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

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

I told me so

November 28, 2011

It was hard to admit that I needed to take a medical leave of absence from work.  A part of me knew it was necessary, but another part kept questioning if I really needed to do it.

When my doctor asked me how long I thought I’d need to be out, I said 2-3 months, but hopefully only 2.  I said that to everyone: hopefully only 2.  I even said that to myself.  I was trying very hard to ignore the little voice in the back of my head that was saying I would need at least 3 months.

We talk about the “masks” we wear, the image we try to project for the sake of others.  But what about the lies we tell ourselves?  Denial is a powerful thing.  I have been in denial over many things in my life, from my own health, to the health of loved ones, to job conditions, to sexual orientation.  Denial is powerful, and lately it has had a lot of power over me.

Yes, I knew I wasn’t getting better as quickly as I expected.  Yes, I knew I wasn’t where I needed to be at this point.  I thought about these things, but I didn’t accept them.  That little voice was pointing them out, but I kept ignoring it, trying to believe that the little voice was exaggerating everything, that my symptoms really weren’t that bad.

This evening I spoke with my doctor.  The short term disability insurance renewal paperwork is due next week, and she wanted to see when I would be returning to work.  The original goal was January.  That is looking very unlikely now.  Even typing this out, it’s hard for me to admit the truth.  Telling her everything was extremely painful.  I had to admit my lack of progress, my increasing pain, my difficulty sleeping, my weight gain…. all of it.  Finally, the denial was gone, and I had to admit the truth.  That conversation was excrutiating.

When I got off the phone I cried.  Actually, I sobbed.  I was probably a month overdue for that crying session.  I don’t cry often, but this was a good time for it.  And in the back of my mind, there was that little voice, reminding me that I had really known all of this all along.  It had told me so.  It knew.  I knew.

Goodbye denial.  Until next time.

 

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Leave a Comment » | Decisions, Expectations, Fatigue, Frustration, Isolation, Medication, Pain, Rants, Symptoms, Unpredictable | Permalink
Posted by chronicrants

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