How Has Your Care Changed?

By GabbyPA Latest Reply 2015-07-04 11:35:17 -0500
Started 2014-02-07 10:26:32 -0600

Today I went with my husband to his lab follow up and sat with his Doctor while he spent most of our time typing on his computer. He reviewed his lab work, asked a few questions and of course the over 50 question is a colonoscapy. "I have to ask" he said "because they audit me and if I haven't asked, I can get in trouble." He said he has to note if we accept or decline the test.

So the discussion continued down a scary road. He said he was talking to one of his Heart Specialist friends who says she knows that so many people cannot afford the treatments she knows are best because the insurance companies won't cover them. So her patient files are filled with "Patient declines treatment" because it's not covered and they cannot afford things.

He went on to explain how he has become so disheartened by it all and he knows he should be treating his patients, but he can't because it won't get reimbursed or paid for. This was so sad to hear coming from his own mouth. I could see it in his eyes.

Has your care or quality of care changed this year? Before, lots of the stories were in the news, now they are becoming personal. I am just curious about the good and bad that may be happening to our members here.

4 replies

Kalisiin 2015-07-04 11:35:17 -0500 Report

Well, as a Type 2 not on insulin Medicare is a cheap bunch of slimy jerks who won't supply me with more than 100 test strips every three months.

And because my meter given to me by my endo uses THE MOST EXPENSIVE STRIPS POSSIBLE…my choices were as follows:

A. Not test as much as recommended, and be labelled "noncompliant with treatment."
B. Go into bankruptcy paying for the brand of strips I needed (and this meter won't take the cheaper generic strips)
C. Buy a seperate meter on my own hook that takes cheaper strips and use that meter and strips instead once my supply of strips runs out less than a month after filling it (and then have to wait two more months for more strips)
D. Submit to insulin treatments and get as many strips as my doctors says I can have, and get them paid for.

Why do I feel like I am being HERDED and rounded up, led to the slaughterhouse instead of feeling like my care is important?

I feel like the dollars and cents are all anyone cares about anymore.

And THEN they scream and cry when we get debilitating, expensive and tragic complications that MIGHT have been avoided if they weren't so goddamn stingy up front.

fozy 2014-02-07 20:41:48 -0600 Report

Yes mine has changed went to walmart to pick my glucose strips and they wanted authorization from the doc and him to call the insurance to explain why I needed that type of strips in stucked for last one wk nobody in my insurance can explain why this is happening I just bought one it's frustrating with all this changes

Nick1962 2014-02-07 11:48:00 -0600 Report

Interesting you bring this up. We recently switched insurance, but under the old policy this test was only covered “in-patient” meaning a hospital or clinic, but the cheaper option of having it done at a gastroenterology center “out-patient” wasn’t.

For me, the care has changed, but slowly over the years, and mainly in response to controlling medical costs/health care reform – a topic I have mixed feelings on.

We participate in all the programs our company offers to reduce our premiums including yearly biometric screenings. While these are usually seen as incentive/wellness programs, I think eventually it will become a “non-compliance” penalty.

Part of this I believe is largely due to the recent switch to a near socialized medical system. Somehow, we all now need to fund healthcare for everyone, and as a result, the base quality of care will be minimal, and anything over and above that will be questioned or denied.

I experienced this with my recent back surgery – the surgeon proposed a fix that was beyond the “standard of care” because I am about 20 years younger than most patients needing this fix. He had to go through a peer review (delaying the surgery 2 months) and did so willingly because he felt the current standard of care was 40 years outdated, and the increase in my case would lead to less treatment and better quality of life down the road. He won (well more like compromised), and I got the “good” fix instead of the “great” fix, but had it been left unchallenged it would have been the “acceptable” fix only with any upgrades coming out of my pocket (or the surgeon’s generosity). I’ve read several of similar stories here over the years, and suspect more are coming.

ashley50 2014-02-07 11:42:18 -0600 Report

Well this year the postive thing is that i am getting my insulin much much cheaper. The negative thing is that my pump supplies went up, instead o paying like 18 dollars for it, i got billed for like 208 yesterday :/