Friday, June 10, 2005

Socialize Medical Insurance

Does it take a brain surgeon to figure out this is a good idea? Countries with better medicine than us do this. It's so the doctors and the insurance companies don't fuck us over!! They have lobbyists. All you can do is vote. Take this true scenario:

In January, I go into the doctor's office to treat a cough. Doc says it's probably bronchitis, so here are some anti-biotics. Your lungs sound fine. But, just in case you are a 29 year old non-smoker with lung cancer, let's run a chest x-ray and a blood test. X-ray = clean = $50. Blood test is fine, but you have an abnormally high liver enzyme count. Let's run another blood test. Same problem. I have no idea, so let's order you an ultrasound.

Hold on doc. Everytime I come here, it's a two hour wait, and you want me to go to the hospital for an ultrasound. Let me get a 2nd opinion. Hey Doc #2, I am coming from Doc #1, can you help me? Doc #1 fax my records to doc #2. Doc #2 make sure you get the fax from Doc #1. Doc #2: Records, we don't need no stinkin' records.

Doc #2, says, why don't we get you a blood test and an in-office ultrasound. OK. 2 out of 2 doctors recommend, so why not? Doc, will my insurance cover it if you recommend it as a preventative test? "Yes. Yes they will." So just on my word of what the first Doc said, without any tests or symptoms, he orders an ultrasound. They use the term "order" because you're supposed to do it. It's a liver, not a fucking car where you can argue with the mechanic and call AAA later.

Guess what? Ultrasound is clean!!! But I've had the blood test before the ultrasound results are back. The blood test comes back with a "marginal" liver enzyme count. Doc #2: "You can consider this normal. Don't worry about it." Could we have possibly done that test (which included Hep A-Z and Lupus) before ordering the $250 ultrasound?? OK. Whatever, I'm healthy. Where's the beer?

Two weeks later, I get a letter from the insurance company. I have to pay up to my deductible on the ultrasound, my doc's considered a "specialist" when giving ultrasounds, and the in-office procedure is considered an inpatient hospital procedure!! The insurance company operator tells me it's MY responsibility to make sure the doctor bills the insurance company properly!! How many fucking times has a doctor got your signature on a bill before it goes to the insurance company? The doctor's assistant then tells me it's MY responsibility to make sure the doctor is not ordering unnecessary tests. Just because I watched E.R. before it sucked, doesn't mean I'm going to gamble with my life, bitch.

Simple solution: When a doc orders a procedure, get an estimate from the insurance company BEFORE the procedure is done. Just like you would at a mechanic, a repairman, or any other person who's likely to use their knowledge to fuck you over!