Tuesday, February 5, 2008

It's not health care, it's Simon Says...

Now I do understand that Simon Says isn't exactly the correct metaphor to use here, but it makes for catchy reading. I went to see one of my (currently 5) doctors as "we" fight "my" cancer. After stuffing a camera up my nose and down my throat (I'm pretty sure he went far enough to check out my colon for goodness sake) he finds a Granulanoma in my voice box and prescribes for me some kind of generic Prilosec, 40mg, 2xday.

I rushed right over to my local pharmacist (well, 2 days later) and proudly hand her my prescription form (which was actually hand written, haven't seen that in a long time). Cue the dramatic interlude music....my insurance company won't approve that drug. How about this other one instead? "Sure" I say. Well another drug means I have to call the doctor's office back and he has to re-prescribe it.

An hour later the pharmacy calls me and says my insurance company won't approve the prescription because it’s written for 2xday and they only want me to take it 1xday.... who the heck are these people! Do they even know WHY I'm taking the drug? How can they know I'm only supposed to take it 1xday?

Because I'm a big $$ patient I have nurse case manager with my insurance company. I call her (and I'm in a pissy mood now cause they are screwing with me again) and when she calls me back and I explain to her what's going on she tells me I need to get the prescription PRE-APPROVED by the insurance company because my DOCTOR wants me to take it 2xday which more than the normal dosage....

Here is the kicker, PREAPPROVALS have to be submitted by my Primary Care Doctor, and he is NOT the doctor (remember I have 5 now) that prescribed the drug in the first place. So I have to call his office and explain what going on to one of the admin people there. They submit a request to my insurance company and 2 (business) days later (today, 4 days after I submitted the request to my doctor’s office, now 7 days after I got the prescription) they say Yes, I can get the medicine I was prescribed.

Now my Primary Care Doctor NEVER SAW ME, he doesn't know WHY I need the pills 2xday, he probably doesn't even know I was prescribed the pills because his office people took care of it. I don't understand why I had to ASK the insurance company before I could submit the prescription, you would think the mere act of the pharmacist submitting it would be enough of an ask. It’s just another hoop, another level of paper work, another thing adding to the cost of health care. Remember the insurance company never got any more information for the PREAPPROVAL then for the initial request from the pharmacy...

Simon Says you may NOW get your prescription filled...

What a load of crap.

Friday, January 4, 2008

Hey, this is a nice place...but...

So on Wednesday my wife and I drive up to the Dartmouth-Hitchcock Medical Center in Hanover New Hampshire so I go see my Radiation Oncologist (my what a nice way to spend the day). This was my first time meeting this guy, and the appointment went very well (I get to "go radioactive" on the 14th).

While we were sitting in the waiting room of the Radiation Oncology unit I looked and noted that is was by far the nicest the waiting room I had ever been in. I mean nice chairs, a library, tables with puzzles set out on them, a place to get a freeking chair massage!

Then I realized, hey stupid, this is the CANCER unit. Hey that reminds me, I have CANCER.

Jeez, so much for the nice waiting room making me feel better.

Thursday, January 3, 2008

So what am I crying about anyway?

What was so bad with 2007 you might ask? Well, let's see, in fairly chronological order:

  • In January we put my wife's father into a nursing home for 100 days of rehabilitation, with (we thought) the understanding that if he could manage to get himself in and out of bed, on and off the toilet, and feed himself a couple times a day, he could come back to our house (where he has been for 6 years). Otherwise he would need to stay.
  • The day after he was settled in his 2nd Nursing Home (the first one was so bad we moved him after one day) Jack, my beautiful, smart, loyal, best friend, 5 1/2 year old German Shepard died from bone cancer, the day before he was scheduled to have one of his hind legs amputated at the hip.
  • I spent February and March doing the little puppet dance for medicaid, trying to get my wife's father approved so he could stay in the nursing home if needed.
  • In April, He came back to the house, even thought he could do none of things we said he would need to do to come home. So the duties of taking care of him (and he weighs in at nearly 300 lbs) fell to me and my wife.
  • On a nice note: In May, my wife and I got to sit in on an interview and a Q&A session with Hillary Clinton. PLEASE don't go all political on me. We would have gone to see any candidate they just happened to call us for Hillary (who did a pretty nice job with the interview and the crowd Q&A).
  • June was spent in a mad dash trying to hire a new Web Developer to work in my department. The HR people "didn't have time" to do any of this and after 3 interviews it became apparent that I would not get the job filled before the end of the month / fiscal year.
  • July comes and the Web Position is pushed back in the next budget until the 1st of the year.
  • August (things really go bad here) My wife loses her job after over 12 years of service in a way filled with such injustice and moral cowardice on the employers part it still makes me see red (did I mention I word at the same place?).
  • They day they kick my wife out of the building they tell me to leave on my planned sabbatical early. After every 7 years of completed service at the place I work you get 3 months off paid. I was looking forward to the time to rebuild my wood working shop, and had spent several weekends before emptying and knocking down the old one.
  • The middle of August I was diagnosed with Thyroid Cancer, and had Surgery on the 24th of September (and emergency surgery on the 25th).
  • We did spend 2 nice weeks at Myrtle Beach, SC in October.
  • I needed to have another surgery, and after fighting with he insurance company finally go it approved at the place every doctor I saw said I needed to go and had the surgery on the 26th of November. (Oh yeah, I am now on Medical leave as my Sabbatical days have run out).
  • My Uncle (who I liked very much) died while having his own cancer surgery on the same day I was going under the knife.
  • Two days later my father died at home suddenly (while I was still in the hospital).

Those are just the highlights... Other stuff happened (broken showers, brother in law becoming homeless again and moving into the house, On a good note we did get a new puppy in July).

So, 2007, kiss my ass. 2008, lets see if we can even out the karma balances this year.