Our screwed-up heath care system

[Ms3r4ISU]

Heath blizzards at DQ are the best though.

Heath blizzards. I love Heath blizzards. Haven’t had one for a long time.

 

[Ms3r4ISU]

I love the vague “I paid” as if anybody has any clue about the total cost paid between them and employer.

@SDCyclonesFamily that is horrible to have to deal with that stuff on top of a death. Seems far too common.

Once is too much.

 

[Ms3r4ISU]

I really hate to bring this up. About a year ago, my wife's lower back started hurting, for now reason. After two doctor visits, the pain was so bad, she took an ambulance to the hospital. 12 days in the hospital and an MRI later, they diagnosed two cracks in her sacrum, pretty much the lowest point of the back. She was then put on inpatient rehab for 7 days.

Close to three weeks later, she was released home. Over the next five weeks, she was in pain, but it was controlled by by drugs. She could move around, but not very well. After five weeks, she had problems with her breathing and heart rate and a doctor sent her to the ER. In the ER, they discovered cancer. Within a week, we knew she had cancer in her bones, which caused the fracture in her sacrum, cancer in her lungs, abdomen, and liver. 7 weeks later, she passed away. Why it took 8 weeks to discover she had cancer just boggles our mind.

Oh, my. I don’t know what to say except I am so sorry.

 

[dirtyninety]

Providers and insurance companies both love to complain about each other, but its an unholy symbiotic relationship. They charge so much because the insurance company will pay that much. Or they charge 4000 for a procedure they know will be dropped to 1500 by Wellmark, then complain about the 2500 as uncovered medical. Blah blah blah. We all have these stories. A necessary evil, I guess.

You're almost describing Secondary Education and Student Loan entities also.

 

[carvers4math]

I really hate to bring this up. About a year ago, my wife's lower back started hurting, for now reason. After two doctor visits, the pain was so bad, she took an ambulance to the hospital. 12 days in the hospital and an MRI later, they diagnosed two cracks in her sacrum, pretty much the lowest point of the back. She was then put on inpatient rehab for 7 days.

Close to three weeks later, she was released home. Over the next five weeks, she was in pain, but it was controlled by by drugs. She could move around, but not very well. After five weeks, she had problems with her breathing and heart rate and a doctor sent her to the ER. In the ER, they discovered cancer. Within a week, we knew she had cancer in her bones, which caused the fracture in her sacrum, cancer in her lungs, abdomen, and liver. 7 weeks later, she passed away. Why it took 8 weeks to discover she had cancer just boggles our mind.

So very sorry for your loss. That is absolutely gut wrenching.

My infuriating medical incompetence experiences at least had a happy ending.

A doctor based on x-ray and MRI told us my dad had lung cancer and probably only had six months left. They wanted to biopsy to determine a course of treatment. Did another x-ray right before biopsy and nothing was there. He lived another 25 years and never had cancer.

Always wondered if the doctor just an incompetent boob, the hospital mixed up the patients and the tests first time and some poor guy was dying and didn’t know it, or my mother’s constant praying actually miraculously worked.

Had a similar experience when doctor looked at radiology report on my mammogram and was too dumb to understand that the radiologist said he couldn’t rule out a type of breast cancer based on mammography that doctor could tell just by looking at my boob. So he wanted to send me to some oncology buddy of his from medical school but I went to my aunt’s oncologist who spared no disdain for the doctor’s stupidity and said I was fine. First doctor had me thinking I only had six months left with two toddlers at home.

 

[RedBlooded]

A friend of mine, his father passed away en route to the hospital in an ambulance. A few days/weeks later, my friend gets a bill for $900 from Waterloo FD for the ambulance ride. Dont our taxes already pay for the equipment and labor? Why is there a bill?

 

[cowgirl836]

A friend of mine, his father passed away en route to the hospital in an ambulance. A few days/weeks later, my friend gets a bill for $900 from Waterloo FD for the ambulance ride. Dont our taxes pay for the equipment labor force? What is there to bill?

Iirc, a good portion of ambulance services are now through private companies

 

[NWICY]

My 98 year old mother will agree. She is not on Medicaid.

How is she not on Medicaid at 98?

 

[NWICY]

I really hate to bring this up. About a year ago, my wife's lower back started hurting, for now reason. After two doctor visits, the pain was so bad, she took an ambulance to the hospital. 12 days in the hospital and an MRI later, they diagnosed two cracks in her sacrum, pretty much the lowest point of the back. She was then put on inpatient rehab for 7 days.

Close to three weeks later, she was released home. Over the next five weeks, she was in pain, but it was controlled by by drugs. She could move around, but not very well. After five weeks, she had problems with her breathing and heart rate and a doctor sent her to the ER. In the ER, they discovered cancer. Within a week, we knew she had cancer in her bones, which caused the fracture in her sacrum, cancer in her lungs, abdomen, and liver. 7 weeks later, she passed away. Why it took 8 weeks to discover she had cancer just boggles our mind.

That's how one of my cousins dad passed, feeling fine until one day he thought he had bruised some ribs, did some tests clear full of bone cancer dead in a couple of months. My sympathies to you on the loss of your wife.

 

[BCClone]

How is she not on Medicaid at 98?

You thinking Medicare and not Medicaid? Medicare is 65+ and Medicaid is for those below income levels.

 

[NWICY]

You thinking Medicare and not Medicaid? Medicare is 65+ and Medicaid is for those below income levels.

Yep I crossed them up.

 

[AgronAlum]

We got a notice from DMOS in Des Moines about paying our account. I called them up and asked them “what account?” The proceed to tell me there are three charges one was our portion of an MRI (which was $900), a wrist brace, and X-Ray for our son after breaking his wrist playing football. Our provider was United Health Care. They took X-Rays and waited a couple weeks. During that time they told him he was OK to practice, no PT. It continued to hurt and then Dr. called for an MRI. We waited 3 days and I ended up calling UHC and asked what was going on, they told me it had just been approved. WTF??

Meanwhile, our “account” with DMOS of which we had never seen a bill for was going to go to a collection agency. I was f’n pissed!!
Turns out they were not happy with the company they were using to send out statements and our account “fell through the cracks” as they were changing companies.
We got the old apology song and dance. They were not going to send a collection agency. After we started paying on it, we come to find out there are two more charges that never got addressed. I came unglued!! Health Care in general sucks!!

BTW- I switched over to BCBS way cheaper than what I had. My BP meds are free of charge now.

The birth of our kids has caused so much of this **** it was unreal. Doctors at hospitals or clinics working for other hospitals and clinics. Bills flying in from everywhere. Nobody’s billing departments wants to figure anything out. My wife literally spent hours upon hours upon hours over a year and a half trying to get multiple billing departments to let us pay our max out of pocket (10k) for our second kid. We just kept on getting bill after bill for a few thousand here and a few hundred there. Once we think things are settled, here’s another 2,000 dollar bill. Add all this to copays from multiple visits a week for months (which they won’t take payment at the desk) you just get billed every couple of days and are expected to figure it out. All of the sudden they’re in collections.

By the time we think it’s settled up it’s time for round two with my third in which my wife had the same complications. Still trying to just pay our 10k that we owe.

It’s truly a system built to get people frustrated enough that they just pay for **** they shouldn’t.

 

[CloneFanInKC]

Look, I am not ******** about BC in particular, but the whole system. Wife hurts knee on Monday, and gets it X-rayed, goes in today, doctor looks a knee and says they need an MRI to know for sure, and calls down, and they are free to do an MRI any time this afternoon, just have to get BC to approve it. But BC refuses to do the MRI without PT first, even though they could have done the MRI this afternoon and by Monday they would know the extent of the injury and the best course of action from there. Instead, she starts PT on Monday, and then we are going to have to see down the road how the knee reacts to the PT, and then have an MRI if its warranted.

The doctor thought we should get an MRI, both my wife and I want to get the MRI, and they can do it this afternoon, but insurance has another plan. Now tell me who is making the decision about treatment here, the doctor, my wife and I or in the insurance company?

The brutal truth.

I work in the healthcare industry and I’m sorry for your wife’s health situation and your shared experiences! I hope she can get the care (that is expected/deserved) and it paid for (why we have insurance).

 

[carvers4math]

Insurance truly is a unique scam. You can pay it for years without getting anything in return but a little piece of mind. Then when you file a claim finally they fight you tooth and nail to provide any benefits at all.

 

[AllInForISU]

My kid had a visit coded incorrectly. McFarland wouldn’t switch it, insurance couldn’t do anything until McFarland changed it. I told McFarland I was never going to pay it and let them know I recorded all the calls. They ended up taking care of it and I never had to pay a dime.

Record calls is one of the biggest things that I have realized helps your case.

 

[cycloneman42]

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.

 

[drmwevr08]

The only real problem here is to doofs at the first stop. I have a torn rotator cuff and I could have an mri but why? PT is a great way to start and if I can't get anywhere you can always spend that money later.

 

[NebrClone]

On Monday, my wife while at work, collapsed while walking, her right knee popped, and she could not but any weight on her knee. They had to wheel her out to a coworker's car in an office chair and took her to the ER. Do an X-ray and put her in a brace and send her home with crutches, telling her to set up an appointment with her doctor in a few days. Last few days she is struggling to walk around, brace is too small for her and keeps sliding down, holding it up with an ace bandage.

So, she missed work this entire week, sitting on the couch, struggling to get up the stairs at night and the rest of it. Today, I have to take a day off work to take her to the doctor, she cannot drive and hell, cannot get in and out of the car without help. Get right in to see the doctor, she says she should not be in a brace, promotes swelling in the knee, and since the X-ray showed no broken bones, it's a tendon or ligament that was damaged and we need an MRI to determine that. They can do the MRI today, if Blue Cross OKs it, so they send us back out in the waiting room, we hang around another 30 minutes, and the nurse comes out and tells us that "BC wants her to do physical therapy first, and then if there is still a problem, we will do an MRI."

So now she will be doing PT for a couple of weeks to determine if there is a problem in the knee, instead of just having the MRI, and then determining a treatment plan off the data from the MRI.
Welcome to the American Healthcare system.

If she was hurt at work. Should be workers comp and would not need to take pto time off.

 

[stateofmind]

A “for profit” system is about as dumb a thing you can have for healthcare.

And some of the people on here with this awesome health insurance live in a dream world compared to what the vast majority of Americans get.

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.

 

[shagcarpetjesus]

Always get PT first.

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.