I had my annual eye exam today. I go to the big teaching hospital here in Rochester because I think they’re good, and because I have some minor issues that I want them to monitor.
Our health plan recently added a new eye care option. I reviewed it when it was first offered and, to me, it appeared to be a way to buy glasses on what was essentially an installment plan. So we opted for the low-level option of the plan, the benefits of which I promptly forgot.
When I checked in, there was a big hassle to make sure that the information about this new plan was in their system. As the young and obviously very good optometrist assigned to my case examined my eyes, she thought that one of my optic nerves was bigger than the other. Then, instead of having a discussion about what that means, we had a discussion about the fucking insurance. You see, the new eye plan is for regular checkups, but the imaging she wanted to order was not covered by the eye insurance, it was covered by our general medical plan. And was it a high deductible plan, she asked with baited breath? No, I said, to her palpable relief. I also noted that whatever plan I have, I also have thing called “cash”, so let me have the study and we’ll deal with the fallout later. Sure, she told me, but be sure to have the receptionist change your billing to bill your medical insurance instead of the eye plan.
Long story short, I had the study, there was no issue with my eyes, but now there’s a baseline in my chart in case anything changes. I received good quality care, because I have good insurance and the money to pay for a few extra tests if my insurance doesn’t cover it.
I realize this is a nothingburger story compared to what some of you have shared in the comments, and what I have shared about my family. Still: every. fucking. thing. — everything — about our healthcare system includes an insurance-related hassle. Think of the bandwidth occupied in my smart young optometrist’s brain — places in her brain that should be used to remember new therapies and advances in care — that are instead housing little details about insurance plans.
Democrats just have to do something about this. And, I realize it sounds simplistic, but Medicare for All or something like it is a fine platform to run on. I make my living understanding complex software, and consulting with companies and individuals who want me to create or modify complex software. I explain the basics to them and then they ask me what to do. The subtext of most conversations I have with clients is “just fucking fix it.” In the end, despite the nit-picking and concern trolling that every Democratic healthcare plan receives, that’s what people want. Just fucking fix it. Take away the anxiety that we feel about cost every time we enter a doctor’s office. Take away the sword of Damocles — the fear of financial ruin — hanging over our heads when we get a serious diagnosis from a physician. My main concern about Biden is simply that he doesn’t understand that we’re 10 years out from Obamacare and the electorate is ready for the next step.
(And, yes, I went to a teaching hospital during the start of a pandemic. My hands are chapped by the hand sanitizer I used, but Rochester hasn’t had a confirmed case yet, so I’m hoping this is still the calm before the storm. I have an annual physical tomorrow, so I’m living on a prayer, I guess.)
germy
Baud
That’s why God created Congress.
germy
dmsilev
@germy: Lipinski is a real ass. Not only is he a conservative Democrat in a very very blue district, he basically inherited the seat from his father.
Ilieitz
You are really lucky. I woke up one day with a opaque band across my left eye. After various tests they said I had Giant cell arteritis or ischemic optic neuropathy. my left optic nerve is permanently damaged. To protect my right eye I was put on large amounts of prednisone. A year and a half later my right eye has been protected but the effects of prednisone has really mashed me up
pamelabrown53
@Baud:
Fuck an A. Obamacare was like 50 years in the making: every other effort FAILED.
BTW glad MM had a satisfactory eye exam: mazeltov MM.
Is there a reason that we’re ignoring todays’ primaries? Seem kinda important?
germy
Since politics is about compromise, why not start with something big and ambitious, so that when it gets pushed back and watered down by our conservative friends across the aisle, we still get something good?
It’s like if you’re selling your house, you don’t set your price lower than what you want. You ask for more, knowing the buyer will haggle you down.
Maybe I’m being simplistic. I don’t know.
Rusty
Was at the same hospital yesterday having probably the same tests. In my case it’s routine, I need regular pressure checks and annual imaging because of glaucoma. Wondering if we have the same doctor. It’s expensive to have the care, but better than going blind. I really don’t know how anyone could afford the copays and all on the average salary. When I told the doctor I was losing my job, she came back with a handful of samples, it saved me hundreds.
germy
@pamelabrown53:
Because there’s no suspense? We know what’s going to happen.
Omnes Omnibus
Let a Democratic Congress put a bill in front of him and see how fast he signs it.
?BillinGlendaleCA
@germy: If you run on something too ambitious, you won’t get elected and won’t have a voice at the table.
Mary G
Bringing up from last thread:
Baud
Bernie going home to Vermont tonight, according to MSNBC.
Cheryl Rofer
Polls start closing at 8 pm Eastern, y’all
White & Gold Purgatorian
This. We have a fantastic young family doctor. Most visits I just see one of her nurse practitioners, which is fine with me. Majority of visits where I’ve seen the actual doctor, a part of the discussion is about what my insurance will cover vs what she feels I need. It is a crazy system. She knows her stuff, medically and insurance wise, but imagine if that insurance bandwidth could be switched over to keeping her patients healthier.
germy
@?BillinGlendaleCA: This is why Republicans always run on platitudes, rather than their real ambitions. From what I understand, their agenda is unpopular, so they avoid discussing specifics.
Baud
@Cheryl Rofer:
MS will be called lickety split.
germy
@Cheryl Rofer:
And at 8:05 pm, the TV network newspeople will announce the results.
White & Gold Purgatorian
@Mary G: No spin room. Finally something good from this damned virus.
?BillinGlendaleCA
@germy: Yeah, but it works.
Baud
@White & Gold Purgatorian:
Can we keep it?
PST
@dmsilev: Lipinski may be the worst Democrat in Congress because he has no excuse whatsoever. You can understand what’s up with Joe Manchin, for example. Lipinski has no reason to exist. Not in my district, unfortunately, so I didn’t get a chance to put my ballot where my mouth is today when I voted.
Patricia Kayden
Omnes Omnibus
@germy: When negotiating settlements, I won’t move off my initial number unless the other side puts up a reasonable number. I also don’t set an insane initial figure.
David ? ☘The Establishment☘? Koch
They couldn’t even pass it in deep, deep blue Vermont.
Forcing people to give up their health care is terrible platform. Even unions reject it.
Roger Moore
Unless you’re fortunate enough to have an integrated payer/provider network like Kaiser. If my Kaiser optometrist wanted to do some extra testing on my eyes because they saw something that made them nervous, they could just order the tests and not worry about how they were going to be paid for. The bean counters may make things a bit trickier behind the scenes by requiring them to have test A done before they can order test B, but they never have to worry about whether their patients are covered.
JPL
@Cheryl Rofer: Will you please put up a new thread at the top of the hour.
germy
@Patricia Kayden: The swiftboating of Biden has begun. It’s the senility accusations, along with doubts about his son and brother’s business dealings.
Ohio Mom
I have the opposite billing situation.
I have ongoing eye conditions that need careful monitoring so I have my regular semi-annual checkups with an opthalmogist.
Since I’m seeing a doctor for a medical condition, it’s all covered by my medical policy — except for checking my eyeglass prescription, that part is $40 out of pocket. As if there is no relationship between how well I see and my overall eye health!
WereBear
I went through something similar with the new doctor after my old one retired. It was an endless juggle of what tests he’d like, which ones they’d pay for, and which ones would drive me insane with false positives and further testing the insurance company might, or might not, pay for.
It was worth it to go on a ruthless elimination diet. I got off the steroids and my autoimmune has faded to a whisper. The nightmare that would be managing it with expensive drugs and side effect complications was so daunting the revamp of my eating was nothing by comparison.
greenergood
I am 63 years old and grew up in a relatively wealthy suburb of New York City, in a middle-class family; my parents were the first in their families to go to college – my dad an accountant, my mom a teacher. After the age of going to school – 7? 8? – I hid every ailment I possibly could from my parents – earaches, colds, rashes, polynidal cysts, etc. – because I knew the expense would be too much. I ripped a foot on a nail on a boardwalk one summer, and only after my mom saw me in the bathtub with green and red veins going up my calf that she realized I might have gangrene. I got glasses in first grade because my teacher saw me squinting at the blackboard – I was terrified that I would lose them or they’d be broken because they cost so much. I cannot imagine how an NHS-type, or Medicare-for-all type health plan would’ve affected my [‘middle-class’] family, for the better.
Scout211
Just read on CNN that all North American Google employees have been advised to work from home through April 10th.
Jim, Foolish Literalist
I’ve been saying for a few months: It’s a fine slogan. Falls apart when you explain that– to some— it means eliminating existing insurance policies. People want to know there’s a safety net if they lose their plan, the don’t want their plan cancelled, especially in the middle of a public health crisis, I suspect.
The evidence for this being…?
Mnemosyne
I love when people forget that the way John fucking Roberts ripped the heart out of PPACA was by making Medicaid expansion optional instead of mandatory. He knew that the purpose of Medicaid expansion was to get us to MedicAID For All by squeezing from the bottom and gradually increasing the income percentage that was eligible. Medicaid is actually BETTER coverage than Medicare and covers far more things (like childbirth), so it makes more sense to expand that up than to expand Medicare down.
But Obama didn’t even try to get universal coverage … ?
David ? ☘The Establishment☘? Koch
Gvg
Just because you are ready for the next step, don’t assume everyone else is. I think Obamacare improvements are a better idea than M4all. The reason is that even after 10 years of insane republican attempts to kill it, it still exists. It seemed too complicated at first and political experts said right here on this blog that Obama and the democratic leaders tried to intertwine it so much with every aspect of insurance that it would be too hard to remove. They were right. Even though it got sabotaged over and over, it is still here, republican states are slowly implementing it, and if we get the Presidency we can reverse some of the sabotage and if we get the Senate we can improve it.
But we need to take a lesson and create something deeply embedded. I can’t think like that, but I have learned to care. The fact that the GOP still try to screw it and run on screwing it tells me almost a majority don’t want change at all. They are nuts, but we know that.
of course the picture may be grimly different after the virus. If we are hurt a lot more than social medicine countries it could finally push us to really be ready. Say lots of grandparents die because they don’t have coverage, and other grandparents live but are impoverished and people see their family homes foreclosed….that might move the needle. It happens now but on too small a scale for the stubborn to see.
i have always thought it was bad that we had to fight insurance if we even had it while we are sickest and most vulnerable. Bad design IMO. I just am sickened by the immoral resistance to improvements based on tribalism.
West of the Cascades
@Gvg: and the easiest ACA improvement is an option to buy into Medicare (or Medicaid) – that will start a flood towards those programs that will, in time, be single-payer nationwide (employers will start buying their employees into those options because they’ll be cheaper than private insurance).
Another Scott
I got my eyes examined at a new (to me) practice a few months ago. I filled out all their paperwork about my medical history, etc., etc. I have BCBS and they asked if I had any other insurance and whether I was going to file things on my own. I said I was just going to use my credit card.
They seemed ecstatic. I seemed to get a decent price, too.
It’s a crime that we all (providers, patients, etc.) have to put up with this insurance stuff. But there’s so much friction that we won’t be able to change it quickly. But change is always slow. We just need to get started…
Cheers,
Scott.
eemom
@Baud:
?And then you sent us Congress
Good God, sir, was that fair? ?
John Adams, 1776
Feathers
I worked for a healthcare economist and they really liked the Kerry Medicare/aid for all, but with a $50,000 deductible. Basically the insurance market would be for everything under that. Cancer, diabetes, basically any chronic condition would automatically place you into the Medicare system for all your needs. Seemed like a good way to ease into a public system. Don’t know if this was in the actual proposal, but part of the idea was to make med school a free ride and basically offer docs a lump sum on their old loan costs to get them to buy into a single payer government system.
One thing that should be done is to start pushing everything onto one coding system.
Brachiator
I am all for universal health care, but I am weary of the simplistic mantra that Medicare For All and Single Payer is the only and obvious solution. It is not.
Even Medicare For All means that you have to spend money to bring existing Medicare in line with whatever fantabulous coverage you are promising everyone else.
And the plans discussed so far gloss over existing problems with actually delivering health care to people, even people who supposedly have insurance.
And even in Europe, which Bernie likes to shouty wave at all the time, they are having issues maintaining their systems.
And it is crazy to shit all over Obamacare, a good start which can be improved, and talk about a fantasy program which doesn’t exist. And let’s vote and get a Democratic Party Congress or none of this makes a difference.
NotMax
She was snacking on worms?
Bated breath.
terben
I assume ‘baited breath’ was a deliberate hook. I’ll bite, reel me in.
(A)bated breath.