professornana (professornana) wrote,

health care makes me sick

Some background: I have the best insurance offered to state employees (HMO through BCBS of Texas) and pay a premium for it and my family (cost nets out to about 20% of my salary for health, dental, life, etc.). Two months ago, my knee gave out on me as I walked back from a meeting on campus. It just stopped working. I could not step without excruciating pain (and I do have a high threshold for pain despite my whining). I had to call an ambulance to comer and get me even though I could see my building from where I sat (no longer able to stand). Short ride to the local ER. Offloaded into a bed. Waited to see the resident. She looked at the kne, listened to my story of the events, commented it sounded like a torn cartilage. However, they elect to do an x-ray despite them telling me point blank that it will not show anything unless I shattered the knee (and they knew that was not the case, no falling involved here). X-ray shows nothing. They bring me aspirin (which I had in my purse and could have taken on my own), gave me a leg brace and crutches. Told me to follow up with my primary care physician if it did not improve. Collected their deductible and let me go.

Ten days later, I see my own doctor. He looks at knee and thinks torn meniscus. Orders MRI and asks ER to send him their report (of course, there is nothing that happens without more paperwork). MRI scheduled for my next free day (a week). Now, I am in Albuquerque at the YALSA conference when the report of the MRI indicates a large tear. Now, I need to talk to an orthopedist. Ortho will not see me until they have referral form (FORM) in hand. Two more weeks. Now, I am at NCTE.

Return from NCTE (where everything involves long walks) and see ortho guy. Yep, it's a tear. Need to do some arthroscopic surgery once I am off meds I am taking for a whole other issue (and that is a longer and sadder story than I care to share). So, now we wait.

Bottom line: between October 14 and today, I have received my share of what the insurance does not cover. Here are the highlights:

$150 co-pay at ER
$200 balance for the ER doc who saw me for 5 minutes
$100 for other ER costs not covered
$20 co-pay for PCP
$100 co-pay for MRI (with more to come given my knowledge about these things)
$40 co-pay to ortho guy
$40 balance from ambulance ride (something about a sterile kit?)
$2.44 (yesm that is right) for X-ray costs not covered

And I know there is more to come. While I am in good financial shape (lots of workshops done this year plus some book sales and savings), I cannot help but wonder about those for whom a trip to the ER like this means no Christmas or Christmas on credit card. I am squarely middle class and can absorb these costs and still buy the resident of the back bedroom what she wants and needs. But I am fortunate. And in a small percentage of people who can afford this sudden yank on the wallet. And there sit the fat cats in DC and the lobbyists for the various companies waiting and doing nothing except threatening to take away the little Obama's bill provided. It's enough to make you sick.

BTW, the knee? I asked the ortho guy what I should do between now and the surgery (maybe in the spring) and he suggested a walker. Oh man, if I were feeling better, I would have slugged him. So, I take some aspirin and use heat patches and try to walk and move slowly. I think a staff a al Gandalf is more me. What say you? I will tell you that I used a motor scooter at the "Magic" Kingdom when we took the resident there. She loved it as we moved to fronts of lines effortlessly. Must admit I liked it better than the 90 minute wait in line as well. Resident says we should do that all the time. I would rather have my knee working, thank you. Maybe later...

ETA: Thanks for all the comments and for the support for the Gandalf staff/ I wanted to add here that therse expenses are mine after insurance pays (and we are not done yet, I know). I also get to see what my insurance is sending these folks, the bills people without any insurance would be receiving. For them, out of pcoket for a torn up knee is $10-15K already. When I think about that, I truly do feel queasy. And, of course, I love seeing itemized bills that include things like 2 Tylenol at a cost of nearly $50. I buy generic and, even if I popped for the real thing, I think I could bring it in under $50 with little effort.

AND I am not being critical of the health care providers. Bless them as most of the ones I have encountered have been as frustrated as I have with all the rules...

To end on a happy note: the newlywed comes this afternoon to help me put up the tree and hang stuff back on the walls we had painted several months ago. Then we head off to see resident play first chair flute in region/district bad. She has her newest patch on the letter jacket (Orchestra for region and district) to show the others she deserves to be first chair. Missed last concert as I was in Mickey's "magical" maze. Get to see this one. And tomorrow the faculty come here for our Christmas celebration. Happy times.

Tags: avoid, medical issues, medical tales, rants, woe is me
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