Friday, November 21, 2008

Lint and Copayments

Does everyone else get bathrooms completely coated in a layer of towel lint or is it just me? I have a shower and toilet in one tiny room and I'm digging it mostly because it contains the lint. Last weekend, I cloroxed the toilet. Today, it was coated with purple fuzz, visible from a distance. It's like I had shedding pets.

Also today, I saw the urologist. I have just not been right since my last UTI. She seems competent and there are tests that can be done that will likely be a little unpleasant, but which will answer some questions. The trick is paying for it.

It's not clear whether or not the doc's on my insurance plan, although I checked and they think she is (call confirmation #28000). But the office is not convinced. The deal is that in CA, Blue Cross and Blue Shield are two competitive companies but I have, for reasons that are mostly insane, BCBS of Massachusetts. I formerly had Harvard Pilgrim HMO and they were wonderful. Now I have this PPO because the one HMO option I have is more restrictive and not cheaper. And I have a fundamental dislike of a primary care physician who has even less time to coordinate my care than I do. Unless it's significantly cheaper or less hassle for me to work that way. Given my two lousy options, the BCBS PPO is better. By which I mean sucks less.

I think one good way to reduce medical costs is to not require 3 staff members per office just to deal with insurance issues and related paperwork. It's not in any way a value added position. It exists only to make sure the doctors get paid. These people generally help me, but my point is that they shouldn't have to.

See, if I could just pay out of pocket and only have insurance for catastrophic costs like surgery, or recurrent therapies, I'd do it. But if I don't have insurance, an office visit is $400. If I do have insurance, they are only "allowed" to charge me $78.56. Then I only have to pay the copayment. How is it that if I'm uninsured I'd get socked with $400 but being insured gets me in for 20% of the charged cost? I would understand a 20% reduction, but 80% tells me that there is institutionalized graft and fraud abounding. Not that it's called that when it's legal, but damn, there's something fundamentally flawed there.

I do believe doctors should be paid. And they currently need to get paid a lot to cover the costs of (our broken) schooling system and still afford to eat. Then they get the loans out of the way and their incomes are wildly disproportionate to the rest of the economy. Some people choose medicine for this reason. Doctors have traditionally been one of the elite professions. And I'm not saying doctors should be earning assembly line wages. But my ENT yesterday pointed out his BMW in the parking lot and told me all about the trip he took to Europe to buy it from the factory. Thanks, Jackass. Here's my check for a tenth of my monthly disposable income. What do people with worse paying jobs do? It's fearful. I hope he's a good surgeon and worth the spiffy car.

As it is, my copayments are going up 50% next year (from $20 to $30). Which doesn't sound horrible either, except that I'm going once a week to the allergist. So that's $120/month. While my allergy shots should decrease in frequency, and I might not be out $1440/year to be less sneezy, and I might be able to find a generic BCP to keep my costs to $200/year if I go back on that to fix my skin (although it could be as much as $600). I still need the allergy nose spray, and any other thing that comes up. Like my podiatry ($90 for an antifungal cream that wasn't covered, $500 for orthotics that as yet don't fit right) dermatology, sleep study, cat scan... don't forget the acupunture, chiropractic, and massage for my tight tendons. And now a set of tests for my urinary tract and possibly surgery to remove my tonsils and expand my nasal passages. So I'm not going for the eye surgery next year. I'll aim for 2010.

How can one tightly wound sneezy and sleepy but otherwise extremely healthy person chalk up this much money in health fees? I just don't get it. It's like that lint in my bathroom, just accumulates in little bits here and there until I'm overcome.


Janet Webb said...

That's overwhelmingly interesting -- if that makes sense -- your personal dilemmas for me so often illustrate a much bigger national question -- so thanks for the linty tale :D

farmwifetwo said...

It's the American way!!!!

Public Health Care is EVIL!!!

gail said...

That's why I buy white towels for the bathrooms with white fixtures and beige for the bathrooms with beige - etc
Sorry you're having so many small issues with keeping everything running perfectly. Don't you just dream that some day someone will say- hey - you're eating/drinking whatever everyday - stop doing that and you'll be fine ??
Happened to me - kept getting HUGE unbearble headaches that weren't migrains - family doc said - avoid all things sweetened with nutrasweet and or aspertaime for one week then come back -
Headaches vanished!!


CrankyOtter said...

JW: Thanks, I was worried that this was just another crazy rant that only interested me.

FW2: Hey! Long time no see. You're right about the health care.

Gail: Ah, I don't want to give up my green and purple and orange towels. Haven't grown up yet, maybe :) I am "lucky" in that I get a headache within moments of my first sip of nutrasweet drinks, so I have never taken to diet sodas. I wish there was something I could cut out that would make it work. I do think the key could be unobstructed breathing, rather than the "light obstruction" I currently have. I've been dreaming of being "fixed" for 10 years or more now. The acupuncture made me almost normal, but not quite.

Beki said...

I have no medical evidence to prove or disprove what a cashier told me recently at the grocery store. She commented on my caffeine free sodas and told me that she had been plagued by UTI's for years but when she cut out all caffeine for other reasons she hadn't had a single UTI since. It might have been coincidence but if you consume caffeine you might want to give it a try.

I know how you feel about healthcare costs. Our keeps going up and up. We also have BCBS of MA---how weird is that? It boils down to if we get sick they will pay for it but most of the diagnostic tests to determine that we are sick or to identify what we are sick from will be paid for by us up to a certain yearly deductible per person. If we are still alive at that point they will pay most of our hospitalization. As for meds we can have anything our doctors orders as long as we pay for it out of pocket---otherwise we can have them pick from the approved drug list. But it could be worse so I best not complain---it's just we used to have great BCBS insurance back when we were younger and healthier and now that we are needing it they are charging us a lot more and paying for less and less.

Anonymous said...

I've never had towel lint other than in the dryer trap, should I be concerned? Ah healthcare, the DH's insurance for his employees just went up 16% this year, it's 75,000 for 15 employees, youch.