Saturday, August 28, 2010

Life goes on

I have really been wanting to post since that healthcare series. Ugh! I really wish we had no reason to be concerned about serious things like that.

The thing is, I don't know what to talk about. I have a lot on my mind, but it's not really fun stuff. Lots of planning. Planning, planning, planning. And with my placement in the Junior League (yes, I'm doing my first League year!), I have MORE planning to do since I am on the Planning Committee for my Leaguer in Training (formerly provisional) class. (And, y'all, it ain't no party planning, either. I'm talking five year plans. As my dear former neighbor would say, "Yikes!")

Speaking of my dear former neighbor, I'm done with that crap. Haven't heard from him in a while, and I'm okay with that. I have better things to attend to than him, and even though I would be lying if I said I don't miss him, I am way too busy to care.

Remember when I though I would write about makeup and fashion on Tuesdays? Whatever happened to that? Well, here's a little fix for y'all. My latest makeup obsession is eyebrow shadow/pencil. I always thought it was for blondes, or filling in bad waxes. Turns out, it's my secret for getting those beautiful Kardashian eyebrows.

Keeping with that, I'm getting anxious about fall clothing. I have Junior League, I have a craft business, and I have my social life (which has plenty of divisions, including game days, casual fall days, classy dates, and bar clothes). I'm going to need a lot of clothes, and a wide variety. My plan is to go either dirt cheap or paying more for high quality. I'm sick of buying clothes for $20-$60 that lose their shape after a few wears. Ross and Talbots, meet your new favorite customer.

Did I say date back there? Yes. Not dating anyone yet. I haven't even been on a date in Auburn yet. BUT, I am telling everyone I meet that I am looking to date.

So, that's the fun stuff. The other stuff? I'm not in the mood to go there.

Saturday, August 21, 2010

On Healthcare, Part III

I've explored the philosophical argument in favor of healthcare. I've explained my reasons why health insurance is a threat to our healthcare. Now, I'm going to offer a few more brief points, some solutions, and advice.

Given all my issues with insurance, I have to lay out one last problem: the cost. So the government is going to offer subsidies to those within a generous amount of income brackets - what about being able to pay for it up front? If people can't afford it now, how are they going to be able to afford it the first year of having to have it, before the subsidies go into effect?

Also, while some employers offer insurance benefits to their employees, what about those of us who don't work traditional, full time jobs? Isn't it the American dream to do what you love? Why should people be forced into jobs they aren't necessarily satisfied with just because they are afraid to not have the benefits?

Solutions:

Solution 1: Do away with insurance. Yes, I just suggested doing away with the system as we know it. My mother tells me stories of back in the day, when the first thing a medical provider did not ask you was for an insurance card. She even says she thinks she's still waiting on a bill from when she needed stitches while on vacation once, decades ago. How nice. Let's go back to those days. Let's go back to a time when doctors provided health care in order to help people. (And to think people thought that the healthcare reform bill was extreme!)

Solution 2: While Solution 1 is very extreme, and would cause a new world order in terms of healthcare, let's try this, instead: have health insurance as a policy against catastrophic (financially and health-wise) health-related events.

Solution 3: So, Solution 2 has its bugs, too. Maybe if we just had a little more compassion for each other. (And act honorably - if you can't afford to pay, make payment plans, and stick to them.)

Solution 4: Quit having healthcare be a for-profit business.

So, I don't have a perfect solution, but they're not bad ideas to start with. Maybe if more people would get together to discuss solutions, a good one would arise.

Advice for healthcare providers/staff:

Be sensitive to all patients, regardless of insurance status. Being at the doctor isn't often on top of someone's list of favorite things, so they're likely not in the mood to be the victim of rudeness. (Not saying all providers are rude.)

Be willing to work with patients on payment plans. Look into offering Care Credit at your practice. Have someone available to counsel patients on ways to pay for healthcare.

Give treatment in regards to a patient's health, not his or her insurance policy (or lack thereof).

Advice for patients:

Be nice to your providers/staff. Niceness breeds niceness. If staff people are rude to you, report them to your doctor. If your doctor is rude to you, report it to the office manager.

Stand up for those without health insurance. Kindly say things like, "insurance doesn't guarantee payment, and lack of insurance doesn't mean you won't get it." The more people who speak up, the more voices will be heard.

Pay in a timely manner, as soon as possible. This will make the practice more comfortable, since they will be getting their money, and they will realize you (and others without insurance) are not necessarily a risk to the practice. If you have trouble paying, alert them of your situation immediately, and assure them you have not forgotten. This may not guarantee great results, but at least you are acknowledging your responsibility.

I know I mentioned these things earlier, but remember:
  • DO NOT GO TO THE EMERGENCY ROOM FOR NON-EMERGENT REASONS!!!
  • Honor yourself by being proactive about your health. Be informed of risk factors, family history, often mis-diagnosed and overlooked symptoms. Be honest with your healthcare providers. Remember, it's generally cheaper and easier to treat something sooner rather than later.
If you have stuck it out this far,
through all parts of this,
THANK YOU!!!

Friday, August 20, 2010

On Healthcare, Part II

Did you know that when you are denied private insurance coverage by one insurance provider, it makes it difficult to obtain insurance by another provider. It's kind of like bad spots on credit reports. One mistake can affect your credit with others, even if you are in good standing with them. That one mistake can also cost you credit with others.

I'm going to admit that what sold me on voting for Barack Obama was his stance on healthcare. I was concerned a healthcare bill wouldn't even pass, and as it worked itself into legislation, it started as something that could be good for our country, but quickly snowballed into perpetuating the problem. When it comes to health insurance, this healthcare plan provides for subsidies to those purchasing their own healthcare plan, requires citizens to have health insurance or pay a fine, pre-existing conditions are no longer grounds for denial of health insurance, and insurance companies must allow children to stay on their parents' plan until age 26. The aforementioned aspects of the plan will be phased into effect over the next few years. Also, a government health care plan will be available(There are also aspects relating to business' requiring health insurance, and while related to what I'm discussing, it's relevant, but as far as actual content, it has nothing to do with my point. As for abortion, again, while it is related in subject, it's not related in content.) While this is good news in regards to expanding health insurance coverage, this reform bill is just treating one symptom of many problems related to healthcare.

In some cases, people without health insurance go to the emergency room for non-emergent ailments because emergency rooms will not turn a person away for lack of insurance or inability to pay. This creates a drain on funds directed to emergency rooms to treat emergency situations for those who can not pay, as well as a drain on the emergency room's ability to attend to true emergent cases. Also, those who do use the emergency room for non-emergent ailments will be billed a large amount of money later on, which is a drain on a person who is struggling financially. To those of you who do this, please do not be insulted, but do consider what you are doing. Emergency rooms are for emergencies. The health department and charity hospitals are available for non-emergent cases where a person might have difficulty paying for treatment. Some medical practices will even work with you on payment if you do not have insurance. I advise calling to find out before showing up, though.

Opinion: Health insurance is the biggest problem in regards to our nation's healthcare system.
What led me to this opinion: Have you ever been to the doctor and been told, "Well, since your insurance doesn't cover that, then let's do this instead,"? Or has the pharmacy refused to or tried to refuse to refill a prescription because of insurance rules? If you're relatively healthy and it's not an emergent situation, chances are, it's not the end of the world for you. But what if something is wrong, possibly gravely wrong and this happens? When you aren't very informed and not an assertive person, you might let this slide, especially if it's not life-threatening. But what if it is? An example of something seemingly monor, but is actually very serious is, in women, ovarian cancer sometimes masks itself as uncomfortable GI (gastrointestinal) symptoms - like feeling full after eating a small amount. Women brush off these symptoms, maybe go see a GI doctor eventually, and get treated for the GI symptoms, while the ovarian cancer spreads and gets out of control. When, and if, they finally discover the cancer, it can be too late to be cured. Feeling full after eating a small amount is a seemingly minor thing, sometimes even welcome in that overeating seems to be cured. But, there is something gravely wrong that is being overlooked. A personal example of how insurance dictates healthcare I have is last year I was going to have an endoscopy done, but my insurance at the time wouldn't cover it because I'd already used up my three diagnostic tests the insurance would cover for the year. The doctors' staffs aren't always paying attention to exactly how much (or in my case, how little) insrance covers for medical tests, and they also aren't always looking at how much of other things the insurance will allow. The nurse called me to schedule me for an endoscopy to be performed under general anesthesia so that the insurance would cover it as surgery as opposed to a diagnostic test. Having had an endoscopy before, and aware of how much diagnostic tests cost (because my insurance would only cover $100 per test - and that ain't a lot!), AND knowing I would more than likely be having a more serious surgery later on (and my insurance would only cover one surgery per year), I discussed my situation with the nurse. It was cheaper for me to pay for the endoscopy done with conscious sedation out of pocket than what it would have cost me to do it under general anesthesia. So, I scheduled the endoscopy, knowing it probably wouldn't turn up anything, but also knowing it could (and if so, would be a cheaper alternative to surgery, and possibly be the end to my illness). Had I scheduled my endoscopy so that insurance would cover some of it, I would have been out thousands of dollars when it came time to have my gall bladder removed. Also, I would have been put under general anesthesia unnecessarily (which, when I had my surgery, I realized was not as pleasant as other methods of sedation I had been administered). An example with pharmacies is one of my doctors wrote my phenergan prescription as "Take one pill everyday for nausea," even though he knew I took one half a pill every six hours as needed for nausea, and told me in his office to continue doing so. Because of the way he wrote the prescription, I had a really hard time getting the pharmacy to refill the prescription after one month, because my health insurance wouldn't cover it. Health insurance dictates what kind of care we receive, not what kind of care we should receive. This happens because plans dictate what will be covered by insurance and medical professionals don't often consider the patients' ability to pay.

Also, a patient's health insurance status affects their course of treatment. The latest doctor I am seeing (for recently diagnosed hyperthyroidism) changed her mind about what diagnostic tests she wanted to run on me when she realized I didn't have insurance. Originally, she wanted to repeat blood work (to see if I was still hyperthyroid), have me get a thyoroid ultrasound, and get a thyroid uptake test done. When she realized my insurance status, she dropped the uptake test to be performed later, depending on the results of my bloodwork and ultrasound. I told her I did not want my lack of health insurance to dictate what kind of care I received. I must wonder if providers assume it's okay to do as much as insurance will allow, and, also, to limit what they would do given a lack of insurance. If so, doctors would be increasing costs to insurance companies, as well as patients, if the former is the case, regardless of necessity. If the latter is the case, are patients really getting the care they need?

Lack of health insurance is used a tool of discrimination. In Birmingham, I haven't been refused to be seen by a doctor for not having insurance (yet), but in Auburn, I have. Some practices have even taken to holding an exorbitant deposit on patients without insurance. I spoke with a manager of a medical practice about this. He justified this practice of charging deposits by saying they take co-pays for people with insurance. I countered with, "Co-pays are generally much cheaper than the $100 deposit I just had to pay. Also, just because a person has insurance does not mean (1) they have a co-pay, and (2) that the insurance will cover the treatment." I understand that practices need money in order to continue. That's a simple, unpleasant fact of life. However, by charging a deposit to patients without insurance, regardless of ability to pay is not fair in the sense that they don't charge a deposit on patients who have insurance, but may not pay the balance that is due. There's a big difference between charging $100 (deposit)and $25 or $30 (co-pay), but expecting the same results. In Auburn, I made a list of all the internal medicine practices in the area, called my first choice, and was turned down due to lack of insurance. I called a few more practices until I found one that would see me. They informed me I would have to pay everything the day of the visit. My reply? "That's the way I prefer it anyway. As far as finances go, I am going to be your favorite patient. You get your money and you don't have to deal with waiting on insurance or having to bill me." Just because a person has insurance does not mean that person will be able to pay for their medical treatment, and just because a person does not have insurance does not mean a person can't afford treatment. Therefore, lack of insurance should not be a reason for refusing patients.

People without insurance sometimes prolong medical treatment (and go without routine and preventative care) because they assume they can't go to the doctor if they don't have health insurance. Let's do some easy math here: if your insurance premium is $1200 per year, and you are a perfectly healthy person, getting an annual physical (and, ladies, a physical is often included with your annual OBGYN appointment), and going to the dentist twice a year, having dental x-rays done once, totals about $700, give or take. What's cheaper? Not having insurance. Health insurance really comes in handy when you have ongoing medical problems. (Unless you pay over $200 per month to have some fly-by-night insurance company "cover" you, and they only cover about $100 per visit or test, and limit the visits and tests to five and three, respectively.) The longer treatment is prolonged, the harder it is to treat, and therefore, more expensive to treat. For example, if you have a cavity, what would be relatively simple to remedy and cost about $175, give or take, prolonging the situation can lead to a root canal (more painful and more money) or even having to have the tooth pulled (even more painful, more involved, and of course, more costly). When situations get out of hand, this again creates a drain on the system. In cases where patients rely on assistance to cover their medical needs, a filling is much cheaper than pulling a tooth, thus the latter costing more money to tax funds allocated for those in need of assistance. For women, getting a routine pap smear can detect abnormal cervical cells, which can lead to cancer. Again, getting the abnormal tissue removed costs much less time and money than treating cancer. And what if the cancer spreads and you find yourself terminal? Is a visit to the health department or about a $200 doctor visit worth your life?

Some (if not all) medical practices offer DISCOUNTS to insurance companies. If practices are so concerned about money, why do they offer discounts to the companies that have the money to pay for it and not to private pay citizens who would benefit from saving a few bucks? Why do they even have a full price and a discounted price? Fortunately, a couple of practices recently have charged me the discounted rate. If you go to a doctor to do private pay, and wonder if they offer the insurance discount to those opting for private pay, just ask. It may help you out a little.

Thursday, August 19, 2010

On Healthcare, part I

Last week, I was telling my mother about my latest healthcare woes. She suggested I write about it, become an advocate for those who are adversely affected by our current system. I've touched on this topic before, as it affects my life more than I would like it to. And let's be real: it affects everyone, some more than others. I have tried before to write about it, to vent my frustrations, but I've always gotten so upset before I can concisely make my point that I just save the draft and table it for the time being. Obviously, being liberally minded, venting my opinions isn't going to get me far, being a big, blue Southern dot in a sea of red. Let me say this, though: I'm a little more purple than blue. I'm going to stick to the facts the best I can, but I am still going to throw in opinion, in order to maintain the passion of this issue. So, if you disagree with my opinion, that is totally fine with me. I believe diversity is what makes this world so awesome. Just hear me out, and consider what I have to say. I'm not trying to change anyone's core belief system or anything like that. My goal is to raise awareness. I also want to acknowledge that I am not a debater by nature. I don't like conflict. It stresses me out, and in doing so, raises my blood pressure, which is not a pleasant feeling. So, I'm going to channel my inner Ralph Nader (as a consumer activist), Julia Sugarbaker (as a great orator, and "diatribe-r"), Political Scientist (as a commentator on the state of affairs) and Chris Rock in Head of State ("That ain't right!"), and just go for it. This is going to get deep and unpleasant and very long. Please note: I will boldface my main points as a way to ease skimming.
The state of affairs relating to healthcare really hits home for me. In 2004, I was diagnosed with polycystic ovary syndrome. In 2007, I began experiencing chronic nausea, fatigue, and abdominal pain (a.k.a. my mystery illness). In 2008, still experiencing the mystery illness, I was denied health insurance (due to pre-existing conditions). In 2009, I found a health insurance plan that was more expensive to pay for than to go with private pay (paying out of pocket, without insurance). In 2010, my health insurance company was ordered to cease and desist operation because it was, at this point, only an insurance card, and not actually covering anything. I am still sick. I pay out of pocket to my healthcare providers. I deal with discrimination in doctors' offices because of my lack of insurance. Thankfully, for now at least, I am able to afford to "do private pay" (as the office staff calls it). But what about those who can't afford it? Just because I can afford it, doesn't mean everyone else can. (And that, to all those sociologists calling me an individualist, is what sets me apart from the individualists.)

Per the Declaration of Independence, I believe that healthcare is a right. I believe this right falls under "right to life, liberty, and the pursuit of happiness". While the "pursuit of happiness" clause is a weak argument (the key word being pursuit), I will state that it's hard to be happy when you are sick. But you still have the right to pursue healthcare in order to heal and, therefore, be happy. The "right to life" clause is what I prefer to argue. Life can be thought of in two ways. One of which is the ability to live in the figurative sense, as in "living life to the fullest." It's hard to do that when you're sick, but given the wording, you can always live as full a life as possible, given the circumstances. The other way I look at life, and the way I prefer to look at this clause for my argument, is the right to live. It's kind of hard to live when you're dead, isn't it? And it's pretty hard to get the treatment you need when you don't have appropriate healthcare. These rights were deemed unalienable by our founding fathers. That means, according to the intention of the Declaration, we have the right to alter or abolish the government when these rights are violated. (I am aware this way of thinking opens up a whole related can of worms, but I'm going to save my thoughts on that for another day. A day when I don't feel the need to advocate for the nation as a whole.)

Wednesday, August 18, 2010

Plan B

I mentioned in my last post that I am moving on to Plan B. With me, there is always a Plan B. I'm aiming for the big picture by doing little things along the way.

So, I'm a self-described Jane-of-all-Trades. I've been a babysitter, sitter (in general - house, pet, child, elderly), bartender, and office manager/bookkeeper. I've also majored in political science, history, education, public administration, and therapeutic massage. I've even taken a course in real estate. I have done volunteer work with GLBT causes and reproductive health. I love Barbies, cooking, and Auburn.

You know what else I love? What brings me peace? My escape from all the nasties of day-to-day modern life (besides Auburn)?

Arts and Crafts

It's probably the only thing I've been doing since I was born (besides watching "General Hospital").

So, I am finally putting my creative side to work, like I always have wanted to do.

Since I am still organizing the business and doing my research, I'm not quite ready to go completely public, obviously. I just couldn't leave y'all hanging, wondering about the mysterious Plan B.

(Alternate title for this post: Plan B: It's not just for birth control! Gotta love my inner reproductive health educator!)

Tuesday, August 17, 2010

Still raining

It seems with me, the story of my life is if it's not one thing, it's another.

So, while I was starting to find my blogging groove, another little rainstorm happened.

I thought, "Wow, maybe I'll have some joy to share on my blog when this is all over," and so I delayed posting. And delayed. And delayed.

And y'all, it's still raining.

What started as a "Go see this doctor and she'll give you some medicine and you'll be feeling great again," phone call from my OBGYN's nurse, has turned into three additional medical tests and almost two doctor appointments. Apparently, hyperthyroidism is not as simple to treat as my OBGYN's nurse thought.

I also hurt my finger while moving my stuff back to Auburn. This may or may not be related to the hyperthyroidism. It also may or may not be related to another autoimmune disease. Oh. Me.

Now, I know how doctors' appointments and medical tests go. One doctor says things aren't normal, they refer me to a specialist who says they are. But, I still feel like crap, so obviously, something isn't right. So, I was totally expecting to go to the endocrinologist and have her tell me I'm fine. Which, apparently, I'm not. To be honest, I was a bit surprised that my thyroid levels were high in the first place. I mean, it makes complete sense, but just knowing my history with bloodwork and diagnostic tests, I was really surprised something was actually wrong. And when the endocrinologist confirmed it, even though I was a bit anxious about getting my treatment going, I was relieved.

For once, the doctors have something that is diagnosable. And better yet, treatable.

Now, what all this means to me now is:
  • I will not be going to school this semester, as advised by the orthopedic doctor
  • I might actually be getting some answers in regards to my health (or lack thereof)
  • I will continue to live in Auburn
  • I will move on to Plan B
And, yes, I am very frustrated that I told every doctor and medical person I have been to see this summer, "I start massage school in Auburn August 16. Will this interfere with that? Should I put it off?" Everyone said it seemed like a reasonable time frame and they didn't see why I couldn't start school. Except for the orthopedic doctor, who suggested I delay school a semester. This was last Wednesday, five days before class was supposed to start. At that point, I had to agree with him.