As of now, I am in control here, in the White House

Obamacare and the Joy of Denial of Service

I can’t wait for Obamacare. Because I love Catch-22’s.

As those of you who read this blog know, I so enjoy irony. It’s worth sacrificing my health for, honestly.

And I relish wading through bureaucracy, and bravely facing death panels. Sarah Palin never had it more right.

I’m sorry, did I say death panels? I meant to say rationing of care. Sarah, please don’t be so honest.

I got a small taste of my future after I smashed my lower left shin two weeks ago against a lighting fixture that had been placed on the floor during a Saturday night party where wine was served in liberal abundance.

No, I’m not suing. I love the people who hosted the party.

As the pain subsided, I felt the blood fill the sock beneath my suit. I thought, well, the room is dark, so it will blend in with the sock’s blue color. I didn’t bother looking at the wound. As long as the blood didn’t start dripping onto the floor, I figured, I’d wait until after the party to treat it.

At home, I cleaned what turned out to be a large messy scrape and threw some hydrogen peroxide over it. Middle of the night I decided I better put some gauze on it too.

Well.

By Monday morning, my left foot was the size of a pineapple. I went to the doctor. She said, “Looks infected.” I said, “No duhh.” She said, “Here’s some antibiotics.”

Two week later, on Friday, the infection was somewhat better, though not at all gone, and the wound wasn’t healing every well. So the doctor said, “I want you to see a wound specialist. Here’s the number.”

And that was when – after two weeks of pain and itching (the latter worse than the former) and having to walk around in sandals in 40-degree weather because my foot won’t fit in a shoe – I began to enjoy myself. Because that’s when the Catch-22’s starting popping up.

The nice guy at the wound center apologetically explained that in order to maintain their status as a wound center they had to follow the Medicare guidelines, which say they can only see people with wounds that are four weeks old.

At this point, I resisted the urge to ask if they would make an exception for the wound that would occur after my foot is amputated.

“Would you like me to make an appointment for you now?”

“No,” I said, hanging up the phone, a little disappointed but gratified that these people were already getting in shape for Obamacare.

So I decided just to go refill my prescription for silver sulfadiazine, the cream I’d been applying to help fight the infection. Since it was a large scrape, I’d started running out of my small helping of the stuff pretty quickly.

The nice pharmacist told me my insurance wouldn’t cover the refill for another week.

I resisted the urge to ask if they would cover my foot amputation.

And BTW, if the doctors then had to take off the rest of my leg, would I HAVE TO WAIT ANOTHER WEEK BEFORE HAVING THE SURGERY?

Got any of your own Obamacare previews you’d like to share?

For further reading, one of our readers, Shofar, chronicles his health and health system struggles with great aplomb on the blog throughthenet.

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67 Responses to Obamacare and the Joy of Denial of Service

  1. You must be exaggerating Keith, because Obamacare is going to make things better. Just ask any Liberal, they will tell you! The most important thing is that women be able to get birth control for free, next will be abortions. After all we can’t expect young women today to behave responsibly! But you, well, next time YOU should be more careful so you don’t hurt yourself, then you won’t have need of wound specialists or cream. After all an ounce of prevention is worth a pound of cure!!

  2. This is confusing. Do Medicare guidelines apply to people not using Medicare? If you’re not using Medicare, why do they have to apply the rules to you?

  3. I’ve noticed a slow down in getting care and more bureaucracy. I hurt my shoulder at the end of December and after messing with it a week, decided to see the doctor who looked at some months earlier.

    I went to the doctor who took x-rays, said he’d order an MRI if it didn’t get better and then he took a week’s vacation. In great pain, I called the office and they then called him and got the order and schedule it for THREE WEEKS from that day. I pointed out that I was in great pain and they informed me that “oh, you can always call on your own and reschedule.” So, I did and it was all right because looking at my paperwork it was determined that I wouldn’t have to fulfill some related Medicare requirement for a form or a time wait. I got the MRI in less than a week, thank goodness, and learned I have a tear in a muscle.

    At this point my first doctor bowed out and referred me to his partner, a shoulder specialist, who had no appointments open that week and was taking the next week off. So I solidered on in pain until that doctor had had his vacation. He looked at the MRI and my physical ability tests and confessed himself unsure what to do. Understandable. He suggested I continue physical therapy (which I had been taking and paying for since the second week in January) and let the situation clarify itself, but he strongly suggested that surgery would be the end result.

    So I soldier on, paying for physical therapy, which adds up fast even with insurance since they charge plentifully for every activity. I feel lost, scared because it seems all I can do is wait until the big tear comes along and makes surgery an immediate necessity. So, I decide to get a second opinion. I call the doctor suggested by a trusted source and he requires a referral. I call my primary care physician, and he refuses all of a sudden, saying that it must come from the doctor(s) I saw first. Hoping to avoid involving the first surgeon in this, I call the doctor who bowed out. It takes days to learn that he won’t do it, it has to come from the surgeon who is his partner. I call that office and it takes a WEEK for my request to get from his assistant to the woman in the same office who does the referrals. And even then I believe it was acted upon because I made the phone call and accidentally learned of her existence and spoke to her personally.

    Now I have a referral appointment — MORE THAN 20 DAYS AWAY. Remember, I have been in constant pain all during this bureaucratic merry-go-round.

    I had to go the hospital and get the MRI on a disk — they couldn’t mail it to him. And may I also point out that when I called the second opinion surgeon’s office it turned out that I couldn’t just get an appointment. My request had to go to a “triage specialist” who would decide if my situation merited an appointment with the doctor whom I wanted to see.

    And I have to bring “all my medication in their original bottles,” not just a list. The MRI disk is in my purse two weeks early so I don’t forget it. My shoulder still keeps me up all night, etc., etc., etc. The physical therapy seems to be helping some, but the horror stories that everyone has been telling me makes the choice between the injury and the injury of shoulder surgery seem scarier than ever. Frankly, I feel like a tennis ball being bounced around among medical “services” that are married to their staff bureacracy. Of course, being in pain and feeling vulnerable, I am probably not completely clear-eyed about what it going on.

  4. “…in order to maintain their status as a wound center they had to follow the Medicare guidelines, which say they can only see people with wounds that are four weeks old.”

    That’s because the government is hoping Medicare recipients (and now everybody) will die from gangrene before doctors are allowed to treat an injury. We live in very scary times.

    My only experience with Obamacare is my primary doctor decided to quit her practice rather than compromise her Hippocratic oath. Fortunately I was able to find a new doctor, but sure do miss the caring, attentive doctor I had for years before Obamacare reared its ugly head.

    Get well soon Keith. As a fellow klutz, I can sympathize with your mishap. Have you tried an Epsom salt soak? Works wonders for me.

  5. I’m sorry to hear about your owie and all the roadblocks that the system threw down in your path to health and well-being.

    I take several medications that are prolonging my sorry life. One day, while refilling my weekly pill dispenser, I dropped the bottle, the pills spilled all over the floor and my dog ate most of the meds. Rushing to the pharmacy to get a refill and told that my insurance wouldn’t cover the new order for two more weeks, I proposed something that shocked the pharma community; I said…I’ll pay for the meds out of my own wallet.

    I got my refill, the dog threw up on my bed, and I was out $4.

    • srdem65 –

      “[T]he dog threw up on my bed” – I had one of those type of dogs. Except with him, he would do that when he was ticked at me. I think he would go and eat the entire bowl of dog food and then wait until my back was turned and deposit it on my pillows. He was a great dog, but had one heck of a vengeful streak in him.

      I’ve got a cat that is the same way, but her thing is to “soak” my slippers (if you know what I mean) when she is mad at me. I’ve been through at least a half dozen pairs in the past three years. Maybe it’s time for fish.

    • I have had the same problem all my pills are small and I drop them and can’t see well enough to find them so I have to pay for mine too freuently.

  6. Keith,
    Thank you for the kind mention, and in the vernacular, “I feels yo pain bro!”

    If anyone doubts the veracity of what you have written, let them go to the nearest public hospital for treatment. I now have what they are calling a “sports hernia” (which I can’t understand, I haven’t been able to play any sports in nearly three years) but I have to wait until I have an MRI or C-Scan before they can do anything. It will be at least 2-3 weeks before I can get the scan, and then another month before they will be able to do anything about the problem.

    I first brought this condition to the attention of my primary care doctor over a month ago, and it took that long just to get in to have a surgical consult. This particular problem has been going on since at least November of last year, but like you and your shin, I thought it was not as bad as it actually is. So now I will have to deal with the pain and discomfort until someone actually looks inside, so to speak, and sees what exactly is the problem. The one thing I will say for my local public hospital is that they will not prescribe any type of pain medication unless you have parts falling off. I guess they don’t want to fuel their patients with hillbilly heroin.

    And for those that do not think there is rationing or “death panels” now, guess again. I have a good friend who is in his early 40’s that is in stage 5 renal failure. The failure was brought on by a screw up in antibiotics given to him in the hospital to treat a deep wound infection that spread to the bone. He not only lost a portion of his foot due to the infection, but nearly all kidney function. He is on daily dialysis, and his only real hope for survival is a kidney transplant. But he doesn’t qualify due to the screw up with the antibiotics, and prior substance abuse (25 years ago). So now he sits, unable to work due to eight hours a day being hooked to a machine, and knowing that his life will be cut short due to government regulations and medical incompetence.

    Obamacare will do one “positive,” it will eliminate a portion of the population very quickly due to a lack of or refusal of treatment. That may in fact be this administration’s way of saving Social Security, kill off as many as possible before they can collect any benefits.

    As a side note, if you do go to your local public hospital, you will see an abundance of people that speak no English, and in many cases have never paid any taxes into the system, receiving medical attention for everything from a hang nail to a heart attack. My suggestion would be that the hospitals only treat life threatening conditions for those that are here illegally. If they have some minor medical problem let them return to their native country for treatment. After all, didn’t Michael Moore say that Cuba and other socialist countries have better medical care?

    • WHy does need daily dialysis? My dad has zero kidney function and has it 4 times a week, 3.5 hours each time.

      I donated a kidney to him, but that failed after four years.

      Just curious.

      • Car – I’m not exactly sure why it’s daily, I know for awhile he was going 3-4 times p/wk, and then he had some complications with everything and now it’s daily and he is there eight hours hooked to the machine. They have been trying to get him set-up with home dialysis, but Medicaid will not pay for a home health care nurse to monitor things, so he goes to the clinic.

  7. Keith…so sorry to hear of the bad boo-boo. As my DH has Type 2 diabetes, I am quit familiar with “wound” care protocol…and the “month” old meme…

    Now my favorite precursor to ObamaCare exists at my pharmacy…where husband’s “cocktail” of prescriptions are filled. Due to co-pay expenses (now at $420 per month) I have spread out the refills over the month with pill inventory accuracy that should qualify me for a job scheduling air traffic. But, occasionally, being a planner–and looking at Pittsburgh winter weather forecasts–I break the cycle and TRY to refill an absolute “needed daily” med like his Actos or Plavix or BP meds and am told that “records indicate 3 doses left CANNOT be refilled til…” but if you then wait, call the pharmacy on “due date” and let’s say we have a couple of inches of ice…THEY SUSPEND HOME DELIVERY…so I/we get to drive out (hey maybe an auto insurance claim!) to get the meds the I tried to get three days before.

    Now I could talk Rx antibiotic ointments and the issue that you must reapply when you change the dressing, but you lose 3 or 4 applications when you use the cap to prick the tube and the Creme that must contain ground up platinum dust “spurts out” ….

    I’ll end with the words of former Congressman Alan Grayson “die quickly!”

    • Oooopie! How could I forget this fiasco…

      Because my husband has extra parts and peices in his heart (stents) he HAS to take a very large dose of antibiotic an hour or so prior to dental work. Our dentist calls the script into the pharmacy…this works fine EXCEPT when an emergency appt is needed. DH had broken a tooth, called the dentist (who is a wonderful man who was willing to stay late to fix the problem and allow time to pick up antibiotic, have him take it, etc). Pharmacy could NOT get insurance approval “so quickly” so meds were to be picked up next day. That wouldn’t work; so after a series of phone calls it was determined that he could go “off network” for this payment. Full cash price LESS THAN TWO DOLLARS!!! Exasperating run around for pocket change…and the dentist DID Rx another “preemptive dose, that we keep on hand “just incase” an emergency occurs again. The co-pay was like 17 cents.

      The logistics and paperwork will only get worse. Much worse.

  8. One of my co-workers is a single mom of 3 on our state’s medicaid (LA Chip) program. Her one year old baby had a follow-up appointment from hernia surgery he had recently had. It took 4 weeks to get the appointment. At this same visit, she mentioned that he had a cough for a few days and runny nose and asked if the Doctor could give him something for it. The doctor told her that Medicaid won’t let them be treated for more than one thing per visit, so he couldn’t give the baby anything but offered to schedule another appointment (which would take 2 weeks) so that he could treat the child for the cough and runny nose. By the way, she had to take the whole day off for the appointment that was scheduled at 9:30am…she didn’t get in to see the doctor until 1pm. I can’t WAIT for Obamacare to take effect so we can ALL enjoy crappy treatment and long waits.

  9. Yes, doctor and pharmacies are irony-free zones. Even sarcasm–the amputation riff–falls on stony ears. This stuff is endless–try going to the ER where every doctor you see is in a “group” that bills you separately. I have been in the ER when a specialist actually came (almost a miracle though required by law) and said, “Hi, do you think your insurance company will pay me?”

    • Oh–I remember another good one. My kid had a pilonidal cyst operated and it had to close from the inside out and I had to put some weird fluff in the wound twice a day–made of seaweed–$500 a sheet. When she finally healed (7 mos), the insurance company asked if we had any of the stuff to give back. The surgeon said to tell them no.

  10. Keith, it’s too bad you aren’t an illegal alien. You could have gone to the hospital ER and had good care with a quick follow-up, free pain medication and cream, and all at no cost to you.

  11. Told you about my Glaucoma drop I’m allergic to the generic and they did not
    want to pay for brand name. I ask the ‘nice’ lady if as I only have one eye
    would she prefer I go completely blind as that would be far costlier? I now have the brand drop. Oh and don’t expect your RX a day earlier guess they
    are afraid we are all saving Lipitor and blood pressure parties:)

  12. It took exactly a year from when my husband fell off his bike and tore his rotator cuff to the repair surgery. It was mostly scheduling and rescheduling problems for numerous x-ray, lab, ekg and other pre-op fun, and a surgeon who’s booked several months in advance.

    On the other hand, a friend who was hit by a car while on his bike, (he’s very okay), also tore his rotator cuff when he fell. Taken to the hospital, surgery the next day !

    Moral of the story, if anything hurts, lay in the street, call 911 and say you were just hit by a car. Sure seems to speed up the process. ;)

    We have very good insurance because we’re retired military, but our co-pays and supplement costs to basic coverage are soaring since Obamacare passed. Methinks the only ones benefitting are insurance companies.

    • My husband had what we thought might have been a very minor TIA, just a few slurred words in a sentence or two. He didn’t think he needed to go to the hospital but our doctor insisted. We arrived at the ER, saw the triage nurse and learned our doctor had called ahead so they expected us. We were ushered back to the waiting room where we sat and waited 8 hours until hubby could be seen. Once he was taken back, it was determined he needed to be hospitalized immediately. Let’s see – 8 hour wait, plus several hours for diagnosis, then another 4 hours wait for an open bed… not exactly our definition of urgent. LOL They kept him a week – he’d actually had a stroke, not TIA, but no damage thank God. We fully recognize our mistakes in this escapade. I pray nothing like that ever happens again, but if it should, it’s 911 all the way. It gets you through the doors and seen much more quickly.

      • This stuff has been going on for years. The triage staff do the best they can, so make sure you make it sound worse than it is, if need be.

        A friend was in a car accident, oh, 23 or 24 yers ago on Halloween as she was driving to work in a clown costume. I think this may have impacted how seriously they took her complaints because she sat in the ER crying on her father’s shoulder about the pain in her left arm. They finally took her back about 3 hours after her arrival, did an x-ray, and as soon as they got the results, they came in, apologized profusely, shot her up with pain killers and started making arrangements for surgery to fix the spiral fracture in her upper arm.

        I don’t think they apologize now.

        Seriously, make it sound even worse than it is. Her father was convinced the only reason they took her is she wouldn’t stop crying in the waiting room and it was disturbing the other patients. They even asked her to hush up but she couldn’t.

        • About 10 years ago I got a headache, just didn’t seem to want to go away so called the doctor after 3 days. It was a sunday so he said to go to the er, a nice quiet one a little farther away so that we could get in faster (we were new to the area and had no idea where to go). The waiting room was empty when we came in early in the morning. A few people come in and are seen right away, I figured they must be serious cause if you looked at me I’m literally writhing in my seat from the pain. I try to lay down (of course they have nothing but single seats) but I try anything hoping I’ll sleep.

          Once in awhile the pain will let up and I’m coherent. Not sure if these are the only times they see me cause I’m still waiting and it’s afternoon. This goes on and on and on. People get seen and I’m not. We ask if maybe they lost my paperwork, Nope, all is well, just wait. They finally get me into the back around 9 pm. They have no idea what could be wrong with me, but people come in, take a look and leave, it’s like no one takes me seriously. Finally they say, our only option is a spinal tap. Okay, fine, do what you need. They look surprised that I would consent.

          11 o’clock. Results come back, I have MENINGITIS! You should have seen them move then. I’m whisked away immediately to isolation. Finally given meds, MORPHINE to handle the pain and I’m in the hospital for 5 days.

          I ask the dr why they didn’t know what this was (we’ve since found out meningitis is kinda common in this area) and he says they thought I was there searching for drugs. I look like a freaking soccer mom. Do people actually sit in an ER for 12 hours waiting to get a PILL?

          And yeah, I have brain damage from it. Doctor said it was like getting a lobotomy. But, it could have been much worse.

          Since I’m getting closer and closer to Medicare, I figure my heathcare will be like this. I’m really worried. I’m really scared. My DH is younger than I am and his job provides very nice health insurance (well, it was nice until oblowmecare got hold of it) but I understand I will be forced into Medicare even tho he won’t be retiring for another 10 years. You would think they would let you keep the heathcare you have instead of being forced into an overly taxed health care system.

          • Wait’ll you see how ERs treat older ladies. My Mom lay there with a dislocated shoulder begging for a sip of water for 8 hrs–she suffers from dementia and asked over and over–we asked over and over…no, she might need surgery…not until “doctor” can come…etc.. Of course, two guys eventually eased the shoulder back in–no surgery and that water sip would not have drowned her in vomit or anything if there had been. But rules are rules. No pain med either. Very nicely played on that–dislocated shoulders hurt! If you are old and in the ER, get behind who ever is last in line and start praying.

  13. Our local health care built a beautiful big new $2,000,000 building. My husband went there to see if a doctor could see him for a rash that has been hounding him. The receptionist informed him that they didn’t see patients, if he was a woman he could be seen to get birth control, but since he was a man all they could do was give him free condoms. We have a $2,000,000 free condom building!

  14. G’day, All! I read here every day but rarely type anymore. This post just begged a comment so here is my 2cent’s worth.

    I have Multiple Sclerosis. I tried every drug treatment available and wasn’t helped. Finally got to the point where there was only one drug left for me – by now I’m unable to work and on disability – they wouldn’t even consider the drug. Their solution? — No. —
    Just No. No disease modifying drug. No keeping the MS from progressing.

    Fortunately, I’m with Providence Health-care. My Doctor, the MS center, the hospital they’re associated with, all are Catholic. Between Catholic charities and the “evil” pharmaceutical company, Biogen-Idec, they got me set up in no time and paid all my costs. My life mattered to them. And until they’re put out of business my life will continue to matter.

    Oh, darn. I’ve lost my comedic and ironic edge completely. Thanks for the forum to speak, Keith. I guess I’ve needed to tell this story for a while. I promise to be funnier if I ever stir myself to type again, this is grim. heh

    Good fortune and Godspeed to us all, we’re gonna need it!!!

    (((poof)))

  15. And let’s not forget the ending of post-operative care.

    I had serious foot surgery and asked the surgeon if it made sense to him to have a brand new hospital, a fabulous surgeon, a fabulous surgical team, and then role the post-op patient out into the parking lot and put her in the hands of amateurs for her post-op care. He looked a little surprised. How quickly doctors have forgotten the days when surgery was followed by CARE.

    Luckily for me, my family paid out of pocket for me to spend some time in a rest home — I had developed high blood pressure as a result of the surgery — would never have known that if I was at home on the living room couch — until a WEEK afterwards when my first post-op doctor’s visit was scheduled.

    Think — how many people do you know who probably died because they were sent home way too early?

    • I have gotten out of the hospital with a handful of “instructions” copied from WebMD and sent on my way. I would lie on the couch wondering where the breathing treatment team was, yet while I was in the hosp, I would think I could just stop breathing and no one would even know. Arg! Sick World stinks. And badly executed Sick World REALLY stinks.

      And speaking of delays–my retina was found to be totally detached Fri morning–and operated Monday nite. Four surgeries later, that eye is blind.

        • You can also have major surgerty with a C-section to deliver a baby which – surprise, surprise – can’t be done via laproscopy and involves cutting all the muscles, etc., and get sent home from the hospital within 2 days to take care of a newborn child!

      • Oh, Star, I’m so sorry about the blindness in your one eye – that seems like an amazing amount of time to wait for surgery considering I’ve been told repeatedly that it cannot wait when the retina is detached!

        • Thanks–Yeah, it’s been a bummer. I never apprec my vision enough–never thought about it. Yes–it’s supposed to be a big emergency–but for me, it wasn’t and I have gotten doubletalk since from various docs. I knew my eye was full of blood–lava lamp–but they thought it would clear. Then it didn’t.

  16. ObamaCare is all about cullng the herd! It’s going to be the survival of the fittest from here on out! If we don’t adhere to the dictates of the potato sack Queen …and start ‘moviing’ – we don’t deserve to live!

    In 2 weeks, the SCOTUS will start hearings on ObamaCare….pray! If they rule it in, Obama will be OUT!

    We have the best h/c system on the planet but it needs to be overhauled! We got into this mess because we have over 20M illegal aliens in this country that need to be fed, clothed, educated and medicated! Unless and until we limit ALL social services to U.S. CITIZENS ONLY….we wlll never dig ourselves out of the black hole!

    • I think I read somewhere that this was all so that 45 million uninsured would have healthcare and then come to find out 32 million will still be left out. So how the eff is this helping ANYONE?

  17. I have another story to share. I needed surgery due to a rather large and painful gallstone. My surgeon jumped through all the hoops with the insurance company and received pre-authorization for the surgery. The hospital also was “in network” for my insurance coverage. Two weeks later I finally had the surgery.

    Several weeks after my surgery we were notified our insurance company denied payment to the anesthesiologist, claiming I had gone out of network. I appealed and they eventually paid since I was not allowed to choose my anesthesiologist.

    The next week I received denial of payment for the hospital bill. The insurance company explained they had a contract with the hospital for in-network coverage the day before my surgery and the day after, but not the day of my surgery. I was furious and asked why they pre-authorized the surgery if it wasn’t going to be covered.

    Eventually my insurance company paid the hospital bill but not until after I filed another appeal and threatened to contact our state Attorney General, Dept of Insurance and every other organization applicable.

    The next year or so our son-in law had surgery and yes, it was the same insurance company. They also denied his payments for the same reason – out of network, when everything was again pre-authorized. He appealed and they eventually paid.

    Obamacare is going to make everything worse – higher premiums, longer waits, poorer quality of service, less treatment options, shorter hospital stays and yes – death panels. They’ll have strangers determining our treatment – if we’re lucky to qualify for treatment – instead of our doctor deciding what’s best for our particular circumstances. I truly believe people need better access to healthcare but Obamacare is not the solution.

  18. I’ve read all the above comments with great interest and concur with all these observations. Let me add one of my own as your humble primary care physician.

    My group as told in 2005 that we had to get real with the coming “new healthcare Paradiagm” (apologies to Newt). 4 years and 5 million dollars later we have a good, not great, EHR (Electronic Heath Record.)
    I can submit perscriptions electronically as the the HHS/Medicare wants. But here comes the fun part: Champus, the local Army pharmacy, and the VA Hospital systems will not accept electronic prescriptions. I have to print out the script and then co-sign my own signature to make these scripts acceptable to these agencies. But wait, there is more. Not to be left out, the DEA has decreed last month any controlled class 2,3,4 medications should not be transmitted electronically. Faxing and handing to the patient is “allowed.”
    So there is the future of Obamacare: 5 federal agencies (Fiefdoms) sending 5 sets of instructions (Edicts) for just prescriptions.

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