company first to find out what is and isn't covered. Get things pre-authorized so you know how much something is going to cost you out of pocket.

Personally, when its me paying for it, I err on the side of caution, especially where my kids are concerned. Do I yield all power to my physician? Of course not. But just because a physician recommends a particular test or treatment doesn't mean they are trying to squeeze more money out of me.

Like I said before, take the time to find a physician who shares your philosophy on diagnostics, treatment etc. Everyone has a good match out there if you take the time to do your research. If you don't understand why a doc is ordering or recommending something, ask. Ask if there are alternatives. Ask for a second (or third) opinion. You will get your best care when you are an active participant.

[shaggy]

Could we please stop judging people who seek medical care for supposedly minor ailments? If they knew they were minor, they wouldn't have to see an expert.

And when I get exposed to poison ivy, I go into anaphylactic shock.

[hamchan]

My choice of doctors is pretty limited due to my insurance coverage and my lack of a car. And I have tried to get costs up front in the past to no avail. The most they can tell me is whether or not it will be covered.

[disneysteve]

Could we please stop judging people who seek medical care for supposedly minor ailments? If they knew they were minor, they wouldn't have to see an expert.

And when I get exposed to poison ivy, I go into anaphylactic shock.

Again, there are patients who need care for "minor" ailments, and like you, they generally know who they are. That's not who I'm talking about.

[shaggy]

Again, there are patients who need care for "minor" ailments, and like you, they generally know who they are. That's not who I'm talking about.

My point is that they might NOT know who they are. Some people will go see a doctor for every fever or stomach ache because they know that sometimes it might be a sign of something serious. Explaining to them that it's minor, and how to tell the difference when it's not, is part of a doctor's job. The patient did not go to medical school.

I admit I have a dog in this fight. My best friend died at 42 because he didn't seek medical care for what he thought was a "minor" muscle pull in his shoulder. He'd had a heart attack and died five days later with the phone in his hand, calling 911.

[disneysteve]

My point is that they might NOT know who they are. Some people will go see a doctor for every fever or stomach ache because they know that sometimes it might be a sign of something serious. Explaining to them that it's minor, and how to tell the difference when it's not, is part of a doctor's job. The patient did not go to medical school.

True, and that is actually something that there is a big push for today - keeping people out of the ER for minor problems. Studies have shown that up to 90% of ER visits are for non-emergent problems. Insurance companies and doctors are working together to better educate the "frequent flyers" who go the ER frequently rather than calling their doctors. I'm involved in a couple of different groups working to lower healthcare costs and this is defiinitely part of that effort.

The problem is that especially once the Affordable Care Act goes into effect, there will be even more people in the system and doctors are going to be overwhelmed.