Tag Archives: health insurance

Today’s Five Things That Are Making Me Crazy – I

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It’s all getting out of hand.

1.       Congress has taken leave of its senses and is considering making rape victims who seek abortions answerable to the IRS. I mean actually go in and tell them what happened, re-live the whole experience—and let little government bureaucrats decide whether or not it’s really a rape and an abortion is justifiable. But the Right (the inventors of the lie about a single-payer healthcare system resulting in “death panels”) says it wants smaller government. I think they want smaller government when it comes to letting them do whatever they want, especially where giving allowances to stupidly wealthy corporations in which they have a vested interest is concerned or keeping the tax breaks for the rich, but they want bigger government when it comes to controlling the masses.

2.       One example of another attempt to break up “evil big government” is to deregulate Monsanto’s genetically altered Round-up Ready Alfalfa (or whatever the hell it is) so it can be fed to cattle and end up in our diets. They say it’s not dangerous…Do you believe them? I don’t believe anything that comes out of their mouths anymore! Watch the documentary film “Food, Inc.” and you’ll never eat again. Haven’t you seen little seven-year-old girls with mature breasts from drinking milk from hormone-saturated cows? I have! It’s freaky! But if you want to buy natural food, food that hasn’t been processed to death, food that isn’t loaded with chemicals and hormones—you have to be rich! I can’t afford to shop at Whole Foods! I have to eat plastic food from regular grocery stores!

3.       Not only is our government divorced from reality on the whole economic front and the high unemployment issue (which they’re just ignoring!), but they want to deregulate any kind of safety measures currently in effect for workplaces! I watched this film called “The Race to the Bottom”, a short but extremely effective piece that I saw on Truthout. There was a fire in Bangladesh that killed over 20 people, very similar to the Triangle Shirtwaist Factory fire in 1911 that killed over 146 factory workers. Like the 125 women and 21 men that died 100 years ago in the Triangle fire, the people in the fire that occurred in Bangladesh couldn’t get out of the building because the main exit was engulfed in smoke and flames; the other exit was locked so they wouldn’t steal any of the clothes they made. They jumped out the windows from the 11th floor—just like the girls in the Triangle Factory. This just happened in December 2010. The factory they worked for makes the clothes you spend a fortune on at Gap.

4.       The workers in Bangladesh demonstrated for a raise in wages—to $0.35 an hour. Gap wouldn’t give it to them! Walmart won’t give it to them! A raise in those people’s wages would be “an impediment to free trade.” The film “Race to the Bottom” tells how the wage paid to the women of the Triangle Shirtwaist Factory 100 years ago translates to a little over $3.00 an hour today. Those people in 2010 Bangladesh were beaten by the police for asking to be paid $0.35 an hour in today’s dollars! And Walmart and Gap said “No”. Now here in the good old USA, we have how many governors attempting to wipe out collective bargaining rights? It just makes me want to walk up to these guys, look them square in the eye—and kick them in the balls so hard they sound like Mickey Mouse for the rest of their sad little lives!

5.       What is with Obama? Whose side is he on? I liked the big push for the health care thing, but since Obama didn’t push hard enough, the people got shortchanged while the insurance companies won! You say “Single-payer system”, they say “Socialist pig! Burn the witch!” And ironically it’s the consumers that need their insurance that get burned. I liked that Obama hired Elizabeth Warren to start that commission to protect consumers; but he’s letting her get walked all over by the banks! She’s a smart lady with a lot of integrity—and they’re trying to eat her alive! It’s kind of like Obama throws a punch at the Right—and ends up shaking hands with them and making deals! He wants to build more nuclear plants in the US—using Toshiba, the company that brought threats of nuclear meltdowns in Japan and toxic fallout to our own West Coast! What is Obama thinking?

Oh, that’s not everything, but I better save some so I don’t explode tomorrow…

My WHAT hurts?

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I’m getting another cyst on my spine. I feel it when I first get up in the morning and it takes a while to straighten up. The pain starts in my lower back, crawls down my leg and curls around the outside of my foot. In another few months, the pain will be paralyzing and I won’t be able to straighten up at all, or walk easily. If you’ve ever wondered about the term “exquisite pain”, I’m very familiar with it.

I live on Long Island. The last couple of times I had an orthopedic problem—rotator cuff repair in 2005 and surgery to remove a spinal cyst in 2009—I went to a place I’ll call We Want Your Dough Orthopedic Group, located all over the place on the south shore. And I do mean all over the place. They have their own physical therapy facilities, diagnostic centers, and, of course, doctors’ offices, with a large staff of physicians and surgeons. I went to them in early 2005 because they were so convenient, and because my shoulder was so sore I could barely lift my arm. The waiting rooms of any and all of their facilities are constantly packed, zoo-like, cacophonous with hoards of people in pain and their extended families, waiting to see a doctor…and waiting and waiting and waiting. The staff, who make the appointments and man the desk, are annoying, disorganized and ignorant. I figured WWYD Orthopedic Group were keeping their overhead down by hiring underpaid dopes to handle the administrative part of their large and humming business.

When I finally got to see one of the doctors—I’ll call him “Dr. A”—an X-ray revealed a bone spur on my shoulder. Dr. A said, “We’ll send you to physical therapy.” I said, “How will physical therapy take care of a bone spur? It’s a bone spur. It has to be removed surgically.” He assured me that he didn’t like to do any invasive surgery unless it was absolutely necessary; after all, the rotator cuff wasn’t torn…yet. Wasn’t Dr. A a fine and ethical physician!

So, for a few months, I went to bi-weekly physical therapy sessions, which seemed to help…sort of. After the physical therapy ended, I went about my life for a while until the pain came back with a vengeance. By this time, my arm was considerably weaker and the shoulder was screaming with pain. A second X-ray showed that the rotator cuff was now officially torn, thanks to the bone spur (and I would bet all the gardening and weed-pulling I was doing at the time really helped do the trick.) So, now surgery was definitely needed, followed by months of physical therapy, because as everyone knows, rotator cuff repair is a real bitch.

Except that WWYD Orthopedic Group had never dealt with me. I tend to heal very quickly, so after only 6 weeks of physical therapy, I was 100% fine. Even my son, who once worked as an insurance adjuster said that it usually takes several months for someone to recuperate from a rotator cuff repair. While the doctors and physical therapists were all impressed with my speedy recovery, I’m sure they were also disappointed that they couldn’t wring more out of my insurance company. The way I saw it, they already got their fair share of income from physical therapy, with the time I put in before the surgery, which obviously didn’t do anything except possibly forestall surgery until the condition was considerably worse. That way they could expect to receive a much larger income for the physical therapy, because, assuming I took the usual six months to recuperate, rather than six weeks, they had expected to make oodles of dough! Oh, well.

Fast forward to 2009 when I started getting lower back pain for no apparent reason. Hot baths and Epsom salts didn’t help; soon the pain began shooting down my leg. I knew what that was; my sister had had sciatica years ago. So, back to Dr. A at WWYD Orthopedic Group, since I was familiar with him and he’d helped with my shoulder…eventually. Dr. A had me X-rayed in the office that day, and upon reading the films, said that he could tell I was in pain because my spine was very straight and tense. Thank you for verifying that my pain was real. He asked if there was any numbness in my leg; well, not really numbness, I told him, but the outside of my leg felt as if it were tingling. He prescribed physical therapy. Of course.

Once again, back to bi-weekly physical therapy sessions, electric stimulation and ice packs, stretching exercises. Some days I thought it was really helping; others weren’t so pleasant. It was starting to feel like I had a steel rod going down my leg that pinched and cramped all the time. My foot felt like a rag doll appendage. Several weeks after starting the physical therapy, I noticed that the tingly feeling on the outside of my leg was gone; now it was just numb. If I touched it, all I felt was pressure. I mentioned this to the physical therapist and he said, “Uh, that’s not supposed to happen. You’d better call your doctor.”

When I went to see Dr. A again, he was very quick to say, “You never mentioned numbness.” I replied, “No, I didn’t, but I did say there was a tingling sensation—which I don’t think of as numbness.” He pretended not to hear me and then told me to make an appointment for an MRI, which I did immediately. The pain was starting to gather and assault me to the point where I took several days off from work because I couldn’t drive. My cats studied me in wonder as I got slowly up from the couch to feed them, freezing for minutes on end while the pain coursed from my lower back down my leg and I could only stand there gasping. I wondered if I collapsed and couldn’t move at all, would the big cat—the one who thought he was my owner—start to chow down on me after a day or two of not getting his Fancy Feast?

I had the MRI on a Saturday morning. Monday I heard nothing, so I figured they hadn’t yet gotten the results. Tuesday I called and left a message that I was waiting for my results. No one called back. Wednesday I called back; Dr. A was unavailable and hadn’t seen the MRI yet; no, they didn’t know where he was, and they couldn’t reach him; I would have to wait. Meanwhile, I went to work when I could and hobbled around like Quasimodo. I called WWYD every day, and they started getting annoyed. No, Dr. A wasn’t available, he was helping to set up a new facility in Bohemia. When I called out there, he wasn’t around and they couldn’t reach him. I called his regular office again; wasn’t there someone who could help me, another doctor filling in for Dr. A in his absence? No. I was in mounting pain and could barely move, what could I do? “Do what the doctor told you to do.” He didn’t tell me anything; he ordered an MRI and I still hadn’t heard the results and it was over a week! “Sorry, can’t help you.”

When the AWOL Dr. A finally came back to this planet from whatever vacation he was on, he finally called back and informed me that there was a cyst on my spine. He would have to hand me over to one of his colleagues, Dr. B, since Dr. A didn’t do spinal surgery. I would have to make an appointment to see Dr. B. He talked fast and didn’t give me a word in edgewise; I was sure there was a line of patients waiting for him, pitchforks in hand. I never even had a chance to beg for something to alleviate the pain! I immediately called Dr. B and made an appointment for the next day.

The next day I eagerly went to see Dr. B and he showed me the MRI. There was the cyst, squashing my sciatic nerve flat; if it wasn’t removed ASAP, the nerve would die and good luck trying to walk.

I liked Dr. B almost immediately, especially when he told me that the pain would end instantly with the surgery, and there would be no need for physical therapy afterward. I wondered if the heads of that medical corporation money mill would approve of his telling me that, but I didn’t say anything. I was thankful I’d finally gotten a doctor who wasn’t going to use me to make his boat payment, and he instantly earned my respect. And God bless him, he prescribed pain medication for the interim between that day and the day of surgery.

Dr. B was right; the pain in my leg was totally gone after the surgery, and the only discomfort left was from the surgery itself. I was back at work a week later. Doctor B said, “Most people take at least two weeks off after this kind of thing; you’re amazing!” Yeah, and I was also looking at the fact that if you’re out of work on medical leave for more than five days at my company, they automatically put you on disability. New York State “generously” doles out a little over $100 a week as your “benefit” when you’re disabled. How ironic; NYS’s ridiculous idea of financial assistance for disability is a disability in itself! It might buy you groceries, but where do you live? And forget gassing up your car!

Now that I feel another cyst growing on the other side, having been through this before, I can plan ahead. Unfortunately, Dr. B at WWYD who removed the first cyst no longer accepts my insurance; therefore, I will have to see someone else. It won’t be at WWYD Orthopedic Group; I refuse to go back there and have some other doctor, who does take my insurance and has dollar signs in his eyes send me back to physical therapy twice a week for something that has to be addressed surgically, just so they can line their pockets and keep driving those expensive cars with their vanity plates. That first time I went to see Dr. B, his office was at a facility I’d never been to before. In searching for a way into the building, I ended up wandering into the underground parking area where all the spaces are reserved for doctors. All the cars were incredibly high-end, of course, with vanity plates. There’s an elevator right into the building from the parking area so the doctors aren’t inconvenienced. (The patients have to park across the street in a metered lot and hope they can hobble across the street fast enough to avoid speeding SUVs driven by Long Island princess-housewives talking on their cell phones while driving, trying to beat everyone else to a convenient  parking spot so they’re not late for their nail appointments.)

In the exclusively-physicians underground parking area, I saw the vehicle belonging to Dr. A, the first doctor, the absentee doctor; it was a brand new Porsche. I knew it was his because the vanity plates had his name on them. A Porsche, eh? I smiled as I fantasized about letting my key drag down the passenger side, leaving a nice jagged silver scar on the shiny red paint, and maybe kicking in his tail lights for good measure. But I didn’t; I didn’t have time to appear on the 11:00 news and be prosecuted for vandalism. Anyway, I didn’t want to hurt myself trying to kick anything; too bad I hadn’t been using a cane. Hey, if you’re an orthopedic surgeon working at a medical conglomerate, you have to expect a patient might stumble into your car and accidentally mar the glimmering new finish with the metal handle of her cane! It was hard getting up! Scratch! Scratch! Dent! Geez, I hope your insurance company understands! Hope they don’t raise your rates!

Okay, so if I’m never going back to WWYD, why bother to bring them up now, two years later, aside from the fact that a cyst is now growing on the other side and I have to have it taken care of? What brought them so vividly to mind was the bill I received from them just last week, $980.00, from the surgery two years ago, for a doctor I’ve never heard of. He wasn’t Dr. A—who would have had no business charging me for anything having to do with that surgery—and it wasn’t Dr. B, who was the surgeon. It turned out to be Dr. B’s assistant “surgeon”, who wasn’t a surgeon at the time, but an LPN; I vaguely remember a young intern roaming in and out of the room during office visits, and I think he might have taken my blood pressure. I called my insurance company; they had requested identification of this doctor almost two years before when they first received the claim, because he wasn’t in their records. WWYD had sent in the claim multiple times, and each time it was denied because…the paperwork was incomplete! See what I mean about their administrative staff? They finally got it together a month ago—a month ago!—and this particular doctor—isn’t in their plan! So, WWYD billed me. When I received a second bill (only a week after the first), I called the insurance company back and they were nice enough to say that they were going to reconsider paying the guy, since at the time of surgery I had gone in network with the doctor and the hospital, etc.

But the real kicker is that I called another spinal surgery place that my GP recommended, and they turned out to be out-of-network. However, they told me that if I choose to go to them, my entire out-of-pocket cost would be $700, and they would accept whatever my plan paid them. But my former in-plan doctors want to charge me $980!

Life is just so full of ironies!