Scary changes in healthcare

December 20, 2011

How much control do you have over your healthcare?

Now, many of us have limited control over our health, but we should at least have control over our healthcare, right?  I don’t know what the answer is, but it can’t be this.

I read this morning about a plan by a local health insurer to reimburse patients for choosing cheaper care.  Well, that’s the basic idea, anyway.  If my doctor sends me for an MRI at site X and instead I go to the cheaper site Y, then I’ll get $10-75 from my health insurer.

This troubles me in many ways.  To keep myself from rambling, here’s a quick bullet list:

  • Will the care be comparable?  Or will patients lose out?
  • People suffering financially may put their money ahead of their health.  I admit that this is their choice, but is it really a choice?  After all, premiums won’t be cut, so this is their only chance for relief.
  • This may make it harder for doctors to coordinate care.  When I get a test done now, all doctors in that hospital system see the results.  If I get a test done elsewhere, I’d have to get the results sent to all of my doctors, which is unlikely to happen, so the burden would be on me to bring the results of all tests with me to all appointments.
  • There are already health plans that only allow patients to be seen by cheaper doctors at cheaper facilities.  How much farther will this cost-cutting expand?  I don’t get to choose my health plan – my employer does.  If they choose one of these, I might have to change all of my doctors, and it has taken me years to build up a medical team I trust.
  • If cutting costs is so important, why doesn’t the health insurer cap reimbursement payments?  Wouldn’t that make more sense?  Why reimburse one site more than another?

Really, what upsets me is the direction of healthcare changes.  Health insurers and politicians are floundering to find a way to save money and stop the skyrocketing costs to patients and employers.  There is talk of a single payer system in my state.  While I love the idea theoretically, I have seen the way it has been put into practice in other countries, and I don’t trust it.  Really, do I want anyone involved in my government to decide if it’s cost-effective for me to take a certain medication or have a certain test?  No!  I trust them even less than I trust health insurers – I guess I trust the devil I know more than the devil I suspect.  If my health insurer chooses not to cover the cost of something, I can appeal within the insurance company and also to a state board.  If the state were in charge, who would I be able to appeal to?  Costs are too high.  People can’t afford care.  Those of us that can afford it, often pay so much that we must cut back on other things (like ever being able to afford to retire.)  This just isn’t working.

We need a solution.  So many of us are desperate for a solution.  If only I had any idea whatsoever what it might be.

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Leave a Comment » | Educating, Expectations, Frustration, Healthcare, Medication, Politics, Rants | Permalink
Posted by chronicrants

The medicine of a simple visit

December 17, 2011

Knowing that I’ve been stuck at home a lot, my parents came over for a visit today.  They don’t live very far away, but they rarely visit.  Usually when we see each other it is at their house, where I grew up.  Since I’ve been staying closer to home, they came over for a visit with their pooch.

It was a simple visit.  We talked, we took a walk, we had dinner.  I pet the dog.  I played with the dog.  I sat with the dog.  It was an easy visit.  Today was a good day, and I felt up to moving around, which was great.  Having company was fantastic medicine.

When you’re fatigued, in pain, or otherwise stuck at home, remind your friends and family that visits can help.  So many of us get offers of help, but the truth is, I don’t always need help with errands or cooking, sometimes I just need some stress-free, activity-lite time with loved ones.  We all need to be alone at times, but we also all need to be around the people we care about and who care about us.  Sometimes it’s just that simple.

 

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2 Comments | Educating, Expectations, Isolation, Kindness, Limitations, Medication, Pain, Raves, Support, Symptoms, Thoughtfulness, Unpredictable | Permalink
Posted by chronicrants

Prednisone boobs

December 12, 2011

They should add “boob growth” to the warning label on Prednisone.  It can’t just be me.

This is just plain wrong.  Our society seems to think that women should aspire to have the largest breasts possible, but that’s just absurd.  I will never understand why women get risky plastic surgery just to get bigger boobs.  And why is there so much pressure on a part of our body that we can’t control naturally?  It makes no sense at all.

When I was in high school, my bra size was a very natural 34B .  This worked for me.  I could go bra-less if I really wanted to, and I could easily wear a strapless.  This was good.  Near the end of high school, my period got so heavy that one day I passed out from the loss of blood.  The doctors put me on birth control pills to regulate it.  Of course, if they had tested me they would have discovered that I had PCOS, but I had a crappy 1990s HMO that didn’t bother with silly things like thoroughness.  But that’s a story for another day.

Suddenly, because of the Pill, my size went up to a 34C.  This was surprising, but not too bad.  I knew that I was too large for my petite frame, and I felt awkward about it, but what could it do?  Eventually I got used to it and I stayed a 34 C for many years.

Then several years ago I went on Prednisone.  I’d been on it before, but this time, for the first time, I gained weight.  I grew in my stomach, my ass, my thighs…. and my boobs.  I flew past 34D so fast that I almost missed it, then landed on 34DD.  Well, that was weird.  It was also uncomfortable.  I was annoyed, but glad that I hadn’t gotten any bigger.  I was shocked to find this size laid out on store racks when I was in London around that time; over here it’s much harder to find.  Still, there are some stores that sell it for prices that won’t break the bank, and occasionally I can even find one that isn’t black, white, or beige (though I still miss my collection of pretty colors, lace, and satin from back in the days of 34C.)

After a lot of hard work, I managed to lose most of the Prednisone weight, but my boobs didn’t shrink.  When I went on Prednisone again earlier this year, I gained back all of the weight and them some!  I’m too fatigued to exercise, so I’m not losing it at all now.  Still, I had accepted the temporary (I hope!) weight gain for what it was, and I was ok with it, until my bra size changed again.  I thought 34DD was difficult, but now I’m a 34F!  That is just wrong, so very very wrong.

They’re heavy, really heavy.  My bras are huge.  The straps pull on my shoulders.  Shirts are hard to fit (because of our society’s ideal of big boobs, shirts are designed to make small women look bigger, not to make big women look smaller.)  The bigger they are, the more they sag.  If you’re big, you know about boob sweat.  If you’re small, be glad you don’t know about it.  (A smaller friend of mine thought I was making it up, until she got pregnant.  She immediately told me she was grateful for the smaller boobs she’d always complained about, and was glad when they returned.)  And then there’s sleeping.  They really get in the way when I’m trying to sleep.  I wake up during the night sometimes, because I’ve rolled over and my boobs have gotten in the way.  It’s harder to breathe (though that could be the extra weight in other areas too.)  Men stare at them more, and those probably aren’t the men that I want attention from.  And then there’s sex.  With others or by myself, it is just wrong when a boob is too big to fit in a person’s hand.  Boobs are an important part of foreplay and sex (at least, they are for me) and it’s much harder to do what I want to be done when they’re so big that they can’t fit in a hand!

Now I’ll be honest, if I manage to lose the Prednisone weight, losing it in my boobs wouldn’t be my first choice.  I’d like to lose it in my stomach first.  But boobs come second, even before my ass and thighs.  Those may not look good now, but big boobs are just inconvenient and annoying!  Damn you Prednisone!

 

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46 Comments | Educating, Expectations, Frustration, Rants, Symptoms, Unpredictable | Permalink
Posted by chronicrants

STD and SSDI: Who designs these things?

December 7, 2011

I visited a friend yesterday who was recovering from surgery.  He had built up a lot of sick time at work over the years, since he is generally healthy, so he will use sick days to cover his month out of work.  He has an understanding boss, who knows that he may need to take off extra time.  His health insurance covered the majority of the costs of the surgery.

He asked me how I’m doing, and how I’m managing to be out of work.  He meant financially.  My friend is smart and well-educated, but he got a new kind of education from me yesterday.

First, we discussed how my short term disability (STD) works.  I’m lucky to have an especially good plan.  We talked about how poorly my boss handled my exit, which makes me wonder if my reentry will be difficult.  We talked about how I want to return to work part time because I’m worried that returning full time will lead to a quick relapse.  Unfortunately, it is up to my boss whether or not I can return part time.  If she allows it, then I will return to work a few days a week, and STD will cover part of my salary for the days I don’t work.  Of course, at some point STD will run out, at which point I’ll just earn a whole lot less.  I should be able to cover all of my bills, but I won’t be able to put any money into savings.  Of course, I need to put money into savings more than ever, as I’ve realized that my body will force “retirement” on me much earlier than I’ll be able to afford.

Then we talked about social security (SSDI.)  We discussed how I may not even be eligible for it.  If I am eligible, then the application process is long and arduous.  Most people are denied and then need to appeal.  If I were to get approved, it could take two years.  For those two years I wouldn’t be working, so I’d be draining my savings account.  The amount I would get would be just a bit less than what my rent is now.  It wouldn’t be enough for electricity, gas, or groceries.

Now, let’s say I did get SSDI.  I have a fluctuating illness.  I have weeks and months and years where I feel better, then I feel worse.  When I feel better I could work.  But I’d lose SSDI and if I needed it again, I’d have to start applying all over again.  That’s why many people are on SSDI even though they are well enough to work.  They know that getting off SSDI now would be devastating if they ever needed it again.  So they stay on it even though they are well enough to work.

My friend just shook his head in sadness, thinking of the many, many people caught up in this horrible system.  And I’m one of the lucky ones: I have STD, I have family to fall back on, I have good health insurance, and I have a little money in my savings account.  I could be so much worse off.  But I am wondering how to pay for the acupuncture treatments that I just started today.  My health insurance doesn’t cover those.

When when I consider all of this, the insurances and the government “help” and all the rest, I just have one question:

WHO ACTUALLY THINKS THIS IS A GOOD SYSTEM?

I don’t know who it is, but I’d be willing to bet that they don’t need to use the system themselves.  If they did, they’d be working to change it.

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Posted by chronicrants

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