So I have an ulcer. I dry heave at least once a day and I haven’t eaten in 21 days. (Please do not give me advice, I hate it, I don’t want medical advice from people over the internet. At best, if you do, I’ll respond with a “thanks.”)
I’m in a somewhat smaller town, not really small, about 80,000 people maybe. There is exactly one gastroenterologist in this town. I went to him when I hadn’t eaten in 6 days. For a $50 copay, he said to take some Mylanta along with the Protonix I was already taking and call him in two weeks if I wasn’t better. So I call him yesterday. I talk to the nurse. I tell her all my symptoms, none of which have changed. She sounds very concerned.
I hear nothing all day. This morning, I call again. The doctor hasn’t even gotten to my information. So the nurse sends a message that I called again, which he probably also won’t see.
I have tried to get a second opinion, or just another prescription for something, but there is not a single gastroenterologist within a 90 minute drive that would see me within three months. I’m pretty sure if I don’t eat for three months, I’ll be pretty dead. I mean, I’m living on Ensure and Gatorade, but I doubt that will get me to three more months.
Oh, and this is the second time this has happened. The first time, I had to take a bunch of tests like a CT scan and an X-Ray and a blood panel and they found nothing. I had a scheduled colonoscopy anyway, so they just went down my throat as well and that’s when they found the ulcer. No one even suggested an ulcer before that.
Why am I saying all of this? I’m not even complaining about all of this. I’m complaining about the fact that this has cost me almost $2000 already and I feel lucky because I have good insurance. I’m not poor, but I don’t really have $2000 to spare. I’m paying it off in installments, but god damn, I have to pay all of this money and they have stopped even giving a shit about me.
What would someone in my position without insurance even do? Die? That’s what conservatives fucking want.
We need universal healthcare and a complete overhaul of the healthcare system now.
And any time you hear someone complain about how long a wait you have in Canada or the UK to see someone to help you and how America has the best healthcare system in the world and how people from other countries come here for treatment, send them to this post before telling them to get fucked.
TL;DR No one gives a shit about you in American healthcare except maybe the nurses and all they do is suck money out of your bank account.
My doctor’s nurse called me up and said I had a high liver enzyme. “What does that mean?” “You can’t drink alcohol.” “But what’s going on with my liver?” “I don’t have the details, you’ll have to talk to the doctor.” The doctor moved away before I could get in to see her.
I called her partner. “New patients are six months out.” Six month’s later: “Sorry the doctor moved away.”
Pick a random doctor in the phone book. “New patients are six months out.” Six months pass. I miss the appointment. “I want to reschedule.” “Sorry, the doctor won’t see patients who miss their first appointment.” I’m trying to get in to the next doctor. So far I have no idea what’s wrong with my liver.
Among other problems, it turns out our local health care group was bought out by venture capitalists. Their mismanagement is part of why so many doctors are leaving.
You’re the person that made the “shitting out the neck of their shirt” comment that had me dying laughing. 🤣
I’ve started just getting bloodwork done out of pocket instead of: going to a doctor, getting the blood work order, going to the lab, getting the draw, making an appointment with the doctor again, returning, and then getting the results.
Now I just pay $50, get the results myself, and then go to a doctor if I need to address something in the results that I can’t figure out by googling. I know it’s absurd, and I have insurance, but to get one blood test is an hour to go to the doctor, wait, go to the clinic room, wait, talk to the doctor for 5min, leave, go to the lab, repeat, then go back to the doctor abs do it again. It ends up being like 3-4 hours over multiple days and in the middle of the workday. For the doctor, it’s two 5min conversations that are PART of their workday.
So, yeah. I tend to just run my own diagnostic blood tests and Google. That’s how inconvenient and frustrating the medical system is even WITH insurance.
And, to be clear, I don’t suggest anyone else do this.
That was morally painful to read.
As someone who lives in a country with a national healthcare system, this kind of situation just disgusts me.
You’d probably be in an hospital bed here, waiting for emergency surgery, considering your condition.
I sincerely hope you can find any other doctor capable of helping you, quickly.
As a former healthcare support staff professional and current medical student, I want you to know that I hate it just as much as you do. I can’t make any explanations for that GI, but my least favorite part of medicine is when there isn’t a good answer, or enough time, or the right treatment is just too expensive…I hate it when the capitalist bullshit medical system gets in the way of actually practicing medicine.
I canceled my dermatologist appointment last winter because it was a 30 mile drive to the clinic and it was the worst blizzard we’d had all year. The soonest I could reschedule was 7 fucking months out. In truth all I needed from that visit was for him to renew my prescriptions, but I’m forced to go in and pay $300 for an office visit to do it.
Wow. Pay money to have prescription renewed. Here in Sweden I just send a message online to my doctor that I need it renewed. No charge or anything like that.
Does your dermatologist not offer telehealth as an option? I’m usually able to just have a phone or video call with my PCP to see how things are going and renew my prescription. Not offering telehealth seems very odd in our post-2020 world.
Edit: Unless you needed to go in for a scan or test. Sorry, I didn’t even consider that possibility.
My problems aren’t anywhere near as bad as yours, but I’ll add my own complaints to comiserate at least.
My wife is a type 1 diabetic. I have a pre-diabetic A1C (type 2) that i inherited from my mom. My insurance (Blue Cross Blue Shield) claims they cover preventative care. But they refuse to cover our regular A1C tests - it’s not preventative because they already know what you have. As a BCBS support person told me, if they’re throwing spaghetti at the wall, its preventative. If they’re aiming for a spot - it’s no longer considered “preventative”. So thats like $600 - $1000 a year. Chump change compared to many in this thread, I know.
Also, for some reason, they only offer coverage for one type of insulin - novolog - which happens to be the one insulin that causes my wife issues. She’s type-1, so her immune system killed her insulin production at around 5 years old. She’s dependent on insulin to survive and uses an insulin pump. Novalog is less effective than literally every other insulin for her - which means she has to take more - which means more risk of long term problems. This insulin also requires a pre-bolus (basically taking insulin) of 1-2 hours before every meal. That means every meal has to be preplanned and prepared for or she starts a rollercoaster of highs and lows. Humalog, aphidra, fiasp? All work more efficiently and within like 15-30 minutes.
The local HMO my work used before offered tiered options. We could pay a bit more for a better option. I would have no problem paying double to get her Humalog. BCBS says no. Novalog or pay out of pocket.
I have occasional headaches that start in the back of my neck that turn into bouts of depression followed by mania a few days later. My neurologist wanted to do a full MRI panel to look for issues. Insurance denies it - medically unnecessary. The neurologist appeals and they’re like “fine fine, but we’ll only cover the head, not the neck” even though the pain started from my neck. They don’t find anything in the head. So the neurologist says, “well unless you want to pay out of pocket, we can’t check the source so…assume it’s just migranes?”
Oh and by “cover”, I mean they paid a small part of it. It still cost me $1,500 to do the ones that were “covered”.
That’s a smattering of the interactions I’ve had with my insurance that I can remember right now.
My parents are retired and on medicare. They pay far less and get way better medical care than I do with one of the biggest private insurance chains in the country. Go figure.
I’m really sorry to hear all of that. It’s ridiculous how expensive insulin can be. It’s not that expensive in other countries.
Thank for your sympathy, friend.
What’s hilarious is that the government recently passed legislation to cap the cost of most formularies of insulin to $35…for medicare recipients. I’ve checked, the vast majority of formularies are participating now.
But if you are reliant on private insurance (because medicare is for seniors), you can fuck right the hell off. You pay what we tell you to. BCBS has not expanded their preferred formulary list beyond this one shitty formulary and I don’t expect them to.
Oh and if you’re like my wife and your insurance only covers a formulary that causes you problems and a demonstratively higher A1C as a result, well you can buy vials out of pocket for $600 - $1000 for a month’s supply.
I’m glad that medicare is as great as it is and have no problem paying into it as a tax-paying citizen, but private insurance is the problem that most of us are dealing with and nobody is doing anything to address it.
Christ, thats fucking horrible
To your point about delays, I waited over two years to see a psychiatrist in a huge university hospital system – one of the only places which would even accept my shitty insurance – as a person with suicidal ideation. It’s so fucked.
Honestly, I got much better and more attentive medical care when I was broke and on Medicaid than in the years since I got private insurance.
Like you said, it takes forever to get an appointment (which might get cancelled without rescheduling) and when you do go in, they just refer you somewhere else, possibly out-of-network. At the Medicaid clinics, they do it all in-house and typically same-day.
I’m fully on the Medicaid for All train.
I know you don’t want advice, but I want to share some information that may be important and helpful for you: recent studies have shown ulcers are essentially an infection and antibiotics have some success in treating them.
For too long doctors thought it had to do with stress or diet, but it’s an infection.
It has been 50€ after refund in total to fix my ulcer. I don’t know the full price of the two medical procedure to check for it and the meds shouldn’t have cost too much.
My colonoscopy with insurance in the USA cost two weeks pay. It would have been 33% of my annual take home pay without insurance.
Profit motives in health care are fucking stupid. End of discussion.
That is awful. I am so sorry squid. I am glad they did find the problem hopefully before things get worse.
Thanks. They found out the problem in July. Now I need them to finally do something about it that works.
My gastroenterologist story:
Chronic GERD. Talk to family doctor, who refers me to a gastroenterologist (one that is “in network” for my insurance"). My insurance is from my wife’s job, who works at a hospital, which you’d think was good. More on this tidbit later.
Go to Gastro doctor (took 2 months to get in), recommends an Endoscopy, which is scheduled for 1 month later. Initial visit is covered (mostly/kind-of) by insurance.
One day before Endoscopy, get a call saying my insurance won’t cover the procedure there, and I’d have to pay out-of-pocket if I proceed ($5k estimate). I say no thank you.
I call insurance company about better location, and am referred to another gastroenterologist. I tried to just get an Endoscopy at new location, but they refused to do so with an Gastro doctor visit with THEIR doctors. I schedule visit at new office (1 month to get in).
Go to NEW Gastro doctor, recommends an Endoscopy, which is scheduled for 1 month later. Visit is covered (mostly/kind-f) by insurance.
One day before Endoscopy, get a call saying my insurance won’t cover the procedure there, and I’d have to pay out-of-pocket if I proceed. I say WTF. Turns out the Insurance company recommended me to a Doctor who was In Network, but their procedure location is NOT in network.
Apparently, despite having a PPO insurance, there is “In Network” and there’s “in IN network”, since my insurance is through my wife’s hospital plan. I have to have the procedure at an official hospital location that is part of my wife’s hospital network.
I schedule an endoscopy at a 3rd location (1 month out again). Finally get an Endoscopy completed.
From initial referral to Gastro, until completion of Endoscopy, was 6 months. This was on supposedly good insurance (which was obviously a lie). We don’t have that insurance anymore.
This kind of thing happens all too often. Going in for a surgery that your insurance will cover? Oops, we forgot to mention that the anesthesiologist is actually out of network, so you’ll have to pay out of pocket for that part.
I live in a city, near a hospital and sort of medical district, so do have easier access geographically than most; also as a legacy of the time when Florida was more rational the insurance has always covered dermatologist, gynecologist, midwife, not just annual visit to GP.
Even so:
Dentist must be scheduled 6 months out.
Dermatologist and almost any specialist 4-5 months wait (basically if you are going each year better to schedule a year ahead of you want to get an appointment).
And cost-wise, the cost in total of insurance and out of pocket cost is batshit insane. Just have to hope nothing happens. Broke my finger, surgery & rehab $5,000. Status migraine, turned away from urgent care, they said I had to go to emergency room, $4,000. If you are designing a system to move money up away from people it’s working as intended.
And on top of the private insurance that only covers anything after I spend thousands of dollars in any given year, we also pay in taxes to cover the sickest and oldest. So insurers are cherry-picking populations. If we had ONE healthcare system it would be cheaper for us. But all my cost is someone’s paycheck and those someones have lobbyists to keep their money coming.
I’m so sorry you have to go through all this crap. I’m lucky that I live in the Houston area, so tons of doctors and even luckier that I have amazing health insurance. Still had to pay thousands of dollars for a surgery since the insurance didn’t want to cover it (it was slightly “experimental”, but it also worked). The US system is screwed up, favors the wealthy, and has lots of profit motives that are counter productive for the “consumers”.
What I hate is that people defend it. I hear arguments about how if there was a one payer system then doctor choice and quality would go down, or that it would hurt rural hospitals. And it’s just all false, but no matter how much you show studies or explain they just keep pivoting. It’s not even a majority of people, but since it’s a vocal minority that votes more, it still hasn’t changed.
