Tag Archives: medical system

My Australia is broken

The socialist sister of my more gentle post celebrating the end of 2014 – fair warning –  this is a rant – and a reminder I have no respect for the right-winged of the species.

(Unless you are Icarus and favor your right side.)

knee 028 - Copy

A brief re-cap (pun intended) and update of my knee troubles.

By June of last year I was unable to walk without considerable pain in my knee.  I went to the doc and she suggested it was a torn meniscus and sent me to PT.  PT was good (and really cheap, thankfully) but my knee didn’t get much better.  In the autumn, I went to see an orthopedic doc and my insurance company finally consented to an MRI – but – it called to give me a guilt trip because the place my doc booked it charged $3,000, and a place difficult to get to only charged $400.  I was irritated, but I get it – it is an utter crime that hospitals inflate costs – despicable – and as consumers we should be aware of such crimes.  But it was hard to get to the recommended place, so I settled for one in a remote-ish suburb that charged $700.   I had the MRI on a Friday, and wouldn’t get the results in the mail until the following week, but they enabled my armchair diagnostician self by sending me home with a CD of the images that day.  I spent the greater part of that weekend correctly identifying my torn meniscus and finding several other dire and crippling conditions.

 (And I also became very put-off by meat – I’d seen too much of my own.)

I called the office Monday morning and asked if the person on the line if she could tell me what was actually wrong over the phone.

She couldn’t do that.

I asked if I had the suspected torn cartilage, and she didn’t confirm or deny…

I asked about other things and got the same non-committal results…

This poor woman finally became flustered and said:

“It’s not fatal, but you can’t go skiing.”

(I was confused if she meant water skiing or downhill skiing because it was the season for neither…)

But in the end, it was just a meniscus tear, and the other weird things I saw and diagnosed incorrectly were just some run-of-the-mill deformities (thanks mom & dad) and the doc plumped up my joint with cortisone and told me to schedule a minor, common surgery to fix it.

Only when I called my insurance company to find out the co-pay for it, I learned that it would be a “co-insurance” cost and I’d have to pay 40% of the entire procedure and all those involved and the facility and so forth… so I couldn’t afford to schedule it and decided to get a better plan from the insurance marketplace for 2015.

I’m thankful that there has been some effort on healthcare reform and we now have greater access to healthcare as individuals, but…

IT IS NOT AFFORDABLE HEALTHCARE

I make a wage just enough to sustain myself (N thankfully covers the mortgage) and I pay our utilities, half the groceries, and my insurance premiums.  I do not make enough to be able to pay over a thousand in deductibles and up to $7,000 in “co-insurance.”

A person who essentially lives paycheck to paycheck does not have extra thousands lying around.

I can budget for a monthly premium of a few hundred dollars – yes, I can’t really afford that either, but it is a known and reliable expense, and I’m willing to forgo a real cell phone and cable TV and new clothes and fancy cheeses and turning up the heat and yarn and haircuts and happy hours for it.

But I can’t just shell out thousands of dollars if I happen to need something expensive – especially if I’m unconscious when it happened and have no choice where I’m taken.

Throughout the mid-late 1990s I had private insurance that offered the same amount of coverage as the plan offered by my future employer and it was good.  Yes, healthcare costs more now since they can no longer deny anyone and schleps like me have something mildly expensive to deal with, but come on – I have not needed surgery, been hospitalized, given birth, had any conditions requiring continual medications, and I have a healthy low-risk lifestyle.

 I’ve been doing nothing but contributing to the profits of insurance companies for decades!

(And another mini-rant is the health insurance exchange is very different in each state, so you may hear something in the media about it being all hunky-dory for someone somewhere, and it is, just not here… And my options for plans in 2015 are worse than 2014 – yes, there are more from which to choose, but the maximum out-of-pocket costs are higher.)

So, I’m soldiering though my torn cartilage without surgery – it has gotten more manageable now 9 months later, though I still can’t hike – so I don’t know if I will eventually recover enough, or I’ll have to wait to repair it indefinitely…

So, is that really healthcare?

No, it is not.

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