Taking the Care out of Healthcare

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A reason not to stay: Healthcare. (Effie, recognise the shirt? It’s the only one that fits over this darn cast!)

I will try and keep this one from being a rant. I already wrote on the subject of healthcare back in September 2014. But this time we thought everything was finally covered after eight months of phoning and faxing and posting bits of paperwork to our health insurers and the people at Obamacare who are like ravenous document-eating monsters. We thought we were prepared. Obviously not. Last Sunday playing an impromptu game of volleyball (anyone over forty take heed) with some friends after a gorgeous day wandering a bird sanctuary spotting bald-headed eagles, kingfishers, and the likes, I caught the ball and heard a ‘crack’. I pretended nothing untoward had happened and carried on with the game so as not to put a damper on the evening.

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A reason for staying: The freedom of riding your bike around the block with no adults hovering…

When I got home, my finger was swollen and purple and I knew something was wrong. So, the next day my husband, J, took the morning off work (which ended up being a day and a half) to ring our health insurance company to find a doctor covered by our health plan. So far, so good. He found a walk-in clinic and we got there just as it opened. I was seen quickly, x-rayed, and told by the doctor there that I would need to see a specialist as it was a bad break. She put my finger in a little splint and after I had given my insurance details and filled out reams of paperwork, they sent us to see a specialist who I was under the impression would be covered by our health plan. This is where we went wrong. At every step of the way, you need to ring up your insurers and check that the doctor you are being sent to, is covered by your plan. Even of you are told he or she is, he or she probably isn’t. But then again, even when you ring your insurer to ask, you are, more often than not, given the wrong information.

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A reason not to stay: The Testicle Festival in nearby Clinton

So we went to see this specialist, who was a lovely, older chap who did more x-rays and said the splint I had been given was not sufficient and I would need my hand in a cast in order to keep my finger absolutely still. If I moved it at all, I might need an operation and the insertion of pins (at which point more dollar signs flashed behind my eyelids). So a cast was put on. I liked this doctor a lot and it turned out he had put money into a film made by a friend of ours. “I got my first cheque from it today,” he told J and I.

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A reason to stay: the golden light.

I was told I needed a follow-up appointment in two weeks in order to make sure everything was healing properly. While making the second appointment, we realised that this doctor was not in what our insurers call “The Ring” (yup, just like the horror movie). “Are there any other doctors at that practice who are in the ring?” J kindly asked our insurers. “Yes,” they replied and gave him the name of a doctor who turned out not to be in the ring. Another few phone calls, and J was given the name of another doctor who was in the ring. It turned out this guy doesn’t have anything to do with bones. Another phone call. This went on from 7:30 am to 5:00 pm with J on the phone being given the wrong information and being told slightly insane things, like, “There are no doctors in Missoula who treat bones and who are covered on your plan.” Then, on the next phone call, he would be told something else. I guess the insurance companies hope to simply wear people down until they eventually give up. I now understand people pulling their own teeth and doing basic surgery in their kitchens. It is awfully tempting.

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A reason to stay: the best signage in the US

After a morning of making more phone calls, J finally found me a doctor who will check my cast in two weeks, and who is part of the ring, and who is in Missoula. We will get stung financially for seeing the first doctor whom we assumed was in our plan, but hopefully from now on, we won’t have to pay. When I say, “we won’t have to pay,” I mean “we won’t have to pay any more than we already do every month for our non-existent healthcare and apart from the amount of money we still have to pay for every visit (35 bucks) and every x-ray (another 120). Apart from that it’s totally free!” Work that one out. But we have learned an important lesson: at every step in the process of seeking healthcare, you need to be on the phone to your insurers for several hours. You need to speak to as many people as possible and sort of deduce what exactly the truth might be based on the number of similar answers you get to your questions. Imagine having to do this if you were in chronic pain, or were very elderly, or had a very sick child you had to watch fading away on your sofa while being dicked around by these idiots? Nope, me neither.

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A reason to stay: the best signage in the US part 2.

Since typing the previous sentence (one-handed), there has been another development. We have just been informed that the one doctor our insurance will cover, and to whom we have just arranged to have my medical notes sent, may not after all accept me as a patient. He is away and won’t be back until next week, which is when I am supposed to have my hand checked again. We have also arranged for J to pick up my x-rays tomorrow and take them to this non-existent doctor. So they are sitting in the waiting room of Doctor Expensive to be taken to the office of Doctor Not-Available-Right-Now. As it stands I am not with any doctor and if the one we have been told to go with by our insurers doesn’t accept me (which apparently is not uncommon) then my choices are to pay through the nose and have everything sent back to Doctor Expensive (at our expense) and pay huge amounts of money for treatment or to literally rip my cast off my arm with my teeth. The latter seems like the most sensible solution at the moment. We were not told any of this when the receptionist at Doctor Not-Availble advised us to move over to them. At every step of the way we have been met with obstruction, lack of professionalism and a total lack of transparency. Oh yeah, and huge bills. The first visit was $369 dollars. Why is any of this significant? Well, for those of you who have read my latest blog post, I had been lulled into thinking about staying here another year. The landscape, the people, my friends, my daughter’s friends, the sunshine, the signage, the incredible literary scene, the thriving film community, the independence we see growing daily in E, the debates about freedom and individuality that rage around us here in Montana. It is all wonderfully seductive. But humming away in the background is this idea that we can’t get sick. If we do, we can’t access the most basic healthcare without being stung financially, giving over our life to making phone calls, and being sent in circles that are making me feel I am the crazy one. And I find this simply too hard.

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A reason to stay: shop windows like these.

After this experience, I just want to get back to the UK. I know it is changing there, too. Cameron and Osborne are doing their best to sell off the NHS, and UKIP is gaining ground. The country sounds like it is becoming less of a kind and gentle island (albeit with its own set of growing and very disturbing problems to do mainly with privatisation) and more of a capitalist’s wet dream.

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A reason to stay: freedom for E

J says I just need another road trip to make me want to stay. Next week his mother and a friend of hers are coming to stay. We’ll be hopping in the car and taking them to Butte and Livingston and some smaller places in between. Maybe once I am back on the road and indulging in all this space that seems to encourage serious thinking, my broken finger will seem terribly small and unimportant. But right now, that doesn’t feel very likely.

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To stay or to go: Places like this make me very curious…

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5 thoughts on “Taking the Care out of Healthcare

  1. Fran Tinley

    Oh Jopo, that is a nightmare. My worst nightmare. When I was there that was my great fear, can’t get sick, can’t get injured. In Australia I can doctor hop as much as I like, I can get my skin cancers looked at, I can see to those niggling pains, I can allay my fears. I can practise prevention. Over there I feel so insecure in so many ways. And to think that you have done all the right things and you are still not covered or looked after or feel secure that you are looked after. It’s a bureaucratic joke. I wonder if you can just get travel insurance. I still think you should stay. Hope you feel better and the finger healing as it should. That’ll learn you and ball games in middle age, it’s a no no.

    • Hey Fran, You are so right.. the insecurity is so hard… Can’t get travel insurance because of my VISA status. I am ‘official’ here… Ugh. Will probably be heading back to Blighty in late July. Sad, but more sensible, I think…. Email me about your screening! Jxxx

  2. Joanna, that is so awful. It’s quite incomprehensible as one needs our fingers! Maybe you could send this post to the health reporter at the biggest Montana newspaper — and if you don’t hear back, pester them. It’s what I had to do when mum needed her new hip, and it did speed things up. Of course, if they are not for ‘Obamacare for all’ they may not care! Which is another blog post… But it may get things rolling, or at least solve your issue of going to the good doctor?

  3. Hi Kate, I think we have it mostly sorted out now. It has taken us 8 months and constant phone calls. The mess is down to the fact you deal with insurance companies here, not doctors. So frustrating! I am seeing a doctor today. We’ll see how that goes. Jxxxx

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