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Showing posts with label Health Insurance. Show all posts
Showing posts with label Health Insurance. Show all posts

Monday, September 5, 2016

Let's talk about how much I hate dentists

I used to be the type of person who didn't mind going to the dentist.  I'd get them cleaned, it didn't cause discomfort, and so it was no big deal.

For 36 years, I had no issues with dentistry at all.  No cavities at all.

I am this close to my 43rd birthday, which means the last 7 years have been a sheer dental nightmare.  That might be a little hyperbolic, but not much, especially for a person who for nearly 4 decades had NO DENTAL PROBLEMS.

I can't tell you how many cavities I've had filled in the last 7 years.

I had to have a mouthguard made because of teeth-clenching, which I blame completely on having 2 sons.

Last year, my dentist fixed messed with a cavity that wasn't bothering me, wasn't causing me any pain, which caused me to develop an abscess and led to Root Canal #1 and a crown.

Root Canal #1 and a crown led to us getting the "much better dental insurance" this year.

And thank goodness!

This year, the day before my 43rd birthday, in fact, I will be having Root Canal #2 at the endodontist's office.

My dentist, like she did last year, fixed messed with a cavity that wasn't bothering me, wasn't causing me any pain.  And now it is causing me considerable pain. I am taking an antibiotic and tossing back ibuprofen and acetaminophen like candy.

This led to me inform her on Thursday that from now on she is not to fix mess with any cavities of mine until or unless they are causing me pain.  I'd rather just have it get bad and go straight to root canal.  These little dinky fillings are leading to full-blown root canal and crown, which in my untrained, non-dentist mind, is complete bullshit.

Apparently, I have high pulp and with my chronic teeth clenching I'm wearing down the enamel on my teeth, making it likely that I'll have problems with getting fillings.  I saw on an x-ray that I've nearly worn a filling down flat from clenching during the night when I sleep.

So while I don't think my dentist is "making shit up," I also think her insistence on getting these fillings "fixed" early is simply making me having to deal with pain and discomfort a whole hell of a lot sooner and more frequently than I might otherwise have to.

Thursday, September 23, 2010

Constant state of recovery

Most of the time I feel so far removed from the days when my anxiety and OCD hampered my life.  When things would upset me so badly that I would rant and rave and become explosive angry and simply be unable to think of anything else but the incident that set me off.  My brain would churn, churn, churn over the incident.

Most of the time I can let things go.  Glide relatively easily over life's little molehills.  My toes are always a little stubbed because I just wouldn't be me if I cleared the hill completely without any kind of scrape.

But then I have today, when I am so out of control of my obsessiveness that it is all I can do and even become physically exhausted by the effort of reigning myself back in, back to some semblance of composure.

I am fighting a battle inside my head.  And it makes me feel like a failure because I sometimes can delude myself into thinking I no longer need to fight.  That I am cured.

But I am not.  Only recovered.  In remission.

And little stresses have been sitting on my plate for months, never fully going away, just sitting, piling up, weighing heavily on their resting place inside my mind.  Keeping me at low-grade worry.

The ENT claims that were just sitting out in space, and are finally being processed (but for who knows how much?).  The specter of M needing surgery for tubes...another expense.  The new school year, 27 school days in force, which has brought with it sickness in each child.  The winter that looms ahead which could be as sickly as 2009 was.  My cavities and new fillings, which are giving me some discomfort and will require another dental appointment.....and more money.

I know perfectly well that all of these are minor, minor health-related issues.  No cancer.  Nothing life threatening.  Nothing that singularly justifies anxiety overload.  Probably even combined, in a person with a perfectly healthy head, they wouldn't amount to the proverbial hill of beans.

But I don't have a perfectly healthy head.

And nearly 12 months of interrupted sleep and very few "Mommy do something fun just for her and not just grocery shopping" opportunities are not good for anyone.

So yesterday's bill for $750 has not upset me solely because of the money.

That is only part A of my worry.

Part B is the knowledge that had I been aware, been notified, I would have been on it so hard it would have been resolved.
Part C is the anger at the whole "health insurance" situation, that by signing into the hospital to have my baby, I agreed to pay for it all, even in situations like this when the billing company and doctor's billing department were incompetent.
Part D is the recognition that I am not cured.  I am dependent on medication to keep my brain functioning in a harmonious way.
Part E is the sadness that my stability is sometimes fleeting.

And as my dear husband pointed out when I called him crying about this whole mess,
Part F is the memory of just how miserable my life was for a time, and that being overwhelmed by my OCD and anxiety brings me full force back into that life.

I didn't miss it at all.

Wednesday, September 22, 2010

Moments of misery (or I'm mad AGAIN)

So yesterday I was mad and realized I was ridiculous (a little).
Today I was even more mad, so mad that it felt like the stress and anger fizzled out all the good stuff my antidepressant does in my brain.  I felt like old Carrie, and that is not a good place to be.  Obsessive to the nth degree Carrie.

I received a bill in the mail from the surgeon who assisted with my c-section on Oct 7, 2009.  This is the FIRST and ONLY bill I have received from this guy.  Saying I owe $750.  What the fuck?  The baby he helped deliver is "this" close to a year old.

So I called the doctor's billing office to see why it hadn't been filed with insurance and explain that, perhaps because it had taken them so effin' long to file it, insurance wouldn't pay.

To make a very long and unpleasant afternoon in my life short, I was on the phone with 2 different insurance companies and the doctor's billing supervisor 3 times within a 2-hour time span.  The doctor has until Oct 7 to get the claim into our current insurance.  And if he doesn't do that, then, technically, he can hold me responsible for the full $750.

EVEN THOUGH IT IS HIS OFFICE'S STUPID FAULT THAT THEY WAITED UNTIL 11 BUSINESS DAYS BEFORE THE DEADLINE TO FILE IT.  (Ok, technically, it was submitted earlier in the year but then the doctor switched billing service companies and then the claim was resubmitted in July.  But since JULY it has been floating out in billing space.  And no one EVER THOUGHT TO SEND ME A FUCKING BILL so that I'd know what is going on.)

Lord knows, I would have been "on it" had I known about it.  I'm sorry that I didn't jot down every doctor and nurse's name in the operating room while my lower body was numb, and I was yakking up the stuff they gave me to "settle my stomach" before they sliced into me.  Oh, yeah and feeling the 8 lb, 4 oz baby kicking at my womb to be let the hell out.

Dammit, I had other things on my mind at that moment in time.

And so, I am sending a politely worded complaint letter (along with a copy of my current insurance card) to the billing supervisor.  As well as a politely worded complaint letter to the office manager.

And you better believe I will fight those fuckers over that $750 if it comes to it.

But dang, I would seriously like for the bitch in me to be able to settle down for like a full 48 hours before I have to go full throttle again.

Hear that universe?????

Monday, March 22, 2010

WWJD?

So the health care bill passed, and everyone's panties are in a twist.  I need a brain dump of all my thoughts, stupid and otherwise, regarding people's comments on the legislation.  While cooking dinner tonight my brain was churning so furiously I had to jot thoughts down in my day planner just so I could get about the business of preparing food.

I have no idea how to organize these thoughts, and I'm too tired to try, so I'm just gonna throw 'em out there because I'd like to be able to sleep without all these ideas running around my head.

1. Many people are concerned about the costs of this legislation, but according to the Congressional Budget Office, it will eventually lead to $138 billion deficit in ten years.  Of course, that's over a long period of time and things could change.  I guess what burns my ass is why weren't these same folks as concerned when the tax cuts for the wealthy were passed or when we invaded Iraq?  A conservative estimate is that the Iraq War will cost $3 TRILLION.  

2. People who are currently on Medicare should have no horse in this race.  When you are the recipient of a government-sponsored health plan and you bitch that you don't want government-run health care for others, you are being a complete idiot.  It's fine for YOU to have it, but not anyone else.  Please just shut-up.

3. Yes, people will have to purchase health insurance, just like they have to purchase homeowners' insurance and car insurance.  If you want to say they are being forced to buy it, ok.  Use that terminology.  But note that there are lots of things we are forced to do for the safety, health and benefit of all people.  Stopping at stop signs comes to mind.  I might want to go through the intersection because I'm late for work, but I am forced to stop.  That infringes on my freedom to drive however I want.  Here are some other things we do or don't do because it is for the good of society:
* No smoking allowed in public places (infringes on the right to smoke)
* Drunk driving is not allowed (infringes on the right to drink as much as I want and drive my ass home)
* Yelling fire in a movie theater (infringes on my right to have a good hee-haw laugh)

Ok, now here are just some extraneous things that got stuck in the mind sludge:

*Regarding complaints about the inefficiency of government---
I have heard people mention the USPO, how it is in the red, inefficient, and do we really want our health care to be like that?  My question is if the USPO is so darn inefficient, why do all these folks who use this as their argument not send their mail, all of it, via UPS or Fedex?  Because they don't want to shell out the money.  They are perfectly content with only paying 42 cents to mail a note to Aunt Mildred.

*Regarding government having too much control over the people---
I think it is interesting that often the same people who complain that the government is too big, is too much "up in our business" are the same people who want the government to put restrictions on abortion---a woman must have an ultrasound, get counseling 24 hours in advance.  They don't want the government in their grill, but they totally want the government as big brother over every uterus.

And I can't help thinking, when I read people's comments in the paper or on FB, what would Jesus do?  Historical Jesus was a rebel, as I understand him.  Thumbing his nose at Jewish authority.  So maybe he wouldn't want the government messing around with health care.  But Jesus was also all about the poor, the downtrodden, the underserved, the have-nots in his society.  And so I can't help but think Jesus would want to help people.

And that's what I keep coming back to.  The need, the dire need, to help people.  There is always a cost to do this, and Americans don't like to sacrifice.

Thursday, September 3, 2009

What little I can do

I have often thought that at some point I might be interested in serving in a public office. I don't know that I've ever actually admitted that to anyone, even D.

Whenever I have this thought, though, I have to remember that even though I think I can "rumble" fairly well, my insides go all bonkers whenever I face conflict, and I obsess over it.

Which brings me to this never-ending saga of the health-care reform debate. There are many things I think could be done to reform health care. Put caps on malpractice torts. Regulate the health care industry so no one can be denied coverage or charged exorbitant prices. Mandate that everyone has health insurance (we do it with car insurance, why not health?) Throw out the whole pre-existing condition rule. Make preventative care and public health stronger than what they currently are.

I am all for personal responsibility. I live my life according to it's principles. It burns my rear when I hear of folks using Medicaid who want to bitch about their "inadequate treatment," like having to see a nurse practitioner instead of a doctor. It pisses me off that generations of families live as parasites off the welfare system.

BUT, I cannot help but keep in my head the saying, "There but for the grace of God go I." A strong work ethic, an appreciation for help when it is given, a belief in the power of education---these are learned. My parents, who both came from very meager circumstances, taught me these values. And sadly, there are many, many people in this country who don't learn these things.

And even among those who do, life is sometimes a bitch and hands you a bucket of shit to hold. I think of them primarily whenever I think of the health care reform debate. The people who hold the jobs and work and try to keep their homes and raise their families and are forced into dire circumstances because of the health cards life dealt them.

I guess I simply don't understand the reasons behind some people's arguments against a government option for health care.

Some say it will be expensive to pay for. I agree, but not doing anything is going to be even costlier to individuals and the country as a whole. When my daughter was born 5 and a half years ago, I think we paid maybe $200 for her delivery. As I've mentioned numerous times, this third child will cost close to $10,000. And I would much rather be taxed at a certain percentage than have all sorts of "hidden fees" in my private health care to cover the uninsured.

Some say they don't want the government's hands all over everything. Maybe not, but have these people ever mailed a letter through the US Postal Service? Do their parents utilize Medicare? Have they ever filed unemployment while laid off? Have they ever used the internet at their local public library or checked out books? Do their kids attend public schools? If you utilize all of these things, and have no problem with it, then what exactly is your fear with a public health care option? The government isn't going to make you use it, right? You will still have the choice of private health care, so run with it if it makes you happy.

Some people are just plain scared of the unknown, and I can completely understand this. The devil you know is worse than the devil you don't know. But the current state of health care is a pretty bad fucking devil, so I'm willing to take a chance on the other boogeyman waiting behind the door.

Monday, July 20, 2009

Common sense and health care reform

Let me begin this post by saying I HATE it when my child wakes me up at 5:30 a.m., and I happen to have a blog post marinating in my head. My only option if I wish to attempt sleep again is to fricking write to get all my thoughts out of my head so unconsciousness might bless me once more.

Lately, I have been hearing a whole lot of naysayers tell these increasingly idiotic tales about health care reform in this country and what it means for us, the US population. I always do what I can to refute their tales with a simple thing I like to call "an ounce of common sense." Rarely does it work, but I feel compelled to share it anyway.

Yesterday, my MIL's neighbor began telling me about her "friend" who lives in England who, GOD FORBID, had a midwife and was in labor 36 hours and then had to have an emergency c-section anyway. Horror of horrors! Clearly this dear woman has no understanding of history because otherwise she would know that virtually everyone born prior to 1940 was birthed by midwives of some sort or another, and at home too. Ob/gyns are a modern phenomena. My father was born at home in 1942, and my mother was the first of her siblings to be born in a hospital in 1938.

Today I am sending an email to the Administration, my senators and representatives and anyone else in Congress who I think needs to hear someone say, "Keep working on this. It has to be done." And in my dear little blog, I'm gonna say why people who think health care reform is the worst possible course for our country are downright fools.

Mind you, I am not studying this in my "free time." My knowledge is limited to what I am able to read in the newspaper, online occasionally, and in the snippets of tv news I see. What I have is my experience and, more importantly, common sense.

1. CANADA and UK
If the health care system in Canada and the UK was so bad, then we would hear a LOT more complaining about it. As best I can tell, I don't know of many demonstrations by Canadians and the Britons denouncing their system. I do hear alot of Americans complaining though about our current system. I do read about more Americans filing bankruptcy as a result of their increasing medical bills.

What I do hear are "tall tales" that go like this: "So-and-so had to wait 3 months for hip surgery in Canada." I've never had hip surgery in the US, so I really don't know how long it takes to wait, but most people don't just wake up one morning with a bum hip. They spend months and years feeling their hip slowly decline and then after medication and batteries of tests, go in for surgery. So, honestly, if this is what a person in the US has been experiencing, what is another couple of months? Ah yes, I forget, we Americans are the Veruca Salts of the world: We want it now.

1a. If the health care system in Canada was so bad, then why are all these American working like dogs to get their medication from.....Canada? We like Canadian health care when it saves us a buck.

1b. A family member recently shared some insane notion with my mother that in the UK they just let people die who are on dialysis (this person's hubby is on dialysis after years and years of diabetes coupled with an utter refusal to eat properly and exercise). Again, countries with nationalized health care do not just let people die. With the media like it is, we would hear about this. Maybe if a person is in their 80s or 90s in terrible health, they might say, "No, you've got terminal cancer, I don't think knee replacement surgery is warranted." But this is COMMON SENSE!!!!!

2. SMARTER CONSUMERS?
D works for a relatively small company which went to a high deductible plan a few years ago. It took a long time to get used to it. One premise behind these plans is to help "consumers" make smarter health decision, and to some extent this has been successful for us. When one has a $4,000 deductible (and is responsible for 10% of costs up to $10,000), you tend to think a little smarter about how often you run to the doctor.

When my kids have a fever, I don't rush to the doctor after days 1 or 2. I usually let them go 4-5 days, treating as needed with fever reducers. Because common sense tells me that if they are running a fever and have a stuffy nose, they have what is called a virus. The doctor is going to charge me between $70-90 to tell me, "Let it run its course." And I let their fever go up to about 102 degrees before dosing them with ibuprofen. A fever is a good thing--nature's way of fighting illness naturally.

Now when G was an infant and began having tons of ear infections, I didn't just let them go. I saw the doctor sooner because of his age. And over time, I recognized the signs and symptoms better. For me, part of being a smarter health-care consumer has been learning better how my children react to illnesses.

(And I don't demand antibiotics. This could be listed as #1 health care pet peeve following closely by people who don't finish their antibiotics as directed.)

But here is one problem with this attempt to be a smarter consumer. There are TONS of health care plans with slight differences depending on which company you work for, which plan it is, and what benefits you have. So I can't just call my doctor's office or pharmacy and say, "How much does such-and-such cost?" in order to determine my cost or whether I really want to have the test or use the medication. The doctor or pharmacist can't just tell me. Believe me, I have tried this approach, and it simply doesn't work.

And even if you try to be a smarter consumer, there are just some costs you simply cannot avoid. With this new baby coming, we are gonna be out $10,000. It is a given. The baby has to come out some way.

My practice doesn't do VBAC, and I opted to stay with the practice rather than search for another doctor. So my c-section will cost an extra $500 for the doctor (it is $2500 for vaginal birth, $3000 for c-section), extra for the anesthesia (although women who do have vaginal births with epidurals pay this amount too so don't poo-poo the c-section's "must use an epidural" thing"), and extra for day 3 in the hospital to monitor me.

If there was a true birthing center in our city with midwives and nurses, with immediate easy-access to the hospital for emergency situations, I would do it no problem. But there is not. Every birthing center is IN a hospital. Every option is an ob/gyn. And when these are the options, there is no option. A woman is going to be over-monitored and over-intervened because that is just the way hospitals and obs are. In order to find something like this, I have to cross the bridge into Indiana (which for me equals more time costs, more gas costs, and potentially another c-section anyway depending on how the birthing process would go.)

When G was breech, my doula knew of 1 doctor who delivers breech babies. ONE DOCTOR in my city. And he is considered a "high risk" doctor because no one else wants to chance delivering breech babies and all the "potential" complications. I wasn't about to switch doctors at 37 weeks of pregnancy and incur the "costs" of seeing a new doctor and the stress.

So the point I'm trying to make here, although I feel certain I've gone off on a tangent, is that even if you try to be a really savvy health care consumer, there are limitations to what you can realistically do (or feel comfortable with) because of the current mess called US healthcare and insurance.

3. PAYING FOR IT ANYWAY
People worry about taxes to cover reform. But what they forget is that they are already paying for the uninsured. Health practitioners, facilities, etc, charge extra to help manage the load of the uninsured or underinsured. It is already worked into your cost in the same way that the cost of the sweater or tv you buy covers all the little tiny, unseen expenses associated with making it. The cost of a sweater is not just the cost of materials----it is the materials, labor, benefits for labor, insurance for the company that makes the sweater, machinery used to make the sweater, advertising to sell the sweater, and so on.

So as more and more people are uninsured, so too does your cost keep rising. As the cost for physicians to get liability coverage goes higher, so too does your cost keep rising. Anyone besides me notice how this has been happening?

To CONCLUDE (although I doubt I can go back to sleep now)......

I know there are inaccuracies in my "mental picture" of health care. But I simply get tired of hearing people lament as if our current system is the best in the world. It is NOT!!!! This has been researched. There is proof that despite all the money we collectively spend, it is not working in its current state because so many people are uninsured, because so many other people are underinsured, because so many people are spending increasingly large chunks of their pay for health care.

There used to be a time not too long ago, when the majority of people spent most if not all their money on meeting their basic needs: food, shelter, clothing, In many countries, this is still the case. The US is slowly moving towards that time again, which just drives us mad because we want to ooze money and spend money on our toys and entertainment. That time, I believe, will come sooner rather than later, if we continue on our current health care path.

Saturday, November 15, 2008

The bite at the pharmacy and doc's office

We have reached our $4,000 deductible and are now paying only 20% of our health care costs (until we reach $10,000, and then insurance will kick in at 100%--well, thank God for small miracles!). By the time we get to that point, we will be eating beans and rice every night for dinner. If G has to have ear tubes, we'll likely be on this diet before Christmas.

But since we are only paying 20% I decided to refill my Astelin Rx (nose spray) before it expires in early December. My allergist gave me an Rx for a steroid nose spray too, but I simply can't afford to fill that one every month. If I have to choose between my brain working properly, having an unplanned pregnancy and having a bit of a stuffy nose, you know which one I will choose. D and I have used up all the Astelin samples I begged off my doctor.

My Lexapro costs me $80 per month, and my birth control pills are about $28 per month. My allergy shots cost me $13.00 every time I go. Before G started with all the ear infections, I was the only one in the family who hit our insurance pretty hard. He is quickly catching up.

N is the only one of us who has spent $0 health care dollars this year (insurance covered her 4-year well visit at 100%). And she eats virtually no fruits or vegetables, picks her nose on a regular basis without the benefit of handwashing, and does anything to avoid taking a bath. Apparently, she knows how to live a healthy lifestyle.

By most standards, I think I would be considered pretty healthy overall, which scares the shit out of me when I think about how much we would have to pay if we were really sick.

I read in the paper on Thursday that Senator Max Baucus is pushing for a complete health-care overhaul in the US so I sent him an email. While I did say I thought an overhaul was needed, I also stressed that Congress should pass legislation that all people with HSAs should be able to save their entire yearly out-of-pocket maximum pre-tax, instead of just the deductible.

We can save about $5,800 pre-tax per year, but with a $10,000 out-of-pocket max, that still leaves a big chunk of change that we have to pay for.

I know there are people far worse off and everyone is feeling the pinch from rising health care costs. We pay cents on our health care premiums, so while other people may have cheaper co-pays, they pay bigger chunks of their premiums per paycheck. So this isn't a complaint post, so much as a "this scares me" blog.

Because more and more, without your health, you really don't have anything.