I’m Hoping To Carve Out Insurance Companies, From My Life.

Doctors and Insurance Pathfinding Parenting

There’s a topic I have been putting off but, it’s like I can’t even write about anything else, until I get this off my mind…

The hard part is staying measured and balanced, as I write about the medical/insurance field… this has been one of the hardest things to write about…but, some things need to be talked about…

To start

In order to become a doctor, a person has to demonstrate some pretty cool attributes.  It’s not just about being book smart. Some doctors are even incredibly intuitive, when they choose to be… they are not born followers. To some doctors I would say, get back to you because, that’s what people need.

Below, I’m not writing about things that we haven’t heard about but, I write because, sometimes we automatically assume that things have to be the way they are.  Things can change if we start insisting on it, together.

I have included some of my personal history so that you can see that I have to deal with b.s. too. Otherwise, you can skip past the following four paragraphs. Further below, I write about alternatives to consider and why I am looking for ways to cut out insurance.

This whole thing started for me, five years ago, when a procedure was done incorrectly- twice.  It involved my spine and a lot of insane pain.  I was told the pain would go away eventually and, given a number to call, if I needed anything. It was a number to some unknown individual, not a doctor’s office. I went to the E.R. and it was handled quickly. When I wasn’t charged and even given an apology, I realized this may have been much more serious. I let it go. Too much was going on in my life. A few years later, I spoke to my primary doctor about this situation. She wasn’t the doctor who did the procedure. I wanted to understand what had happened, nothing more.  Her and this other doctor were a part of the same, highly recommended hospital, in a major American city.  My primary doctor insisted that nothing really happened and she quickly changed the subject.  I could read her and I instantly felt betrayed.   She was lying to me. I was just another patient and she had become just another doctor, to me. To this day, I really don’t know what went wrong, with that procedure.  I do know that the doctor who was working on me, no longer works as a doctor, with that hospital.  I actually tried to look her up, to see where to avoid but, there was a part of me that was curious.  Her name has no online presence.  So, who knows…

Recently, I received a bill for 22k.  I had to go to an e.r. because, I had severe sinus pain and it was in the late evening.  I have “great” insurance and I thought that was enough to avoid being totally ripped off.  Why else do we put up with insurance- well, to speak doctor language. I should mention that the bill was lowered to just under 2k. Oh, boy!  Was I supposed to be grateful? (Stay balanced, Erica.) Between the pain and the amount of time I waited in a room, I just wasn’t thinking about the bill. Yes, I should have thought to ask about the bill before getting treated. I should have known better, at my age…

Since then, an ENT tested me for allergies.  I’m allergic to grass and Oak pollen and cats and dogs and other random things common to this planet.  I used to joke about being allergic to Earth…it turns out there was some truth to it.  

I mention my allergies because, it may be something to consider, if you also have crazy pain.  Have you ruled out allergies? I learned that allergies aren’t just about scratchy eyes and sneezing….all of this time I was attributing this pain to random migraines and just having sinus pressure.

Getting back to the topic-

Cash- Only doctors

It seems like everyone has her/his own experience to draw from with regards to the medical field. Most of the time, these experiences have me wondering why we aren’t paying more attention to the “Cash-only” doctors- “Cash only” means no insurance involved. They are up front about costs and accept different forms of payment. From what I see, some of these doctors have something like a monthly fee. This covers the various treatments they perform and, some do house calls.

They do exist in more places than you may expect.

Alternative healing is absolutely amazing.  It is something to experience and hard to explain.  I suggest to anyone to research practitioners, in their area and to try it out. I don’t go for my sinus issues because, the practitioner explained that in my situation, I would need to be able to come exactly when I began to feel the pain.  This has been hard to pull off, in my situation. If I didn’t have this particular issue, I’m not sure that I would even bother with western medicine, at all. That’s me though and, clearly that isn’t for everyone. 

I know that some people want to know how a treatment like, Acupuncture, could work. I don’t understand how the internet works. I don’t know how vehicles work. I use both of them. Stay open. The mainstream use to say that the universe revolved around Earth-

Reasons why I am beginning to research ways to cut out insurance and to break up with the doctors who enable these insurance companies:

  • It isn’t right that prices aren’t disclosed up front.
  • It isn’t right that prices seem to vary depending on the patient. In any other situation this would look like discrimination or exclusion or, it would simply be called an unfair business practice.  We’ve heard all kinds of excuses for it.  The truth is, the agreements between doctors and insurance companies should be much more transparent to us, the patients.  Why? We are directly involved!  Even the semantics, in medical and billing, could trip a person up. And…I hate to say it but, it’s like most doctors are fully in on this game.  I don’t want to be asked, “Did you ask________, up front?” I don’t even know, what I don’t know! This whole process is so convoluted and I am not a part of this crowd.
  • I have come to realize that “great” insurance doesn’t necessarily mean *great* for me.  This may have more to do with the relationship between the doctor and the insurance company…
  • What’s with the tone? A banker actually told me he doesn’t know anyone, other bankers, who will work with a doctor. A banker told me “no one can stomach their arrogance.” Yes, I laughed and thought I was a part of some cosmic joke. “What do you get with a banker, a doctor and__________?” Admittedly this isn’t Everrrry doctor. Still, it happens enough that I will mention it. I don’t appreciate the condescending, superior tone, delivered with a smile at the end of every insult, remark and opinion. You know, a lot of people aren’t afraid of doctors or needles.  They just hate the experience of being in some doctors’ company. They hate being a slave to an insurance company.  So, they avoid going and spending a fortune for a demeaning, disempowering experience.
  • If more doctors practiced listening skills, they may be more helpful. I have learned a lot about my body and this is in part, why I maintain great health.  I don’t need more tests to prove me right. I just need you to listen. Oh wait, more tests mean more…charges…? Hmm, is there a conflict of interest between patients, insurance requirements, and a doctor…YES!  Healthcare has a third party who is in the way of a very important relationship. Ok, to be fair I know it isn’t cheap to have any kind of a practice, I know, I know, everything cost money.  Still, somehow the medical field is caught up in a web that other fields don’t deal with, in such an intrusive way. Let me add again, some people have practices without dealing with insurance companies…it can be done…
  • When looking for doctors for my sons and myself, I can literally call any office, even the offices not taking new patients. When I tell them my insurance info, they have always suddenly changed to an office that can accommodate us.  I found this out because, I didn’t always look online to see if a particular office was accepting new patients. I would just call.  Plus, I’m not the type of person to not try anyway. I’m putting myself out there because, when I realized what was happening, I felt like one of those people who don’t have to play by the same unjust rules.  I can be honest and say I didn’t like the way it felt. I’m not one for rules but, some things are just not right.
  • The psychology elective a doctor can take at some medical schools, doesn’t give a doctor the power to read a patient’s mind. It also doesn’t make you more relatable. Sorry, I’m getting cheeky again.   If you are a doctor and you want to use interviewing skills a psych major studies in her very first class, you should practice in front of a mirror, at the very minimum. Discernment or problem solving involves more than faking an expression.  It’s more than asking, “What does that mean?”  Simply, Listen and See your patient.  Can I say something, as a friend? If I were you, I wouldn’t even use the beginner level psych “skills.”  It can be a tiny touch revealing and can back fire. It is its own practice and, you don’t need it anyway. Just be straightforward and try to have a heart, while you are at it. Have a normal conversation with your patient and x the ego. Just be a person and think or breathe, before you speak. Being a doctor already gives you more privilege than most people. There is no need for more tactics, masks or, some other internal computing of some sort. Just be a person.
  • The blame game. Insurance companies blame the doctors. Doctors blame the insurance. Everyone blames the patient. All I know is, a person goes to a doctor for help, the doctor submits changing (?) prices/procedures on paperwork and, insurance companies always have the right to accept or to deny without notice.
  • Who is working for who? I mean who is actually calling the shots in this field, when we include insurance.
  • Why do we need insurance? If prices were fair would we need insurance?  As I have stated above, there are people who are getting around insurance and ACTUALLY helping the people. Do we automatically sustain this broken way of doing things when we assume medical intervention *should* be unaffordable without insurance.  Do we really need a third party to interfere? Personally, I feel squeezed for my extra cash no matter whether I have great insurance or no insurance.  I know a man who got stuck with a 50k bill. He called 911 because his son was choking (we’ll skip the horrible details). The operator thought it was medically necessary to have the helicopter pick up the son. Later, the insurance company said that there was no emergency.  So, dad got to flip the bill for the ride, in the end (btw, the son lived).We’re told that people with no insurance are responsible for making it all more expensive but, from what I see, we are all getting squeezed. When I think back on what I was charged for little things, when I didn’t have insurance, as a student…I was getting squeezed then, too.
  • We don’t have to do things the same way because, “it has always been this way.” We have brains and the ability to be creative.  Let’s solve this- patients and doctors together.  Maybe we need a kind of couples counseling for patients and doctors- let’s make it work out…

Let me apologize for any lack of sensitivity. I don’t see doctors as the enemy. We do need to make changes.