Wednesday, August 08, 2007

I Feel SiCK

Today I received the Summary of Benefits for my stay in the hospital for my transplant. This does not, nota bene, include any blood products (including the stem cells themselves or their collection), any outpatient visits or medications before or since my stay, or any care provided by any doctor not employed directly by the hospital itself, ie, by the cancer clinic next door (guess who employs my doctor?).

So "summary" is a bit of a strong word. It's more like a level 1 subtotal, with levels 2-5 to follow, to be further followed by a final grand total summary when all is said and done.

Ladies and gentlemen, I give you:


As the cliche goes, "that's not a typo."

I don't know about you, (and since you'll note that most people who are sick are not able to work/earn a real living), but if I didn't have insurance, this entire year would bankrupt me. [My medications alone are about $3,000 per month]. In fact, that bill alone would bankrupt me. In fact, the cost of blood products and the stem cell-related stuff alone would bankrupt me. And that would be my best option: to file for bankruptcy and hope the hospital would forgive the debt or give me a 40-year payment plan.

Thank you God that I have unbelievably good health insurance. Thank you God that they have no lifetime maximum. I ask you, God, why I am in the tiniest minority of the American population regarding such insurance.

I challenge anyone to tell me that Michael Moore's SiCKO does not have an extremely valid point to make. Obviously, those who disagree tend to have the best health insurance and cannot fathom how a person with obvious cancer is denied a lifesaving treatment or how everything can possibly cost so much. They should feel lucky that they have what they have, rather than doubtful of the state of affairs concerning our healthcare system. I sure do. I thank God every single day--and especially on days when I receive things in the mail reflecting a quarter of a million dollars in PRELIMINARY charges--that I have the insurance I have.

So, good for me. But isn't there a larger issue with our health care system beyond the simple issue of good/bad health insurance? An issue that even those with stellar health insurance and a deep enmity for Michael Moore should care about? Isn't the issue of actual access to healthcare something we need to address lest any kind of universal coverage become meaningless? I'm speaking, of course, of the current wait times for appointments, regardless of what quality of health insurance you have. Every woman knows this one: "We can see you for your pap smear/gyn exam in October." "Oh okay. But I run out of birth control pills in May, next month [or, I have some pains in my abdomen, etc]." "Hmm...I'm not sure what to tell you. We can put your name on the list and if any cancellations arise we can call you." "Oh, okay." Rich or poor, insured or not, I am certain that almost all women have encountered something very similar to this conversation.

Even for pediatricians the wait is staggering. Luckily a lovely ped through family connections here in Boston agreed to see Bambina even though his practice was already closed to new patients. I literally lie awake at night pondering what the Hand Foot Mouth situation would have been like without a doctor to call; or worse, heading to an ER to sit for 10 hours with a sick and cranky three year-old (me, who cannot go into crowds). Or trying to get her into preschool without anyone to perform the required physical.

My transplant doctor told me just today that my dermatologist had just opened a new post-transplant specialty practice which is why he saw me within a week. "If I'd tried to get you into one of the senior dermos here it would have been three months minimum." And this is the head of transplants talking! Even he would not have been able to get me squeezed in. Imagine trolling through the phone book and cold calling! Or imagine trying to get an appointment to rule out uterine or prostate cancer, and being told to come back in November. The physical, not to mention emotional toll, is unspeakable. Surely this issue, whether we believe in universal coverage or not, is something everyone can agree needs to be addressed?

Think about it. And think about the difference in an as-yet-undiscovered tumor's size over a 3-month wait. Think about the dangers posed to a person with dementia as you wait to confirm the diagnosis for 3 months and therefore must wait for insurance to help pay any costs of care. Then think about the kid who died last year of an infected tooth because his mom couldn't get an appointment for him due to lack of insurance. It's time to recognize that just because your health situation may not be in shambles, most other people's situations are. And then ask yourself what sliver of good fortune or insurance company fine print separates you from them.

That thought really will make you feel SiCK.


Vigilante said...

Makes me sick, I'll tell you.

Ed said...

You alive. A bargain at 20 times the cost.

(I was going to use the Mastercard "Priceless" thingy, but it just seems so cliche.)

Lori Ann said...

So.... what do you think can be done about the 3 month wait for an appointment? If a doctor's schedule is legitimately full and he works more hours than the average person already, what can be done? (please read no antagonism in these questions, absolutely none is meant)
I just bring up this side of the question because my husband works his butt off, takes last-minute work-ins, hates to take time off because of the patients who need follow-ups and the workload that will be waiting when he returns. And his wait is still 3-4 months out. What can he do?

E said...

Lori Ann,

No antagonism taken. You raise a really good point for which I have no ready answer. I can't figure it out. Surely there is not a shortage of physicians, but I am at a loss.

Any ideas, anyone?

St said...

Surely there is not a shortage of physicians

I honestly think it may come down to a shortage of good physicians. Based solely on my own experience, I can get in a lot quicker with the OB/GYN I didn't like than I can with my preferred baby doctor. But then, I've never had to schedule 3 months out for something ailing me, only for the yearlies. Annoying, but not life-threatening. Maybe it's different in other parts of the country.