Tag: Health

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Talking to a doctor’s office, not the doctor, but just the fucking doctor’s office has become nearly impossible.

In late September, I talked with my primary doctor about a skin problem I was having. He advised me to see a dermatologist and referred me to one. I called the dermatologist for an appointment where I was strongly advised to leave a message and that someone from the doctor’s office would call me back. I get an email that very same day saying that someone would investigate (I am assuming whether they take my insurance and they will pay for it) and get back with me. So far, things are going swimmingly.

But then no return phone call for a week. As I was going out of town, I put it on hold, thinking foolishly, that eventually someone would contact me with an appointment. When I returned to San Diego, still having not received a response from the doctor, I called the office to inquire about my appointment. I talked to a nice woman who apologized profusely about the failed response and booked an appointment for me. Success.

A day or so later, I received a phone call from the nice woman telling me that while they took my insurance this year, they weren’t taking it next year. Since it is now mid-October and the soonest they can get me an appointment for was mid-November, they didn’t want to start seeing me as a patient in cases their services were needed into 2026. All vaguely rational sounding, so I went back to my primary physician.

The assistant at my primary physician’s office, who has always been helpful, couldn’t understand why they just didn’t keep the appointment and, if I needed further treatment, refer me another dermatologist in 2026. She said I had a legitimate concern about a growth on my hand and they could, at least, get the ball rolling.

She told me she would take care of it. A day later she calls me back saying that they don’t want me as a patient and she find another dermatologist to look at my hand. She added it might take a little time because she now has to investigate which doctors will take my insurance in both 2025 and 2026. Towards the end October, she finds one.

I got swept up with other events in my life but was finally able to contact the new dermatologist at the beginning of November. A very unhelpful phone tree took the call. The recorded message kept advising me to use the on-line scheduling system. My experience with on-line scheduling has been horrendous. There is no response to my request or a continual back and forth about a suitable date for the appointment.

I opted to stay on the phone line where every so often I was encourage again to use the on line system or leave a message on the recorder and someone would call me back that very same day. My experience with this is I rarely get a call back and, if I do, it is never on the same day. I chose to stay on the line. Fifteen minutes into my wait, I was disconnected. Or I think I was disconnected. I stopped getting the annoying messages about using the on line system and my phone stopped timing how long the phone was. There was just silence which I deduced was a hang up.

I called again but this time I decided to look at the on line system. I completed the form as best I could knowing that there would be a back and forth about the actual appointment. I sent the form in while waiting because what the Hell, I was on hold any way, it was something to fill the time, I got some lunch and, after a half hour on hold, I surrendered. I would just have to trust that the on line system would work.

Later that day, I received a response from their on line system telling me that they were working on scheduling my appointment and I they would confirm an appointment soon. I don’t like the sounds of soon. Soon. That could be any time frame they choose.

So it is approaching the middle of November and I still do not have a scheduled date for someone to look at the growth on my hand. Think about that. A month and half just trying to get a fucking appointment.

Thank God I don’t live in a country with socialized medicine who knows how long I would be waiting for an appointment.

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Since Bob’s fall, I have learned the secret of getting what you want in the American Medical System — be aggressive. It is the one piece of advice I get from almost anyone who has had any dealings with the system. Be aggressive. You have to be an advocate for your loved one in order to get the treatment they deserve. This advice is given to me so often that it took me awhile to hear what people are actually saying.

I thought good medical insurance was sufficient for good treatment but it also helps to be a bit of an asshole. Now some of you will say being aggressive is not necessarily being an asshole. You can politely but firmly be aggressive. But that wasn’t the advice I was getting. People were actually saying be an asshole, get in their faces, don’t let them push you around. Some of this advice came from medical professionals.

Also, and this is important, why do I have to be aggressive at all? If my insurance covers it, why do I have to aggressively monitor his treatment at all. He should be getting it without asking. But this isn’t the impression of an awful lot of users of the American Medical system.

The saddest part of this advice is we passively accept it as they way things are. The only way to get good treatment is to be aggressive. So, yeah, mother fucker, I will do whatever it takes to get my loved one what he needs. My biggest worry since Bob’s accident is am I being aggressive enough. What did I fail to see or do. Who should I be chasing down. Will Bob get screwed by some mistake I made. This is hardly conducive to healing the patient and it is exhausting for his loved ones.

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I have spent the last few days in the bowels of the American Medical system as Bob, my partner, took a fall and has been experiencing the noxious gases of this infernal system.

The profit motive is a terrible way to make decisions about a person’s health. What may be the cheapest way to handle a problem may not be the best. Bob took a fall and damaged both legs. He can’t put pressure on either leg for now. This means that the simplest task is virtually impossible for him to perform. We are out of town in Modesto and need to get home for his surgery because the recovery could take up to three months. It makes sense to send him back to San Diego where we live.

The solution they are purposing, however, is ridiculous. They want me to pack the very injured Bob into our car and drive for 7 and a half hours to San Diego. Right now, he can’t get into a wheelchair without the help of two medical professionals. Yet they want me, a 68 year old man alone with a 76 year old physically incapacitated man, to make this car trip.

Now this is where things get interesting. When we balked at this suggestion, the case manager at the hospital decided to argue that it was cheaper for a medical vehicle to take him back San Diego than for Bob to stay in the hospital until he is physically able to make the trip. Brilliant right.

Brilliant and horrifying. The thing that is deciding how to proceed is the cost to the insurance company (in this case Medicare) and not the health of the patient. Even more horrifying is that the people who look at spreadsheets could decide that it still makes more economic sense for me to drive him home.

Now I get it, money has to be taken into consideration at some point but it seems like this is not one of them. The bean counters are weighing the economic cost of two options — paying for an ambulance or paying for a hospital stay. The deciding factor isn’t the health of the injured man. And, more importantly, why do the bean counters seemingly have the final decision. And don’t say the doctor has the final say. The case worker’s argument is financial because he knows the bean counter has the deciding vote. If Bob’s health mattered, the argument would be it is better for his health to be driven home in a car with medical professionals. Right?

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I have to give it Donald Trump and his administration. They definitely know how to make a mountain out of mole hill and gain advantage from that little mole hill.

Demetre Daskalakis, director of the National Center for Immunization and Respiratory Diseases, resigned in a wave of resignations that struck the CDC last week. He also wrote a memo using the term “pregnant people” as opposed to the Trump preferred “pregnant women.” People and women are not the important words here, pregnant is. This is a message to advise someone who is pregnant about a health issue. It doesn’t really matter if you call them people or women.

But, of course, I am wrong. It matters greatly and people are hopping mad about it. One side believes pregnant people is more inclusive of trans people and the other side is claiming that only women can get pregnant and it’s ridiculous to use the more inclusive term.

Trans-obsessed lefties want everyone to use the more inclusive people and make no bones about telling people they should. This irritates trans-obsessed righties who think this is a biological question and that only women can get pregnant, so when talking about pregnant people, people should say pregnant women. This is so much cage rattling and of little significance to the majority of Americans.

First, the necessity to use pregnant people over pregnant woman is incredibly stupid. 99.99% of the people who are pregnant are women and like to be called women. Plus there is little chance that a pregnant trans man ( I am assuming about .01% of the population or less) would be confused by what the sentence means and how it might relate to him. But because somebody somewhere might be offended, people should be used instead of woman. This is the mountain they want to die on.

Language is social lubrication. It is there to make our lives easier. If you want me to use specific personal pronouns for you. I have no trouble using them. On the other hand, if I see a person with a beard, I am going to think this is a guy and I will trust my eyeballs and use male pronouns. 99% of the time I will be correct and offend nobody. This makes my life easier and less awkward because a lot more people would be either stumped by your personal pronoun question or unnecessarily angered by it. Why bother making trouble for yourself?

Which means I will continue to use visual cues, like a beard, to guess at someone’s gender identification until I start having trouble with people about it. Right now, I think I will die before having to ask someone their preferred pronouns.

What to do if people say “pregnant people.” I say deal with it. I admit it is a little clunky but perfectly understandable. Someone who says this is talking about pregnancy and want to be inclusive. Let them. Do what is comfortable for you. But no, “pregnant people” has become fighting words, so a fight must ensue.

The worst part is Trump has managed to turn the chaos at the CDC into a problem with politically correct bureaucrats. They have gone after Daskalaskis for being both gay and a satanist. So what should be about how to effectively get health information out to the public has become a witch hunt about being politically correct. And Trump has the advantage here.

I’m not sure this helps pregnant people or pregnant women but public health should be about using the right terms instead of delivering important information about people’s health.

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One of the things I like about Slate, an on line magazine, is its advice columnists. They have a variety of subjects like finance, misbehaving children, people being assholes and sex questions. I enjoy reading and seeing whether I agree with columnist about the problem being discussed. Every so once in awhile there will be a non problem that I think why would anyone even bother writing about this extremely lame “problem.”

A reader addressed one of these non-problems to Slate’s sexual advice columnists recently and I have to admit being baffled by the reader’s concern and the columnist’s advice. The reader’s boyfriend, while asleep, vigorously touches his dick to the point of semi-erection. He never takes it to climax, he doesn’t make any demands on her, he remains asleep during the whole time and doesn’t seem to be negatively affected by the time he sleeps in this semi-aroused state. So what exactly is the problem here?

The woman is concerned that this might be a form of sexsomnia — a condition, I have to admit, I never even heard of until reading Slate’s sex column. For those of you, like me, who are new to sexsomnia, I have provided a link but I will try to summarize as best I can. A person with this condition acts out sexually during sleep – this could include attempting to have sex with a partner sharing the bed. The person who suffers from this condition is actually asleep and not faking it in order to get sex. They are genuinely asleep.

The advice columnist thought it could be a form of sexsomnia and suggested the woman have her boyfriend take a sleep study done to ascertain if this is indeed true. All I can say is WTF. Really. A sleep study to find out if he touches himself to semi-erection while sleeping? Why would anyone consent to a sleep study when he is bothering no one? The woman isn’t being harassed for sex and he isn’t complaining about the lack of sleep. How would anyone’s life benefit from a sleep study here? Yes you do have sexsomnia but it is so mild we don’t suggest you do anything about it? Or no, you don’t have sexsomnia, you dick is just getting hard because you touched it for a few seconds. It’s all perfectly normal so don’t worry about.

I would suggest the woman just go back to sleep when she finds her boyfriend in this state and to stop worrying about nothing.

On the other hand, it does keep my mind off of Donald Trump for a few minutes. So, there is that.

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My doctor and I have been working on the best way to handle my acid reflux. Antacids work but some are better than others. The one that I have had the most success with can also damage the liver. Our discussion turned to what do I do if the new antacid fails to work. He said then I would have to make a decision – is the toxic antacid worth continuing for relieving the symptoms of my acid reflux or should I take the less effective and less toxic antacid and learn to live with acid reflux which also carries the possibility of esophageal cancer. What is the better choice then — liver problems or esophageal cancer.

As I get older, I’ve been noticing that a lot of my healthcare decisions are like that — the choice isn’t an obvious good versus an obvious bad. It is two imperfect choices where I have to sort through the information and weigh the good and the bad to come up with an answer for me. Which got me thinking of chronic pain and addiction. There is this default preference for living with the pain over becoming an addict.

But why, particularly if the choice is being unable to have a normal life because the pain is too great versus living with addiction and having a normal life. The important question here is what makes the person more functional. Can they enjoy their lives with the pain or is it better lived with the addiction? There is something in the American Mind which fights the idea of addiction. Addiction is bad. Addicts ruin their lives and the lives of their families. At all cost, we must avoid addiction.

But can addiction be better than the alternate.? And, importantly, can addicts lead normal lives while addicted to drugs? Surprisingly, at least to me, most addicts lead pretty normal lives. They hold jobs and they take care of families. Now I am not saying it is ideal because it isn’t. It would be better not to be addicted to drugs. Life long drug use is associated with younger death — somewhat like the experience of cigarette smokers which is an addiction that is tolerated and we get along just fine. The problem with addiction is when the addict’s drug of choice is illegal or regulated by people who want to discourage addiction (think Oxycodone). Then the addict has to deal with dangerous suppliers, unregulated doses of their drug and getting arrested. These would all go away if we just let them use it legally.

And, yes, there will be deaths but would there be more than there are now. Certainly we would have reduction in deaths to turf wars between drug lords and wrong doses. It also opens up the possibility of working with addicts to get them off drugs whenever possible. Think again about cigarettes. An aggressive anti-smoking campaign has been successful in cutting the number of smokers dramatically. All while cigarettes were legally available and easily accessible.

I know several people that have chronic pain. They are in their 70’s. Their doctors try to find a way to stop the pain without addictive pain killers. The pain is still there which leads to the question what is worse chronic pain or drug addiction. And is getting off of drugs made more difficult by the return of pain? What is the point of 70 years not getting addicted to drugs? I know very few people in this age bracket that isn’t already taking a life long drug.

Personally, I have 4 prescriptions that I will take for the rest of my life. One of these is anti-depressant which if I stop, I will have problems. I am sure I can deal with them but it would be a difficult week or two and, if I do quit, would my depression return. So am I an addict and, if the addictive drug, allows me to be lead a normal life, why would I quit. If an addictive pain killer can do this, and everything else has been tried, why keep people from an effective, but addictive, pain killer.

This is a valid choice between options. I could live in pain and be addiction free or can live in pain with a dependance on drugs to keep me that way. I suspect this is already happening in the wink, wink nudge, nudge world we live in it. Doctors and patients are already making this decision but if Medicare and the insurance companies decide to monitor this more stringently, this wink wink nudge nudge deal can end tomorrow. Why not just come clean and say sometimes drug addiction is the best option in some cases.

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I was appalled to read that Mary Lou Retton, Olympic Gold Medal winner, doesn’t have health insurance and has to raise money for her hospital stay through an on-line fund raiser. She has a life-threatening pneumonia and is in critical condition. She has been in the hospital for over a week, so you can imagine the cost already and she isn’t out of the woods.

How does someone so well connected not have health insurance? This absolutely blew me away. If Retton is taking risks regarding health insurance, then the number of people who faces these choices must be much larger than I imagined. This doesn’t mean that they decide not to get health insurance either, they may decide for health insurance but what are they doing without. This is about life on the margins where the cost of health insurance might make people sacrifice other necessities of life — like not paying the mortgage, half dosing prescription medicine, skipping meals. But, then, there will be people who will argue that this is good, Retton will make better decisions in the future from the lessons she learned from not having health insurance.

Like delaying necessary treatment because she doesn’t have health insurance. I can’t imagine what I would do if I were sick and didn’t have health insurance. You don’t know if you will get off easy with $100 bill for a doctor’s visit and prescription or a $50,000 hospital stay. And even if you only have to pay $100, it may be $100 you don’t have, so what do you do? How is not taking care of your health beneficial to society?

Then when you are so sick you have to seek medical treatment, who pays the bills when the person involved is not America’s sweetheart? What happens to a person who is an asshole and people hate the person so much that they are angry at you for even thinking of helping the asshole. Though it pains me to say this — even assholes deserve healthcare and they probably won’t fare well in the Go Fund Me Route. So instead of contributing to every Go Fund Me asking for help with medical bills, our system is set up to treat everyone through a universal health care system.

That won’t happen because that is socialism and socialism is bad. I honestly don’t care how it is done either. If you can propose a way to do it through the markets and it is both affordable and universal, I am cool. But I haven’t heard one yet so there is that. The Republicans, who I would assume after bitching for 8 years about Obamacare, would have passed reform bills with these market solutions incorporated when they took over, but they didn’t so it looks very much like they don’t have anything. Which is unsurprising but nonetheless disappointing.

Until then I will continue to enjoy the best medical care in the world.

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A television ad blew my mind the other day. An American Health Insurance companies was offering health plans that included Mexican doctors. I thought this had to be wrong. American Insurance companies would never include cross border doctors. I was wrong. I googled it and sure enough I found a Health Insurance company that includes Mexican doctors. Forget the bullshit about being culturally sensitive and giving customers a wider network of doctors. They can’t contain themselves about the real reason. I am betting you already know the answer but just in case you are struggling, I will let you know — it is cheaper. The lower co-pays for using Mexican doctors gave the game away.

Living on the Mexican border, on and off, for the past 30 years, I knew people who have crossed the border for medical care but I always was a little suspicious because there alway seemed to be some horror story attached with the doctor’s visit to Mexico. Plastic surgery gone wrong, dental work that turns into health emergencies. Of course, the same horror stories happen with American doctors every day so why this influenced my thinking is a mystery. I am sure it has something to do with having been told my whole life that American healthcare may be expensive but it is the best in the world

But now that American Insurance companies allow Mexican doctors in their plans, this lays to rest these concerns. Of course, it also raises a big question – why is American healthcare so much more expensive. I mean, any insurance company that includes Mexican doctors has to believe that Mexican doctors are, at least, comparable to American doctors or why would they include them in their plan. They could never publicly say there is a difference in service because to do so would undermine the whole idea of American Healthcare which is price doesn’t matter. The quality is the same, the different prices customers pay only means lower co-pays, lower deductibles. and more doctors in the plan. But the quality is exactly the same.

How, then, can American Insurance companies continue to say that American Healthcare is the best service at the best price when they are also willing to pay for comparable services of Mexican doctors which is a lower rate. It is a contradiction that requires some explanation. I am listening.

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I am about to turn 65 and I will finally get socialized healthcare (otherwise known as Medicare). Yeah.

Except the insurance companies are involved and everyone (otherwise known as people already in Medicare) says you have to choose the right program. Grrrrrr.

I thought I was done with the yearly Hell of medical elections but it seems that the insurance companies have found a way to stay in the game after we turn 65. At this point, I am not going to complain. One, it does absolutely no good because there is no way, outside of rewriting of the American Constitution. And two, all it does is raise my blood pressure which is now something I need to watch.

I do however have a suggestion on the names that might help someone like me choose the write program. Gold, Silver and Bronze are meaningless to me. I know the Olympic medal system and get the idea of Best, next best, and least best but, for some reason, that doesn’t necessarily apply here or, at least, not always. Which means I have to go in and spend some of precious few years of life parsing Health Plans.

Instead of the Olympic medal description, I suggest:

Rich and Hypochondriac

Just Pay the Damn Bills

Poor, young (read here 65 to 70 years of age) and careless.

If would be invaluable aid to someone like me and would also insure that my eyes will be relieved to skip the insurance fine print. This is important because Medicaid does not automatically cover eye care. Grrrrr.

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Medicare is socialized medicine. I think it is important to note this. Every American 65 years and older gets their healthcare paid for by the government.

A lot of people, particularly on the Right, hate socialized medicine but like Medicare. In their misunderstanding of what Medicare is they trick themselves into believing that Medicare is a uniquely American idea of healthcare. It isn’t. It is socialized medicine for every American 65 and older pure and simple.

I think if people would start calling Medicare socialized medicine, some opponents of socialized medicine just because the word socialized is in the phrase would see it for what it is — a government run program designed to control the costs of healthcare. And, as far as I can tell, people actually like Medicare, which is the same feeling that most of the citizens of other countries who have socialized medicine have about their healthcare system.