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Oct 16 2013

Add this to the sick healthcare system we have

 

By win, Cruz neglects to mention Teaparty added estimated $24 billion to nation’s deficit as result of shutdown
You’ve been feeling lousy, lately it’s turned into full blown exhaustion and a little dizziness. You start out trying an in network specialist, but soon come back around to your PCP as the network requires. Expensive out of pocket short cuts just aren’t an option on the $12/hour you make on the days you can handle a whole shift. A couple of exams and blood tests later, that PCP is really worried, calling you in and sitting you down for a close, grim face-to-face hand-holding discussion. You have all the classic signs of serious, often fatal conditions, we’re talking cancer of the marrow, liver/pancreas, or lymph system just for starters. The PCP is so worried she orders a suite of tests to begin immediately, including a CT scan. It’s so bad the doc actually has her MA call and schedule the most important tests while you are still in her office. You’re lucky in one small way, the radiology group the insurance company uses has an opening that same day, if you can hustle over there quick and have no other responsibilities that afternoon. Now, where in all that in-network drama might you suspect that that CT scan was not going to be authorized after the fact?

In America, in our corrupt healthcare system, on employer sponsored group health insurance considered better than average by most standards, that’s where. I just found out that scan has been denied, my PCP will fight it and probably win. After all, all they found was evidence for past chest injury or infection and a touch of pneumonia in the right lung … the real action turned out to be in the blood chemistry. But I don’t know if we’ll win or not, either way it just goes to show fucked up this system is and how badly it needs to be changed.

 

 

 

3 comments

  1. 1
    smhll

    All I can figure is that Ted Cruz and other politicians that share his attitude just want us to get down on our knees and pray and beg for a miraculous cure (magical, rather than medical).

  2. 2
    Bicarbonate is back

    I think Cruz just likes being surrounded by cameras and journalists and feeling his power. Nothing else matters to him.

  3. 3
    magistramarla

    I had the same experience with an MRI of my knee a few years back. When the orthopedic surgeon demanded that I go straight to the test, I detoured to my car, called the insurance company and begged and pleaded until I got the OK. After having the test show that I had Avascular Necrosis, I had knee surgery a couple of months later.
    Imagine my surprise when the insurance company disallowed the payment for the MRI and claimed that it was never pre-authorized. We wound up paying for it out-of-pocket.
    I’m glad that your PCP is fighting this for you. I hope that she hangs tough with them and wins.

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