Reply #57: Oh man, what a nightmare. [View All]

[Foo Fighter]

Dragging your ass around to the doc and then couple of different pharmacies when you're sick as hell is NO FUN AT ALL. Been there, done that. Luckily for me, my health care provider (hereinafter abbreviated as HCP) has an in-house pharmacy so that saves a HUGE hassle. When you're sick as a dog, it's a battle even dragging yourself to the doc's office. Luckily, my HCP knows that, hence the in-house pharmacy. I'm sorry your HCP couldn't provide the same for you.

How are you feeling now? I hope you're doing better. I'm sure the hassle you went through didn't help your health situation at all.

Since everyone else has been pitching in, here's my story. A couple of years ago, in searching down the source of a lung problem, one of the specialists I was seeing discovered the cartilage in my nose greatly restricted my breathing. It was a congenital defect and I had never complained about it because, well, like he said, I had never known any difference. At any rate, that wasn't the issue we were looking into at the time but he said that once they got that sorted out, I should have surgery to take care of the problem with the cartilage in my nose.

I had other things to deal with in the meantime but eventually brought it up with my doc in my annual physical. (My HCP requires annual physicals at no cost to me. They even waive the co-pay.) My doc (who is awesome, BTW) discussed it with me to determine the nature of the problem and referred me to a surgeon.

The surgeon I'm referred to is excellent. He's very congenial and straight-forward in that he informs me this will be a difficult surgery due to the complexity. I kin of expected that going in but we both agree it will be a huge benefit to me to be able actually breathe decently through my nose. (Wow! What a concept!) Would this change the appearance of my nose? Absolutely. Would my nose look better afterwords. Very probably. But it wasn't a "nose job" per se. It was a medical procedure to improve my breathing (or rather, actually allow me to breathe) that happens to alter the appearance of my nose. We have a couple of visits or so and he sets everything up for the surgery but says I'll need to check with my HCP to make sure it's covered. I call them and they had all the info (electronically) and said the procedure absolutely would be covered as they deemed it a medical necessity. No question.

I have the surgery (total cost to me; $0) and get a couple of prescriptions afterwards. The hospital pharmacy couldn't find the info on my prescription coverage so I was billed for full price. When I got the bill in the mail, I called them and gave them the info for my prescription coverage (which I was too goofed-up post-surgery to be able to give them) and they apologized for the error, told me to ignore the bill I had received and sent me another bill for the $8 co-pays on my 'scripts. I had a few follow-ups with the surgeon. The first one or two or so were free and any others had a $10 co-pay. So, aside from a few co-pays which I'm sure came to less than $100 total, I paid nothing.

The result? Holy crap! I can breathe through my nose! I can actually be active feeling like I was dying to breathe!! Has my HCP benefited? Most definitely. I had a total of ONE visit to my HCP this year for a virus. In prior years, I had numerous visits for all sorts of upper respiratory problems. These days, I can bust my ass at the local health club without struggling to breathe. My overall health is WAY better than it's ever been. And that, the way my HCP sees it, is what's important.

So, who is my HCP? A NON-PROFIT HMO. Let me state that again. It's a NON-PROFIT HMO. Take the damn profit out of medical care and EVERYONE could have the same coverage as me. And everyone DESERVES the same coverage as me. And believe me, I didn't post this to gloat about my great coverage while others out there have none at all. Hell, I actually feel guilty that I have the coverage that I do which is provided by my NON-PROFIT HMO. No, nothing pisses me off more than people that have NO ACCESS to health care when there is absolutely NO EXCUSE why this country can't provide that for them. NONE. I posted this to demonstrate that it's entirely possible to provide absolutely top-notch medical care to everyone once you get rid of the concept that some fat-cat execs have the RIGHT to PROFIT off of what they sell as "health care" which is nothing more than a system set up to force people to pay premiums while denying them coverage in order to increase the profit margins.

Again, my coverage is with a NON-PROFIT HMO and I couldn't ask for better coverage. Absolutely every single person in this country deserves the same. NO DAMN EXCUSES. We need SINGLE-PAYER and we need it NOW. Anything less is nothing more than a sell-out to the health care execs at the expense of the poor and working class.