I have to prioritize which of my diseases (asthma, eczema, allergies, anxiety/panic disorder, etc) are the most bothersome, SAVE UP, and THEN treat them. It sucks.

Vision and dental only come into the picture if I’m having a GOOD year. Sigh.

my insurance costs 20% of my paycheck. and then on top of that, i must pay for every office visit, every test, every needle poked into me, every prescription.

i have to look for home remedies for everything that afflicts me before i can afford to go to a doctor - as a rule.

I’m lucky enough to have health, dental, & vision insurance through my employer.  I’ll lose dental & vision when I retire later this year, but I’ll keep health.

 I really believe there is a revolution coming in this country, & it will be over health care.

I think it is bizarre how we treat cancer survivors in this country.  Lots of surface sympathy, but then try to get health insurance afterward.  A member of my family lost his health insurance after his cancer diagnosis.  He could not afford the expensive annual checkups to make sure it was not coming back.  He died because he did not live in Canada.  Even the assigned risk pool in California has been not taking applicants in a long time, and if you do get in, the cost is very high. 

We need a better system of health care.  I don’t think the private market health insurance companies have been doing a good job.  I think a public option has to be included in any legislation to set up universal health care.  Some of the features that have been built into health insurance plans in the last twenty years make no sense.  Deductibles and co-pays discourage people from getting screened for things that are cheaper and easier to treat when caught early.  Some insurance plans refuse people for things as easily treatable as high cholesterol.   It is bizarre to live in the nation that spends more per capita on health care than any other nation and yet see so many people dying from lack of access to appropriate health care.  And don’t get me started on the infant mortality rate.  How can we do that to babies!?

We have a high-deductible healthplan with a health savings account. We deposit $5850/yr for our family of 5 and whatever we don’t spend continues to grow from year to year.  It is tax-advantaged.  And it reduced my monthly premium from $1100 to $620.

BUT I didn’t anticipate I would be loathe to spend that money on myself. What mother would? With three children, I conserve that money in case someone breaks a leg again or worse. So when the doctor tells me I need, e.g., $4k worth of periodontal work, the chances I will do that are … nil.  

It is clear to me now that making people fully accountable for their own health spending can backfire :D  

I could write a book about my thoughts on our wretched healthcare system.  The first shout-out I’d like to express is to those who complain about "government bureaucrats" who would dole out care if a universal system were to be established:  insurance company bureaucrats are doling out your care right now.  Haven’t you heard of anyone or their doctor having to argue with their insurance company over whether this or that procedure will be covered?  It’s a nightmare.  My boyfriend’s wife of 26 years died of cancer six or seven years ago, and even though they had "excellent" insurance through the university here, he had to spend hours and hours on the phone with the insurance company trying to get things covered.  All this while he was exhausting himself caring for her at home, since the insurance would only cover x number of days in the hospital at a time. Her illness lasted several years. He was a saint, dealing with the ugliness of cancer—the pain, the mess, the emergency drives to the hospital.  And when the company refused to cover a life-extending procedure on the basis it was "experimental," he contacted a state legislator he was fortunate to be acquainted with who wrote an uncompromising letter to the insurance company and the problem got resolved. Not everyone has a connection like that.  Now my friend is looking after his 95-year-old mother (she’s in a nursing home).  She’s had lots of health issues, but is on Medicare, and he has had no problems dealing with them.

I am grateful I am on Medicare now myself.  When I got laid off/downsized from my last job of 15-or-so years, I was informed I was being bumped off the health plan.  But there was COBRA—which is a joke, really…I was on unemployment benefits, and because I was over 50, I suppose, the premium was over $500 a month.  Like you can afford that when you’re not working.  Just try to find an affordable private plan at that age.  I went to a broker, applied for the one high-deductible plan I could manage, sent in my check, and back it came a few weeks later.  The plan said they couldn’t cover me because I was "too expensive."  This because I actually told the truth on my application form and said I had one on-going prescription, which at the time cost me $11 a month (hormone replacement pills). I’d been in good health and rarely had to see a doctor, so there were no other "pre-existing conditions" in my history.  What a crock.  So I basically thought, "screw them all" and decided to knock on wood until I hit 65.  I practiced denial and self-medication.  The only thing that happened was when I almost tore off my big toenail (I know, arghhh!) trying to kick the front door shut when my hands were full with groceries.  My sandal was full of blood. I cleaned and wrapped my toe and managed to drive to the drugstore to look for a splint thing to protect it, but they only sold finger splints and said to try a medical supply store.  It was Labor Day weekend and those were all closed.  So I went to my local old-fashioned hardware store in case they had some first aid thing that carpenters might need if they drop tools on their feet.  I told the first guy I saw about my situation and he immediately went to aisle number 4, pulled out a little plastic drawer in the nuts and bolts section and picked out a little pack of something that was encased in a short cardboard tube.  He got down on his knees and gently slid the tube over my poor bleeding toe.  It fit perfectly.  I felt like Cinderella.  He didn’t charge me anything and I gave him a big hug.

Well, that was then.  Bottom line is, Medicare works.  The solution is simple.  Extend Medicare to everyone.  People have to buy car insurance to drive.  Have everyone pay into the plan. Much less for younger people, but everyone pay something.  The risk pool will encompass every citizen, hence, more money into the plan.  Costs negotiated.  If rich people want to have expensive private insurance, let them have it. 

If you need health care, run don’t walk to your nearest, but best public hospital, and just get seen. Call first, and if you cannot get anywhere with an appointment in the "Clinic" call the affiliated medical school department you think you need to be seen in - Internal Medicine is a good start (but fewer and fewer are in any of our states, now), or Surgery, Ear, Nose, & Throat, Endocrinology (often under IM), Orthopedics, Neurology, etc. and talk to the chairman’s/chairwoman’s office … just get a link to get in. Communication is key.

Or, e-mail someone at NIH (www.nih.gov) and ask for help or a referral - look for the head of the department you think you need to get to, and send that person an email (I did that with cancer, once, and he saved my life!). That’s where my entire estate would go - if I had one left!

Take your medical records with you, and if you have trouble, go to the middle of the main lobby and throw them up in the air, and scream!!!! Just get attention!

Check out the top public hospitals, and worry about the $$$ after you are well. Blood cannot be withdrawn from a turnip.

Check on the top public (non-profit) hospitals and charge airfare if you have to - but get to excellent physicians (they study, practice, and learn in different hospitals, cities - NO institutional incest - so watch for where they studied, and did their residencies, and post docs).

Look up hospitals records/ratings on the Joint Commission website (its vague but they do a good job) - aka JCHA - or Consumers Union, or the Commonwealth Fund’s data (eg: http://tinyurl.com/oe3c5m). "Aggressive" entities did not pan out in the CF’s study of hospitals - as far a life saving procedures went …  :-(

Go to Mayo (east coast, or Mayo’s in Scottsdale AZ where they aren’t so busy), Hopkins, Henry Ford, Parkland, et al - or National Institutes of Health (www.NIH.gov) - just do it! You will see how excellent physicians conduct themselves compared to those most Americans see.

Never fear recording your sessions with any doctor, and do not sign the new forms some less than professionals MDs hand out to sign that you won’t write your impressions of them on the on-line "Doctors" report websites. Excellent clinicians don’t have time for such trivia.

Communication is the key to excellent and sound medical care. No none has to "take" any doctor who comes along - even in a public hospital, and medical school facility, you have a right to ask for someone else, but also remember, they are teaching centers, so students (sometimes referred to as "Externs"), Interns (graduates from medical schools), residences (MDs/DOs who are studying to specialize in a certain branch of medicine), and post-docs (MDs/DOs after specialization - often on a Fellowship) will be involved in your examinations, diagnostic testing, conferences, and diagnosis, and ultimate care and treatment.

Be not passive about your health care. It cost far more to let something go than to address it early - all around. There are no guarantees - just letting something go does not mean it can be simply left alone, it may mean months of suffering ahead, which serves no one!

There are doctors who care, and care very much - dedicated to health, and healing. Those are the doctors we want, and need.

Let me know if you need help.

"Does the cost of health care affect the frequency of your visits to the doctor?" Duh. Ya-ah.

 [Hey, what’s up with the pie charts?]