Meathead complains about health insurance...doesn't know what's coming

[BannedFromDU]

Star Member mike_c (32,935 posts)

wherein mike_c rants about health insurance shortcomings....



Twice in the past year my insurance company-- one of the biggest in California-- has dictated my cardiac care to my cardiologist, despite his objections.

Strap yourself in, dude. If you don't like it now, you're reallllllly not going to like 0dumbocare.

The back story: Just over a year ago I became a common statistic of aging You mean eating too much and smoking weedand went into atrial fibrillation. A-fib isn't particularly uncomfortable, or at least it wasn't for me, but there is significant risk of throwing a clot and having a heart attack or stroke, so it needs to be dealt with. I underwent a successful cardioversion last June, and have had normal heart rhythm since.

For several months before the procedure I was on anticoagulants to reduce the risk of stroke. That was the first time the insurance company intervened. My doctor prescribed a drug whose name I don't recall, but when I arrived at the pharmacy they told me the insurance company had refused to cover it because there was a less expensive drug available. The less expensive alternative was warfarin, of course. The difference between the drug my cardio guy prescribed and warfarin is vast. The prescribed drug is not nearly so dose dependent, so it doesn't require constant monitoring, and it's much easier to tolerate. Warfarin requires frequent-- at least weekly-- blood tests to prevent bleeding. I don't tolerate warfarin well, and went through several months of hell. Unbelievable bruises that literally wept blood. I pissed blood-- not just a little blood in my urine, but let me tell my brothers that when arterial red blood streams from your penis, it gets your attention fast.  Especially at the bathhouse, huh? A week after the procedure the cardiologist took me off warfarin, saying that my risk of bleeding out was greater than my risk of complications from the a-fib. But the insurance company would not relent.

Today I was scheduled for another follow up appointment-- my cardiologist had ordered an echo-cardiogram, cardiac ultrasound imaging-- to see whether my atria had been damaged and just to get a general look at my ticker. Yesterday the office called to cancel. My insurance company had denied permission for the procedure-- that's the precise phrase used to explain this-- because there are less expensive diagnostic procedures available, presumably a stethoscope and an EKG, neither of which let the doctor directly observe a beating heart. He expressed considerable frustration about that.

So it seems that my cardiac care is ultimately being directed by the profit management division of my insurance company, with the primary goal being to control my access to medical care in order to maximize their profits.

This is not a rant about Obamacare, which has nothing to do, at least not directly, with these events. Oh, but it will, homeboy. It's about my anger that my cardiologist must seek approval from some cubicle dweller with a bachelor's degree in oral communication or some such thing and a manual of "no's" before applying his best medical judgement to my cardiac care. Have you noticed that physicians or doctors-- both terms that imply lengthy education, experience, and considerable knowledge-- have become simply "providers" in the parlance of modern American health care? They are increasingly regarded simply as the patient contact wing of the health insurance industry.

/rant

Just you wait, Meathead.

Another opportunity to , coming right up.

[Bad Dog]

Mike's problems are just beginning.  Wait until Mediscare gets ahold of him.

[Chris_]

Star Member mike_c (32,935 posts)

Twice in the past year my insurance company-- one of the biggest in California-- has dictated my cardiac care to my cardiologist, despite his objections.

You voted for it.

Enjoy.

[jukin]

Die bug man, just die.

[SSG Snuggle Bunny]

On the bright side:

If he dies we can throw him in the incinerator to help heat the hospital.

[freedumb2003b]

On the bright side:

If he dies we can throw him in the incinerator to help heat the hospital.

Or the cafeteria....

[HawkHogan]

On the bright side:

If he dies we can throw him in the incinerator to help heat the hospital.

The Dummy would be useful for the first time in his life.

Alas, it's disgusting to even think that some liberals in England are actually using babies to heat their hospitals.

Sick world.

[obumazombie]

On the bright side:

If he dies we can throw him in the incinerator to help heat the hospital.

Are you referring to...

http://newsbusters.org/blogs/matthew-balan/2014/03/26/foreign-media-fox-news-cover-british-prenatal-incineration-scandal-ot

[Ptarmigan]

[GOBUCKS]

I agree with DUmmy mike_c's insurance company.

I wouldn't pay a dime to keep the bastard alive.

He would rather piss blood than pay out-of-pocket for the "unapproved" anticoagulant?

Let him die. The sooner the better.

[franksolich]

I agree with DUmmy mike_c's insurance company.

I wouldn't pay a dime to keep the bastard alive.

He would rather piss blood than pay out-of-pocket for the "unapproved" anticoagulant?

Let him die. The sooner the better.

That's what gets me about the primitive decision-making when it comes to their health.

No matter what it is, if the insurance company (or the taxpayers) is willing to pay for it, they'll have it done.

But if they're going to have to pay a dime out of their own pocket--no matter for what--they won't have it done.

And it's not like the mike_c primitive has money problems anyway.

[longview]

That's what gets me about the primitive decision-making when it comes to their health.

No matter what it is, if the insurance company (or the taxpayers) is willing to pay for it, they'll have it done.

But if they're going to have to pay a dime out of their own pocket--no matter for what--they won't have it done.

And it's not like the mike_c primitive has money problems anyway.

That has always bugged me, too.

I see it in my work.  And often people complain and whine about some symptom until the doc fears a lawsuit if he doesn't run some test or give a med for yet another side effect of a needed med.  When it's insurance denies to cover those, then nothing but long faces.  The patient won't pony up for the cost themselves.

I, on the other hand, had a kid who's condition did respond to covered meds.  Docs wanted to try some things that weren't covered.  I don't know which ones helped or if they all helped, but she is happy, healthy, productive mid-20s and I finally paid off the bill 21 months ago.  

I guess she's lucky I'm not a DUmp monkey.

[Gina]

You know what's weird and maybe I'm just a great patient and the doctors love me but when my insurance has denied a procedure the doctor has done it anyway and said they did the other approved procedure.  My chiropractor informed me yesterday that my insurance only pays for so many visits and then I have to be reviewed for whether it's helping by insurance. He said "if they deny you more visits, don't worry.  You can still come as often as you like paying just your co-pay and nothing more".  My insurance denied my RF nerve block one time and my doctor performed it anyway because I guess he cared that I was in pain. 

[BlueStateSaint]

You know what's weird and maybe I'm just a great patient and the doctors love me but when my insurance has denied a procedure the doctor has done it anyway and said they did the other approved procedure.  My chiropractor informed me yesterday that my insurance only pays for so many visits and then I have to be reviewed for whether it's helping by insurance. He said "if they deny you more visits, don't worry.  You can still come as often as you like paying just your co-pay and nothing more".  My insurance denied my RF nerve block one time and my doctor performed it anyway because I guess he cared that I was in pain. 

My chiropractor is still seeing me after the insurance denied more visits.  He's charging a tad more for the visit than my co-pay was, but I'm alright with that, as it works like a charm.  If he didn't have so many demands on his time (he's also a farmer!), he'd probably be a member here; his views are right in line with conservativism.

[Gina]

So does that mean doctors will treat conservatives more than liberals? 

[RobJohnson]

You know what's weird and maybe I'm just a great patient and the doctors love me but when my insurance has denied a procedure the doctor has done it anyway and said they did the other approved procedure.  My chiropractor informed me yesterday that my insurance only pays for so many visits and then I have to be reviewed for whether it's helping by insurance. He said "if they deny you more visits, don't worry.  You can still come as often as you like paying just your co-pay and nothing more".  My insurance denied my RF nerve block one time and my doctor performed it anyway because I guess he cared that I was in pain. 

I've had several doctors like that. Mostly chiropractors. I still do. I don't even pay a co payment, my gift of marketing helps them gain new business.

[RobJohnson]

You know what's weird and maybe I'm just a great patient and the doctors love me but when my insurance has denied a procedure the doctor has done it anyway and said they did the other approved procedure.  My chiropractor informed me yesterday that my insurance only pays for so many visits and then I have to be reviewed for whether it's helping by insurance. He said "if they deny you more visits, don't worry.  You can still come as often as you like paying just your co-pay and nothing more".  My insurance denied my RF nerve block one time and my doctor performed it anyway because I guess he cared that I was in pain. 

I've had several doctors like that. Mostly chiropractors. I still do. Most of my medical doctor friends had to join the corporate groups and no longer have much control over the billing. But I have been Blessed with good friends in the medical field. 

[DumbAss Tanker]

I agree with DUmmy mike_c's insurance company.

I wouldn't pay a dime to keep the bastard alive.

He would rather piss blood than pay out-of-pocket for the "unapproved" anticoagulant?

Let him die. The sooner the better.

Works for me.

As far as disposition of remains is concerned, I say feed him to the bugs, it's the Circle of Life.

[Bad Dog]

So does that mean doctors will treat conservatives more than liberals? 

Perhaps it is just easier to treat decent civilized folks than spoiled demanding brats.

[Dori]

So does that mean doctors will treat conservatives more than liberals? 

Not if Democrats are in office.  The R's will be the first to get denied treatment.

[GOBUCKS]

I'm wondering how long before the death panel pulls the plug on that Cleveland ward heeler.

I reminds me of the young girl in California who ended up brain-dead after a tonsillectomy.

In her case, it was a tragic outcome.

But that useless Cleveland ward heeler has been brain-dead for decades.

I think Pajama Boy will sneak into his room pretty soon and stop the waste of money.