Post Written While On Hold (I Hate Our Health Care System)

I need to see a dermatologist about a funny dot of skin under my eye. My doctor tries to expedite a referral. But I have to wait two weeks for it to arrive. The number on the sheet that arrives yields a busy signal every day for a week. I call back my primary and am told that my doctor isn’t authorized to make a referral to a dermatologist and I need to call my insurance and get temporarily assigned a new primary care physician in order to get a working referral. Call my insurance (wade through interminable voice-activated phone tree, which of course does not transmit any of the information I’ve entered over to the worker who ultimately responds), who has no idea what I’m talking about. I give them number of my doctor’s office, he puts me on hold, calls them, I wait on hold for 11th time today. He gets back to me, then says my doctor doesn’t exist. He names a doctor I had two years ago, not my current. Everyone totally confused. Finally it’s (presumably) straightened out. Now I just have to wait another week for a replacement referral sheet and then make the appointment.

Seems like this kind of stuff happens every time I need to do anything in our medical system beyond having my blood pressure taken. And yet people continually refer to our health care system as “the best in the world.” I don’t get it.

Music: Sunny Ade :: Ja Fun Mi

15 Replies to “Post Written While On Hold (I Hate Our Health Care System)”

  1. Your healthcare sounds horrendous. Here in Australia, we currently have universal health care, with a subsidised prescription drugs scheme where govt. buying power keeps the prices down. Everyone loves it, but the govt. is trying to increase the dependency on private health insurance, cut back on the prescription drug list and generally move more towards a US model with the attendant astronomical prices, all the while portraying it as the best thing for the people! Thankfully the populace see through the screen, though I’m sure they’ll present the same thing in a number of different guises until it gets through…

  2. Sorry to hear about your health care problems, Scot.

    What type of health care plan do you have? An HMO? Do you think your problems are the result of the health care plan or just the lack of an adequate number of health care providers in your area?

    Over here in North Carolina, we have PPOs which are like HMOs except we get to choose our own primary care physicians, specialist, etc. Of course, the rates are lower if we choose a provider that’s “in the network”, but just about every doctor we’ve ever seen has been in the network.

  3. of course it’s called the “best” in the world, because we’re americans! like general jay garner said about the invasion of iraq, we should look at our health care system and beat our chests and say, damn i’m an american!

    imagine the difficulty you face accessing medical care and then imagine if you were much older and you had many other health problems, and limited or no insurance, and on and on.

    we are being sold grand larceny. grand because it involves deception and manipulation and assault. an assault on people who need health care, i.e. all of us. we could share this cost according to our wealth, but that wouldn’t be fair to the very richest people in our fine nation because they’ve worked harder for their money than we have haven’t they.
    why should they pay for the care of a bunch of losers like us?

    canada is looking more and more attractive, especially w/ global warming:

    “North of the border, the Canadians said:
    Universal health from cradle through nursing home;
    You don’t have to see a bill;
    We’re going to do it on 10% of the economy;
    We’re going to spend 11 cents per dollar on administrative costs;
    We’re going to give you the freedom to choose your own doctor and hospital;
    We’re going to relieve the anxiety of losing a lifetime of savings to an illness.

    Down South of the border:
    We’re spending 15% of our economy and we’re not even covering everybody, almost 50 million uninsured and millions grossly under-covered;
    Worrying about pre-existing conditions, co-payments, and other fine print, to take away your right to bring these HMOs to justice after they deny you health care;
    24 cents on every dollar on administration, not to mention $100 billion in billing fraud every year;
    And more and more we can’t choose our own doctors and hospitals, so were losing our choice.
    And they’re telling us the Canadian system is no good.”
    —-Ralph Nader, Source: Horace Mann Middle School, San Francisco May 3, 2000

  4. In addition to being The Computer Guy at my office, I’m also the Benefits Administrator. If one of our employees so much as changes a phone number, it becomes a bureaucratic nightmare. “That person doesn’t exist” is actually a common problem. The solution to which is almost always, “Oh wait, I was looking at the wrong screen. Ha ha.”

    Worst is when an employee leaves and wants to continue their coverage. Then I have to coordinate communications between this office, where no one (including Yours Truly) knows nothing about how The System works, our mega-huge national HMO, the state government, and the federal government. Benefits administration, more than anything else in this job, has been my curse, my albatross, and my number one reason for almost quitting.

    I often feel like I’m in Terry Gilliam’s Brazil. I fully expect to one day get past a half-hour series of decision paths on a phone tree only to have someone inform me: “No no, you’ve reached Information Services. You want Information Retrieval.”

  5. A colleague and I were just commenting today on our relative happiness with Kaiser, perhaps the most-maligned health care provider in the West. It has its problems, to be sure, not the least of which is that they’ve let it get overcrowded. It feels a bit like a factory, at times. But after 12 years of medical care at Kaiser Oakland, including two births and other assorted semi-major events, I can’t recall a majorly bad experience like Scot just described. And my co-pays and prescriptions are a measly three bucks. Amazing.

  6. I’m on my third insurance program in the three years I’ve work for my university. I’ve had to pay more into it both for premiums and co-pays but have never received poor service at any of the companies. The new program allows me to go to specialists without referrals. The way the company is keeping people from abusing that option is by making us pay a 20% copay. A specialist is definitely more expensive than a gp.

    Scot, I would suggest that you mention your problem to your benefits administrator. I’m sure other people are having similar problems. If enough people complain maybe they’ll change insurance companies.

    As for Canadian health care I just heard from a friend that she had to wait three weeks to get her test results. Yikes!

  7. Mark, I’m struck byone of William Anderson’s arguments: If health care should be egalitarian, shouldn’t everything? Why stop at health care? Should it not be allowed to have expensive and cheap restaurants? Expensive and cheap housing? Expensive and cheap transportation? It’s an interesting point: Before we can talk about nationalizing health care (which was NOT the point of my post), we have to satisfy the question of why health care is special/different from other categories of basic human need.


  8. Rinchen, if Nader’s numbers are current/accurate, then it sounds like nationalized health care really *does* save a ton of money system-wide. William Anderson (Mark Odell gives his URLs above) refutes this, but I wonder if he’s seen Naders’s numbers?

  9. Javahead, certainly no lack of providers here. I think my problems are an artifact of too much bureaucracy, too many rules, too much paper, too little integration. I’ve heard people with Kaiser and PPO plans complain just as loudly.

  10. WebSwim, I actually lived in Australia for a year in 1983 and remember having *great* encounters with the nationalized health care there. $8 for a visit, no matter what, and i wasn’t even a citizen! (though I would call that a bug in the system – not paying taxes, I should not have been entitled, but there you go).

    I would be intersetd in seeing a comparison of Canada’s and Australias’ nationalized health care systems.

  11. gattaca, I’d kill to be able to see specialists without referral, though 20% copay seems steep.

    I’ll definitely be talking to my administrator, see what she has to say, find out whether this kind of experience is common.

  12. The 3 main objections to nationalized health care are:

    1. Inefficient national bureaucracy. However, we must ask ourselves why less wealthy nations, e.g. Canada, and many European countries are able to provide health care to all their citizens (and visitors as Scot pointed out). Perhaps, those who favor managed care (HMOs) would like to privitize the US Postal Service?

    2.Lack of choice. Actually Canadians, according to Nader, have more free choice regarding Physicians. And obviously, if you are one of 50 million uninsured Americans, you don’t have free choice.

    3. Unfair tax burden. Let’s consider that for a moment in light of the distribution of wealth in the U.S.:

    “The top 1% of Americans own as much wealth as the bottom 95% percent. 
    Source: Edward N. Wolff, “Recent Trends in Wealth Ownership, 1983-1998,” April 2000.

    The total wealth owned by the top 1% of Americans is equivalent to 200 times the total combined wealth of the bottom 40%.   (Or, the top 1% owns 200 times the wealth of the bottom 40%

    Bill Gates, America’s richest individual, alone has more wealth than 40% of the U.S. population combined, or 120 million people.

    The top 1% of households own almost 40% of the nation’s wealth.
    The top 10% of Americans own over 70% of nation’s wealth.
    The top 20% of the nation’s households own 85% of the nation’s total wealth.
    The top 60% of households own almost 100%, or 99.8%, of the nation’s wealth.

    The bottom 40% of households own one-fifth of 1% (or 0.2%) of the nation’s wealth.

    The bottom 80% of Americans own only 15% of the nation’s wealth.”

    In answer to Scot’s question re: why is health care a social need vs. a personal privilege (like eating expensive cheese):

    Because our society can provide health care (see Canada, Europe, etc), and because compassion for the sick is basic.

    If someone is bleeding, I would hope most people who would try to stop the bleeding (if within their power).

    On the other hand, do we really feel everyone should have access to the most expensive cheese? Does everyone like cheese? No. Does everyone want to stop bleeding? Yes.

  13. Freinds Don’t let friends have Kaiser!

    They are a “Not-for-profit”, not a “Non-Profit” as they would like to Spin themeselves in their Slick Expensive Ad Campaigns, of which they have a HUGE AD budget to try to brain-wash people of their ‘bennevolence’. Sorry , no sale.

    This Not-For-Profit is a tech qualification that allows Kaiser to escape taxation and tricks people into thinking that they are not in the Business of MAKING MONEY, which of course they are.

    Ever wonder how socialized Medicine in Red China might be? Then try the actual health-care with them, minus the slick advertising, imo.

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