how is this better than single payer, or even different
other than the profit aspect?

my son has an apparent pinched nerve in his back which is
causing him constant pain. the doctor recommends an MRI.
i'm scared shitless of how much this will cost me since
my Aetna "gold" HMO has already resulted in surprise
charges following my colonoscopy and IVP procedures
(even though in the latter case, i was very careful
to explain to the Dr's office that i needed to know
my bottom line before anything was done).

so i called Aetna this morning to get the bad news
ahead of time. if it's too much money we'll do
cortisone shots first, or acupuncture. but given
the amount of pain he is in, how long he's been
symptomatic, and his tender age (he's only 17),
i would like for his doctor to be able to see
what's happening in his back. as would his doctor.

so aetna tells me that authorization must come from
their "third party Administrator" MedSolutions. Apparently
what must happen is my doctor's office calls these
MedSolution people who request and review the
"clinicals" and then render their decision on
whether an MRI is indicated. According to my dr's
office it's 50/50 whether they'll approve it. i
am then told that if it is approved it will cost
only my copay of $30.00. I record the Call ID so
that when they hit me up for more than $30 later
they can hear for themselves this rep of their
company telling me repeatedly that i will only
have to pay $30 as long as the doctor's office
contacts the proper "third party Administrator"
and procures authorization through them.

i want to know: how does this rigmarole constitute
making a decision "between the patient and his doctor"?!
it's BULLSHIT! private insurance companies, ever mindful
of the business they are in (read: it is NOT patient care,
it IS profits for the shareholders), have created a
bureaucratic nightmare for hapless consumers to try
to pick their way through even a minor illness or injury.
i dread ever having to maneuver this maze in the event
of a major life threatening illness.

the government could not possibly do worse than this,
probably would do much much better, and without a doubt
when the profit aspect is removed from the equation,
more people will be covered for less money.

SINGLE PAYER Health Care for Everyone. NOW.

PS - authorization acquired in record time. procedure
scheduled for tomorrow.

do you think they might be working with people with
more alacrity and liberality due to the political
storm underway?
- posted by barbara @ 8/10/2009 08:48:00 AM