Tag Archives: healthcare

The Price You Pay

I’ve voiced my opinion once or twice before regarding healthcare in the United States, specifically Highmark in Pennsylvania.

I feel like I’m turning into my grandparents when I say, I remember when….(insert memory here).  But I seriously remember when healthcare was affordable.  I don’t know specifics as to why premiums have skyrocketed from lets say 25 years ago.  Seeing a primary doctor (general practitioner) and paying $20 for my entire visit, start to finish.  I would have blood work AT the office, get lots samples of a drug prescribed to see if it worked prior to purchasing it from the pharmacy.  It worked pretty smoothly.

There were things that didn’t work smoothly, such as people with pre-existing conditions being turned down for insurance. Your children had to attend college full-time to STAY on your insurance, otherwise they were kicked to the curb as soon as they turned age 18.  I’m sure there were plenty more, hence the reason for the Affordable Care Act.

Looking back now, I believe it should have been named the Accessible Care Act.  I don’t honestly know if the reason we are paying such staggering amounts of money is due to the fact that no one could be turned down for insurance, no matter how sick they were?  I don’t know the reason.  ACA is not working.  Period.

If I remember correctly, the original ACA had been revised several times so that the Republicans would allow it to pass.  What did the original look like?  I’ve heard it was 1400 pages, so maybe nobody knows what it stated.  The Republican party is very quick, as well as President-Elect Trump, to point out that it needs to be repealed.  And certainly there are quite a few changes that I see myself that need to be done.   I wonder how much of the suggested repeals were in the original document?

At any rate, my complaint has an agenda.  My current “out-of-pocket” (OOP) is 2600 per person per year.  After that is reached, I pay 10% of the charge.  Last year I reached my deductible by July 1.  The difference in fees that I paid prior to July is an exorbitant amount of money.  I just recently  called a script refill in to my pharmacy on December 31, 2016.  That date is important because I intentionally had the rx request in to the pharmacy BEFORE 2017 because I knew the new deductible would kick in and once again I would be paying out the ass for my medications.  Unfortunately for me, the pharmacy didn’t have my medication, it had to be ordered and wouldn’t arrive until Jan 3, 3 days too late.  Prior to January I paid about $8.00 for these meds.  Jan. 3 I was asked to pay $1000.  Yep, a grand.  I was told that it was much better than if I didn’t have insurance, without it I would pay $3000.  And the pharmacy tech was being serious.

What do you think that I did?  Ofcourse I didn’t get it.  Now here’s the kicker….the rx is for a medication called Duexis.  This is a pill which contains 800mg of ibuprofen with famotidine added.  Famotidine is Pepcid, which helps heartburn that you may get from taking the NSAID (non-steroidal anti-inflamatory drugs)  So there you have it.  What on earth could possibly make this medicine price in at $3000? I read this recently, which  explains it a little bit.  Apparently taking twelve 200mg motrin and four generic pepcid pills will do exactly the same thing for me, at about $0.51 cents compared to about $51.00!  So basically you are paying for the convenience of taking one pill instead of 4 every 6 hours.

I’ve been taking Duexis off and on for about three years.  I had no idea that my insurance company was being billed about $1500 each time I had this prescription filled.

This is just one example.  Just one medication of the thousands of medications that are out there.  One drug company of the THOUSANDS of drug companies that could possibly be gauging the consumer, the provider and anyone else in its way.

Do you still wonder NOW why we pay such high premiums for health insurance?  Can you imagine the mark up on medical supplies?  MRI machines? The list is endless.  When you allow a company to charge what EVER the hell they want to, especially something medical related,  where the consumption of such medicine could mean life or death for someone, then you allow someone other than God to make the decision about the quality of life.  The life that we live is being negotiated and predetermined by people and corporations whose bottom line is the almighty dollar.

How many spaghetti dinners and chinese auction raffle tickets are we going to continue to attend and sell in order to make up for the financial devastation that potentially terminal and debilitating illnesses carry with them?  Trial medications that HAVE saved lives not covered under your insurance plan?

But hey, at least they won’t cancel you, right?  You will get a second mortgage on the already too small home that you live in, replace the transmission in your 12-year-old car instead of buying a newer, more reliable model. Vacations will consist of a Sunday at the local park, if everyone is feeling well enough.  Do all the things you need to do to get by while you are paying the mountainous pile of astronomical medical bills that will NEVER be paid off in your lifetime, no matter how long or short that is.  And all the while the makers of  medicine and testing and supplies are vacationing in Dubai every couple of months, living in multi-million dollar summer and winter homes and taking a stink-less shit on a 22k toilet.

To be clear. I don’t have a problem with people making money, just not at the expense of the health and welfare of the people they profit from.

I believe we’ve been priced right out of our comfort zones, and there’s not one damn thing we can do about it aside from bending over and taking it up the tailpipe.  I don’t particularly like the personality and morals of Donald Trump, our new President.  I have no idea what kind of business man he is, but I do know that if he does a complete 180 and suddenly cares about the medically financially strapped Americans who face financial ruin rather just saying he does, I hope that he uses every ounce of his bullshit, bullying tactics to make the situation better, more affordable and legitimately fair for all people of the United States.








Frustration multiplied by 100

My experience with doctors, nurses and health insurance these past couple of years has been horrendous, and that’s putting it mildly.  I’m not alone, this is currently happening with close members of my family as well.  I will only discuss my own issues here, since hearing an experience first hand is always best.

I’ve been treated for a few medical problems that continue to go undiagnosed.  This has been going on for about 15 months.  I don’t need to be specific about my personal health obstacles, because this blog is not about health dilemmas.  Today I will discuss members of the medical field and the laws that seem to govern healthcare today.

First off, it’s incredibly rare that you find a doctor who gives one flying fuck about you or your problems.  Excuse the use of foul language, and if this is something that bothers you, stop reading now because this will contaminate your virgin ears with relatively atrocious language.

If you’re still with me, welcome.  High five to you and your filthy mouth.

Doctor’s and their companion physician assistants are some of the worst people practicing their form of medicine, while still continuing to be paid nicely for their service or lack thereof.  They don’t care about you, they truly only care about themselves.  Period.  They hide behind the Rod of Asclepius with the kind of cowardice snobbery that we’ve sadly become more than accustom to over the past decade. The days of caring about the health and welfare of patients is now all but a distant memory.  No one is trying to figure out what’s going on with you.  They are medicating the symptoms and not finding a solution to the problem.  That’s only if you can find a doctor who really feels like working the day of your visit, and you can get past the irritable bitches in the front office.  Why are they all so mad?  What could possibly make a person be miserable EVERY SINGLE DAY?  I’m looking forward to the “off day” that they might actually treat me kindly.  I’m not permitted to be evil to people in my office/workplace, why are they?  Do they fly under the radar because their boss is actually the doctor you’ll be seeing,  with other things on their mind like golfing or golfing?  Yep, I’m stereotyping and guess what…..I couldn’t give two shits.  I’ve always appreciated and given accolades where accolades are due when it comes to the amount of studying and working and schooling that encompasses being a doctor.  There’s a certain amount of respect that you MUST give those individuals who take they Hippocratic Oath, that’s a given.  If you haven’t read the Hippocratic Oath recently or EVER, go have a read.  Someone needs to update that shit.  No wonder we are where we are in the medical world.  They take the Oath and then forget everything it stands for.  Again, I’m assuming and generalizing.  This is due to the fact that I’ve seen probably 30 random doctors/offices/testing facilities over the period of 5-6 years.

I’m not all that old, but I can remember about 20-25 years ago when healthcare was actually that, CARE OF YOUR HEALTH.  Anyone remember when doctor’s and the like made house calls?  Can you imagine someone caring THAT MUCH about you?  Yeah, me either.  Not anymore.

Ok, so I believe there has been a death of sorts as far as the practice of medicine goes.  Speaking from a managerial stand point, with every problem we should find three solutions.  I’m honestly sitting here wracking my brain and I can’t come up with a damn thing that will change the way we are medically treated in this country.  At least not any time soon.  There are extremely bright, intelligent men and women in this world who could and SHOULD attempt to make a change in the curative direction.  I believe it may take the undiagnosed illnesses of quite a few of these geniuses before we see anything remotely close to an attempt in change.  As a doctor, if you suffer no consequences for your actions, or in this case inaction, why would you change on your own?  Have you been fucked over by the insurance company that pays you?  Has it taken 3 months to see your $300-an-office appointment payment for your patients?  Poor baby.  I’ll bet you don’t have to keep your furnace a little lower than normal because you don’t have the money to pay your utility bill.

That’s all I’ve got.  I literally have no idea what to do. We are spiraling out of control in a downward motion.  It’s time for doctors to wise the fuck up.  Get your asses up in the morning and make a difference, because it might just mean the difference in your patient’s life.  If it only changes one little illness that they’ve got going on, do it.  If it means that they stop waking up in pain, trying to function at work, at home, in their minds.  We are talking about the sanity of a human being.  We NEED help.  We can Google the shit out of our symptoms, researching why we feel the way we do, but we aren’t able to do a damn thing about it on our own.  We need your help and we are paying you to help us, many times breaking our budgets and going without to visit you and take your suggestive drugs.  Do you know that we cut our family vacation out this summer because we are taking your prescribed medicine and getting your conventional first step MRIs and Xrays, with only a slight chance of feeling better?  Do you care?  Are you listening you money hungry ignorant fucks?  Hey and while we’re on the subject, I like that Mercedes ya got parked out behind your office.  Thanks for moving my appointment that’s been scheduled three months in advance to another month because you’re leaving the office early that day for your trip to Spain.  Enjoy your infinity pool and $500 vacation dinners while I rest my throbbing head in a dark, quiet room unable to lead a normal life.  How’s that private school you send little Jimmy to?  Oh yeah, have I mentioned that I forgot to sign my kid’s permission slip for a field trip before he left for the school bus this morning, because I was suffering from a bout of I HAVE NO FUCKING CLUE disease?  Ya, that happened.

I will however promise you this:  I anticipate an extreme rise in the number of suicides in the United States in the upcoming few years.  I believe we will see an increase in such epic proportions that those considering entering the medical field will instead opt for that of funeral director/cremation provider.  It’s going to be BIG business.  At the rate we are being misdiagnosed and even not diagnosed at all, I feel like many will have no where else to turn.  Before you start texting or emailing me, I’m fine.  I’m not planning my demise now or in the near future.  As most of you may know, I’m one of those people who really refuses to give up.  I might not have a lot of company, unfortunately.  I have felt the effects of being kind of thrown around and treated/mistreated for many of my health dilemmas, but as I said, I’m not a quitter.  That’s not to say that anyone who decides to go a different route is, but having an overwhelming, daily feeling of malaise, it can take its toll on you, both physically as well as mentally and possibly spiritually.  How long should you be asked to try a drug, have a test and return in three months to see how it worked out for you?  Return in three months only to have your medicine increased and asked to return in three more months, never feeling any better.  Years of that HAS to take its toll.  If you can get up each morning and be hopeful that one day you’ll be cured, you’re a few steps ahead of the proverbial mind game.

My fear is that some are getting tired of playing the game.



No One Is To Blame

It’s honestly hard to relate to another person’s dilemma if you haven’t actually been through it yourself.  The reason I’m saying this is because I watched and for the most part, participated in the appointments and relative testing of a close family member.  I visited doctors and listened intently as each one floated in and out of the medical office with their own sense of style and grace.  I use those adjectives loosely as at this point in time, I’ve truly only met one gentleman among all these healing gurus who has successfully completed his medical school honors, and most likely other prestigious schools and classes to garner the knowledge to actually make a difference in how I feel about the medical community as a whole.   One.  A genuinely caring person with high standing in the hospital he practices.

The sad part of this statement is that I, myself have had many surgeries over the past 4 years, and the opportunity to meet many, many doctors, physician assistants, nurses, medical testing technicians and the like.  I’ve come into contact with more therapeutic personnel than I care to mention.  I do believe that for whatever the reason,  most of the medical population working in healthcare today could really give two shits about you.  They exist for a pay check only.  Your health, sanity and complaints are wasted on deaf ears.  They look beyond you, staring through your tormented, withering soul sitting atop the uncomfortably sorry excuse for an exam table.   They appear to listen to your problems as they type into their little laptops.  Tap, tap, tap, tap, tap.  Did I not just fill out a boat load of paperwork in the waiting room which includes everything but my high school transcripts? Yep, that was me.  I checked all the boxes that applied.  I already listed my medications.  I included every one of my 300 surgeries.  You made a copy of my insurance card and my drivers license to be sure that I’m not trying to get that MRI of my brain, with my entire head encased in a plastic cage, contrast dye shooting into a vein in my arm intravenously with someone else’s health insurance.  Ya, I’m using someone else’s insurance card, just getting the test because I like being completely immobilized in a tube with the sound of a jackhammer pounding into my ear drums.  I’m certain that nobody will ever find out that I’m using someone else’s insurance.  Really?

Doctors don’t want to really be bothered with finding out what is causing your symptoms.  We live in a world of instant gratification.  You go to a doctor with a problem that you can’t fix yourself, they treat the issue surrounding it, pump you with some medication to ease your concern and CALL IT A DAY!  To me this is so frustrating.  I’ve been treated with an ailment for the past year and a half, being asked to return every 3-6 months, with no relative absolution to my illness.  As I continue their expert diagnosis of:  “Attempt, Wait and Fail”,  conservative approach to treatment, I’m no closer to resolve than I was when I started.  Recently new issues arose and I’ve already paid my “specialist” copay to 4 doctors, had 2 tests for my condition with an out of pocket over $150.00, and STILL am no further along than I was when it started.  The last doctor of medicine that I met with liked to play a fun game with me.  When he couldn’t find a reason for my illness, he proceeded to ask me what I thought was wrong with me.  Being the thrifty little bug that I am, of course I’ve researched my symptoms online.  No, I don’t always think I’m dying, but I do try to self-diagnose.  Hey why not, the doctors aren’t taking the bull by the horns, why shouldn’t I attempt it?  It’s not going to help, but at least I’ll feel somewhat fulfilled in the fact that someone, albeit myself, is making an attempt to determine the cause of my affliction.  Jokingly he told me that my headaches were, and I quote, “all in my head”.  He finished that comment with a gentle chuckle.  How cute is that?

The state of healthcare in the United States is deteriorating in epic proportion.  We have become a country that ingests hormone fed animals, most of which are being confined in spaces half their size, and treating our necessary toxic consumption filled diseases with prescribed addiction pain killers.  It’s the easy way out.

It’s bad and it’s only going to get worse.  When I hear of an 80 year old Vicodin addict, trading their premium Social Security check for a necessary “fix” of anesthetic pellets of deterioration, I can only wonder how on God’s earth we’re going to  make it out alive.

Oh guess what, we’re not.