Our screwed-up heath care system

Before surgery? Sure, seems logical. Before a scan to determine the extent of the injury? Why? Isn’t there a benefit to know the seriousness of the injury before a PT plan is developed?

I will admit I’m totally ignorant and there might be a very valid reason to just prescribe PT without an MRI.
PT is about strengthening the muscles around the injury. So, even if surgery is required, the recovery is so much smoother because the muscles are built up to take the extra strain during recovery. Plus, if there is a ligament tear, you're not going to do any further damage and if there isn't a tear, the PT will most likely resolve the issue without the test.
 
I love how you all think this is unique to the American healthcare system...as if in Canada or the UK you just waltz in and get an MRI whenever you want.

MRIs are expensive and thus their access is limited. I work in ortho. If a patient really needs an MRI for an acute injury, they are almost always approved. It sounds like in the case of the OP, this should have been approved. If yours wasn't, it's because the provider did not include the necessary information.
They only thing expensive about an MRI is the price of the machine and the billed man hours of the people who assist with the MRI and the people who read the MRI.

(NB: price vs cost)

I don’t believe the OP stated these issues are exclusive to the US.
 
I love how you all think this is unique to the American healthcare system...as if in Canada or the UK you just waltz in and get an MRI whenever you want.

MRIs are expensive and thus their access is limited. I work in ortho. If a patient really needs an MRI for an acute injury, they are almost always approved. It sounds like in the case of the OP, this should have been approved. If yours wasn't, it's because the provider did not include the necessary information.
Please comment on my situation. I suspected something so I visited my general. He, correctly, escalated his suspicions. I was diagnosed with testicular cancer. But, it took 4 scans about 1 week apart for each to determine the extent of the cancer. Which was needed to determine which treatment (eg surgery, radiation, chemo) I was to have. Each scan was a bit further north. Why so many scans when one should've sufficed? I was lucky because I was in such good shape and my cancer was treatable. Succinctly, the better shape your body is in the more poison they can throw at you. My oncologist told me if I'd waited another week to come in, I wouldn't be here today. And for all this only $50k out of my pocket. Imagine what the insurance company had to pay. YOUZA. And I consider myself the lucky one in this so-called healthcare system. I am so saddened to read about all of your negative experiences. That said, I believe this is an educational 'systemic' problem as 'individually' I think there are good intentions, but the lack of responsible oversight at the management and educational levels has made this whole system a joke.
 
You thinking Medicare and not Medicaid? Medicare is 65+ and Medicaid is for those below income levels.
At one time Medicaid was used to help Medicare seniors for things like nursing home care. I believe Medicaid also used to help middle-class families who had children with disabilities.
 
I mean wasn't some of it used to help people who weren't necessarily poor in some cases?
There are people who play games. I know couples who have divorced (FAFSA works this way also) and they pick the parent who doesn’t make as much and just list their income to get them on it. I know couples who wouldn’t marry (advice from one of the families) while they had a kid or one was going to college, in order to obtain government subsidies, although they were living with their fiancé and has a kid or two.

That is where the talk of the marriage tax happens. If one makes 150k/year and their SO stays home and watched the kids. (They would be considered high middle income combined), it would be max grants, free lunch, qualify for Medicaid, everything available through the government. If they get married, they would get none of it, college kid wouldn’t even be offered a subsidized loan.

So yes, there are many working the system.

Don’t get me started on how the care center game the system. Wow!!
 
I work for one of the largest not-for-profit health systems and we have a CEO making north of $10M/year. Just like sports, money spent on individuals will eventually not be sustainable. Greed in this world is crazy.

Kneel down, ye sinners, to streetwise religion................greed's been crowned the new King.................... **nikki sixx :)
 
There are people who play games. I know couples who have divorced (FAFSA works this way also) and they pick the parent who doesn’t make as much and just list their income to get them on it. I know couples who wouldn’t marry (advice from one of the families) while they had a kid or one was going to college, in order to obtain government subsidies, although they were living with their fiancé and has a kid or two.

That is where the talk of the marriage tax happens. If one makes 150k/year and their SO stays home and watched the kids. (They would be considered high middle income combined), it would be max grants, free lunch, qualify for Medicaid, everything available through the government. If they get married, they would get none of it, college kid wouldn’t even be offered a subsidized loan.

So yes, there are many working the system.

Don’t get me started on how the care center game the system. Wow!!

Is anybody gaming any system just to get healthcare access that nearly everybody in every other developed country already has?

It’s not fair to those who don’t do it but in the big picture it’s still one less person screwed over by a type of “system” that shouldn’t exist in an advanced nation.
 
Is anybody gaming any system just to get healthcare access that nearly everybody in every other developed country already has?

It’s not fair to those who don’t do it but in the big picture it’s still one less person screwed over by a type of “system” that shouldn’t exist in an advanced nation.
You just want to discuss access? Look at the MRI wait times that I posted earlier, are you fine with those?
 
I worked in health care for 8 years in the imaging department (X-ray and CT). It's been almost 11 years since I left it.

My advice to family & friends (based on personal experiences and working in healthcare): You have to advocate and stay on top of things for yourself and family members. If possible, stay with a family member that's in the hospital or spend as much time as you can with them. Obtain your medical records and review results yourself. You can google search the terms you don't understand. But don't try reading more into things - let your doctor interpret it. Ask questions. Make sure they explain so you understand. If they don't/won't - find another doctor. Remember, you have the right to make your own decisions for what to do with your health.

Doctors and those working in healthcare are not gods. Like all humans, they are fallible. And, as in all jobs on this earth, some people are good at what they do, some are mediocre and some just suck at it. Sometimes doctors (or anyone else talking with the patient) do not pass along enough history for those scheduling/doing/reading the exam or those making a decision to pre-authorize it. Sometimes an incorrect exam protocol is ordered or done. And - sometimes results are not read properly or just not reviewed right away.

I've had my own personal battles with doctors not listening to me. I've found male doctors don't listen to female patients as well as they do with men. (Believe there are studies backing up the same) Years ago my son fell and it took almost a week before we found out his shoulder was fractured (BTW fractured, broke & cracked all mean the same thing). Another time I took a son in, thinking he had bronchitis or pneumonia. Doctor didn't think he had either or needed a chest x-ray. I insisted. They did it - I was right - he had pneumonia. My Grandma had a colonoscopy at her local rural hospital with a general surgeon and afterwards was told she had colon cancer and needed to schedule colon removal/resegmentation surgery immediately. She got a second opinion & went to a gastroenterologist, was told she had suspicious polyps which were removed and sent for testing. Results came back showing pre-cancerous and just monitoring was needed afterwards. (Still trying to figure out WHY those polyps weren't removed & tested during the first colonoscopy).

How can it all be fixed (including costs, etc)? No clue. IMO - it's a very complicated mess on all sides and not just one thing will remedy it. But there are good people in healthcare doing what they can to give their patients the best.
 
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Guessing those were done at a hospital? Unsolicited but free advice... Avoid imaging at a hospital at all costs. Imaging done at an outpatient imaging center is typically less expensive. If you're going to hit your deductible for the year it doesn't really matter where it's done. You're going to pay somebody that money anyway.

Learned the hard way but tough to take time and comparison shop when you’ve been scared about cancer. Doc told me symptoms weren’t in line w kidney stones. I also live in an expensive area for care but my previous city (Chicago) is actually higher so it could have been worse.

I did try to get an estimate before the first scan but they dragged their feet to the point where I was just ready to move on, I don’t think the people who wouldn’t give me an estimate were bad people. I think they work in the only industry where people buy things and almost never know the cost of what they are buying. Designed that way by people getting rich at the top, not some poor lady who would give me an estimate if it was possible.

Meanwhile I take my dogs to this new type of Vet where I’m in the office with them and get real-time instantaneous estimates on my phone while I am talking to a vet that I can confirm or deny instantly before I ever spend one dime. Having dogs is opening my eyes to how horrific our health profit system is.
 
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You just want to discuss access? Look at the MRI wait times that I posted earlier, are you fine with those?

I think you can spin things however you like. My mom waited 95 days for a cancer specialist and she had cancer. It’s not like we don’t also wait while paying 20x more.

My best friend’s family holds degrees from Harvard/Stanford and has citizenship in the US and Taiwan splitting time in both nations. They get absolutely nothing done here despite having good insurance but go to doctors and dentists when they are in Taiwan, faster and something like 97% cheaper to do there, they love it.

My office has people in the US, Hong Kong, and Toronto. The non US employees are horrified of the realities of our “system” when we review “plans”.
 
I think you can spin things however you like. My mom waited 95 days for a cancer specialist and she had cancer. It’s not like we don’t also wait while paying 20x more.

My best friend’s family holds degrees from Harvard/Stanford and has citizenship in the US and Taiwan splitting time in both nations. They get absolutely nothing done here despite having good insurance but go to doctors and dentists when they are in Taiwan, faster and something like 97% cheaper to do there, they love it.

My office has people in the US, Hong Kong, and Toronto. The non US employees are horrified of the realities of our “system” when we review “plans”.
Taiwan has government funded HC, so of course the bills to the patient are much cheaper.
 
Taiwan has government funded HC, so of course the bills to the patient are much cheaper.

Looking up their net health expenditures vs ours, may surprise you.
 
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Own experience, I am on Medicare but the wife is too young. Diagnosed with cancer and Type 1 diabetes, and her job was terminated. Cobra for 1 and1/2 years and then in the insurance market for another 1 and 1/2 years. With her treatments and immunity issues, she cannot work fulltime as a nurse and feels safer working from home. At least with the ACA she can get insurance, although costs are exorbitant. Luckily our savings will help, but how do others less fortunate hope to make it.
 
Wait times vary on MRI's depending on where you are, but in my limited experience, my wife or anyone else could have walked in and had an MRI at our local hospital yesterday, their afternoon was free. My mom had to wait a week to ten days to get one, in South-Central Iowa, they have a mobile unit that serves many of the hospitals down here one day every other week. There are plenty of MRI machines within an hour drive of us, so if you are waiting more than two weeks for an MRI, you need to check around at hospitals in medium size town like Ottumwa, Pella, Oky or Bloomfield, all have full time MRI machines and staff.
 
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Wait times vary on MRI's depending on where you are, but in my limited experience, my wife or anyone else could have walked in and had an MRI at our local hospital yesterday, their afternoon was free. My mom had to wait a week to ten days to get one, in South-Central Iowa, they have a mobile unit that serves many of the hospitals down here one day every other week. There are plenty of MRI machines within an hour drive of us, so if you are waiting more than two weeks for an MRI, you need to check around at hospitals in medium size town like Ottumwa, Pella, Oky or Bloomfield, all have full time MRI machines and staff.
Local clinic has the mobile one day a week. I can drive 32 miles and do it the others. Generally same day or next day at worst.
 
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She is on Medicare and supplemental insurance. Just like many retirees. Medicaid is if you dont have the money.

Yep BC pointed out that I had flipped them in my mind. My folks are on Medicare and supplemental, but luckily they still do it themselves and I haven't had to learn the terminology. Have had to sort out some problems with insulin pumps and cartridges where they needed pics of defective items sent to them etc...
Doing this stuff can really eat up the time.
 
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