Saturday, February 21, 2009

Things That Make Me Sick!

Merry Meet Family, Friends, Followers and Lurkers:

:::Rant warning:::

So, last night at the suggestion of my 12 year old son, Justin, Ray and I watched Michael Moore's documentary "Sicko" which describes how seriously we are being bent over by the managed health care system in the country.

Oh, I know, there are some who question Michael Moore's credibility, but as someone who works in health care, I can tell you for a fact that these things are actually taking place. Your health care isn't in the hands of your physician anymore and hasn't been since the Health Maintenance Organization Act in 1973. If you are lucky enough to have health care insurance, the decision of whether or not your care is administered properly is being decided by some "medical director" who reviews your medical records and then determines if there is any way of avoiding paying for your treatment.

And what if you are one of the unfortunates who can't afford health care insurance? Well hopefully, you won't end up being put into a taxi by the hospital who's rendering your care, driven to skid row and dumped out onto the street still in your hospital gown because you've become too much of an expense.

Michael Moore took a group of our own 9/11 responders to Cuba to receive the medical treatment that was repeatedly denied to them in this country. Yes, Cuba. The communist country run by that evil, wicked, horrible dictator, Fidel Castro. There they were able to receive medical treatment, free of charge. Yes, free. These people were ill and that was the only criteria necessary to receive care. This is called the Universal Health Care System and is also available in France, Canada and the United Kingdom. Just not here. The people of Cuba looked upon our first responders as heroes. Our country, thus far, had only looked at them as an expense.

And this situation isn't confined to medical testing alone, but to the medications prescribed for you as well. A prescription medication that you are paying $120.00 per month for here in the "Greatest Country in the World", will cost you 3 cents in Cuba. And no, it's not a generic or off brand medication, but the very same prescribed by our own physicians.

Personally speaking, I have a stable lung nodule which was detected by chest x-ray. The guidelines for follow up of this type of diagnosis is that you need CAT scans for three consecutive years. After the 3rd year, if all has remained the same, no further testing is necessary. Well, for the first two years, I was given a prescription for a CAT scan, got the required authorization, had the test and it was all good. This year, I got the prescription, called for authorization and was denied. Why you ask? Because the "medical director" deemed my test, "not medically necessary" because...are ya ready? I have no symptoms! My pulmonologist spoke to the medical director, sent in the documentation supporting medical necessity and it was still denied because I have no symptoms. My sister died of Idiopathic Pulmonary Fibrosis, which is a fatal lung disease. "Idiopathic" means that they have no idea what caused it. Now, if I had symptoms, I could possibly be at risk for dying, but of course, then they would pay for my care. Just not for very long. The prognosis for Idiopathic Pulmonary Fibrosis is 4 - 6 years.

If you haven't seen this documentary, I would highly recommend you do, but only if you don't mind being pissed off beyond all definition of the term.

In Darkness, Light,


Tracy

7 comments:

carol said...

the health care is awful in this country of ours! As we all know people die in the emergency room just waiting for someone to look at them and then the drug cost is outrageous.

I also have nodules that must be checked so far no problems but who knows they are taking away so many things from everyone!!

I think the Universal Health Care System is what we need. Nobody gets turned away and the prescription drugs (which we will all need eventually are almost free)

It seems everything is getting worse there is no good news at all something must change and soon or we will all be in trouble.

Tracy said...

Carol, it really is awful. I have patients that have been waiting for treatment for longer than 6 months at a time. Whenever I call to follow up, I'm told that it's still "in review" by the medical director. If I ask for a phone number or e-mail for the medical director, I'm told that there is no such number or e-mail address.

Bullfuckingshit!

And good luck trying to get someone with a grasp of the English language on the phone. There's so much outsourcing, it's friggin' ridiculous. I actually had a representative ask for my call back number because my call had been rerouted through India.

Too many people are out of jobs with no means of supporting themselves or their families, no health insurance and it's all due to the corruption perpetuated by our own Country.

It terrifies me to think of what's going to happen if the tides don't begin turning for the better.

Carol said...

Your right it is the corruption of the leaders and CEO's. I think the CEO's should all be put in jail. So many of those big companies knew this was coming down and took their bonuses and had their office refurbished!

Medicare took some doctors away from my mother too! that is all they do to senior citizens that worked all their lives!

It is scary!!!!!!!!!!

and of course most of the workers are not from this country so after a while you hang up frustrated - what a system!

Manerva said...

I watched Sicko a few months ago and I totally agree with you. It's CRAZY what's going on down in the US. I felt so bad for that one woman with her child who smuggled themselves over the boarder.

It's just sad. Hopefully with Obama sitting in the big chair he'll be able to change things around. Hopefully anyway!

Tracy said...

Manerva said...
I watched Sicko a few months ago and I totally agree with you. It's CRAZY what's going on down in the US. I felt so bad for that one woman with her child who smuggled themselves over the boarder.

One word Manerva...."Greed".

Suzanne White said...

Yes, Sicko should be a must watch movie for every voter (imho) and I just love Michael Moore, despite what his detractors have to say. As a nurse I've seen, as you have, and it breaks my heart.

Tracy said...

Suzanne White said...
Yes, Sicko should be a must watch movie for every voter (imho) and I just love Michael Moore, despite what his detractors have to say. As a nurse I've seen, as you have, and it breaks my heart.


I have to be honest Suzanne, I'm finding it a lot harder to be civil to the insurance carriers I deal with since seeing this documentary.