[Outdated, please look at pinned post] Casual Conversation

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.

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.

It's fucked and I'm sorry you're a victim to it.

There are small pockets where it doesn't suck. My current company has amazing benefits where my youngest had to have major surgery and it literally cost $100. My previous company however my wife had to have minor surgery and 6 years later we still owe them $23k. We're paying it off slowly.....

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'll commiserate with you on the fact that the healthcare system is totally broken. My Mom has had a problem with one of her leg nerves for over a year and a half now, and she has been going in to see specialists, getting told "this is what you have, here's what we can do", getting the prescription/treatment, having it not work at all, and then gets told to get back in line for another appointment with several weeks, if not months, of lead time. Even when she gets put on a priority list for when there are cancellations, there's almost never a cancellation that let's her get in earlier than her original appointment.

In her case, I'm not blaming the doctors. They are trying their best. I just don't understand how it can take 1-2 months per visit, or even upwards of 6 months, and meanwhile she is in agonizing pain whenever she stands or walks too long.

Meanwhile, I just paid out $6k in dental bills this year alone because my regular dentist missed a cavity until it became bad enough that it required a root canal, but they tried to fill it first and it didn't work, so then I had to pay for the botched filling procedure (partially covered by insurance), and a root canal that sadly doesn't seem to have made the tooth any less sensitive, and copayment fees to other dental providers for second opinions because my tooth still hurts even after all they did to it and I want to know what else could do to help, and now I am looking at paying another $3000+ to have the tooth extracted and replaced with a prosthetic implant, which was an option in the first place but they encouraged me to try the fillings and the root canal to "save" the tooth first. Now, I'm trying to wait until January 1st to have my benefits reset so it softens the blow significantly, but until then I'm suffering with this zombie tooth rotting away in my mouth.

The healthcare system in America is fucking garbage and needs to be destroyed and rebuilt with a human-first mindset, not a for-profit mindset.

I hope you are able to get the treatment you deserve. Stay strong and stay positive.

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.

What would someone in my position without insurance even do? Die?

Even those who have good insurance and can afford ….. my doctor’s office stopped refilling my prescription, stopped returning my calls, after he had expressed concern about not wanting me to “stroke out” over my condition. I doubt it magically fixed itself, but I’m still having a hard time overcoming inertia to find a new doctor

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.

I've never heard anyone say that the American healthcare system is the best in the world. Even from critics of universal healthcare.

The best systems are mixed systems like you see in Germany or the Netherlands. As someone from the UK, don't fall for the propaganda about the NHS. It's really not very good.

Sorry to hear that...

Sorry to hear about everything you're going through and how much it costs for no treatment. I think a lot of doctors do care but they are overworked and have to constantly battle hospitals and insurance companies. A lot of them seem to be seeing less patients which is not going to be good, and many are retiring or burning out. There are also now more seniors than people under 17, the seniors require more care. Article on the doctor shortage: https://time.com/6199666/physician-shortage-challenges-solutions/

This probably won't help you since you live in a small town.

Finding a doctor in the united states sucks. Literally the worst experience I have ever had was transitioning to a PPO insurance policy after being in a combine managed HMO / healthcare group.

People told me for years "oh, that health care provider sucks. You get sub par care and nobody ever knows your name." You know what else I got? Same day doctor visits and same day specialists, literally anytime I wanted or needed anything. I had reasonable medical care at a reasonable schedule for a reasonable price.

When my insurance switched to a PPO, people told me "oh, you will love this doctor! He is so great!" And... every... single... time... it is exactly as you described. "New patients are 6 months out." And when I finally got a primary care doctor, they would recommend specialist who were their friends also in private practices with 6 months waiting lists.

Private practice medical care is an absolute joke. It's another shitty system the boomers saw their parents use successfully that simply doesn't work today.

The solution was to find a high quality medical group in my city. It took me nearly a year to figure it out. Same day doctor visits? Done. Same week specialists? Done. Same system / in network urgent care at the same price as a regular doctors visit? Done.

I don't care which doctor I see, I just need medical care.

Just another symptom of how rigged our economy is!

https://www.cnbc.com/2021/10/18/the-wealthiest-10percent-of-americans-own-a-record-89percent-of-all-us-stocks.html

Unless this is ever addressed, the symptoms will only get worse over time. The system is designed to siphon the nation's capital to the owner class, they aren't interested leaving you enough to get medical care, quality food, acceptable education, etc. You are nothing but livestock to the people that control this nation through the economy and the fully captured government, and they use it to make sure you don't have a scrap for yourself.

Wait, they didn't prescribe you anything when they found the ulcer?

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.

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.

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.

Christ, thats fucking horrible

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.

OECD data actually puts the USA in the middle of the pack for wait times for specialty care for developed nations. I believe it could largely be solved by companies switching to advanced access/open access scheduling models, but most are too afraid to upend their business model.

Lmk if you have any questions about navigating appointments, I’m actually in grad school studying healthcare business. My only real suggestion at this point is to use your doctor’s electronic portal for communication. In many cases it’s more effective than a phone call, plus you have written records.

I know you said no medical advice, but I’d ask a doc about H Pylori. Always something that should by ruled out in cases like these.

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.