The Uninsured Breast

 

I have little tolerance for people who don’t accept responsibility for their problems. Your choices bring you to your problems and no one else. I admit that my decision to eke out a living writing and not as, say, a public relations person for Halliburton have brought on mine. You see, I’m self-employed, and I pay my own health insurance. Because writing, not something fancy like owning my own chain of moderately successful steakhouses, constitutes my self employment, I opted for a type of health insurance called “major medical.” That means if I need a heart transplant, I’m mostly covered (after I meet a deductible, as long as it isn’t a pre-existing condition, and as long as I haven’t maxed out my lifetime limits. Also, I think the moon has to be waxing gibbous and I need a south-facing hospital room, but I’m not sure, because I never read the fine print on the policy), but things like blood tests and annual exams are not. Essentially, anything that could keep me out of a hospital isn’t covered, but once I get there, I’m all set.

Except for my annual mammogram, which Florida law says my policy must cover. My aunt died of breast cancer; another aunt died of lung cancer. I know two people undergoing cancer treatment today – literally, right now – and cancer freaks me out. So I go, religiously, for my annual mammogram.

Here’s where it gets complicated: the radiologist found something he wanted to look at more closely, so he ordered a more involved mammogram. Because the doctors don’t consider this preventative, my insurance didn’t cover it and I needed a doctor’s referral. I, of course, don’t have a doctor, except for Planned Parenthood and the walk-in clinic. This presents a bigger problem for St. Pete General than the possibility I have a cancerous tumor growing in my breast, because until I give them that referral, they won’t give me the mammogram. I call Planned Parenthood and they assure me they will fax over the referral.

Problem solved, right? Not so fast. Let me share with you how my appointment went when I showed up for the mammogram Monday morning.

St. Pete General: Oh, I’m sorry – you need an MD to sign your prescription, and Planned Parenthood had a Nurse Practitioner sign it.
Me: Your registration department told me that last week, but said they’d asked Planned Parenthood to send over a revised prescription and they would call me if they didn’t get it. I never got that call. Is it possible you’re looking at the first one and there’s a second one in there?
St. Pete General: I’m sorry, I don’t see it. We need an MD’s signature.

This continues for a few minutes, interspersed with St. Pete General trying to call Planned Parenthood, until I get very, very quiet and the lady trying to admit me goes in the back. I hear her whispering and a tidy little man comes out and tells me he’s very sorry, he knows how frustrating it is (because we all know hospital administrators have the same issues getting medical care as the underinsured lower middle class) but I didn’t get an MD to sign the prescription. The PA or ARNP or whoever signed it would have been acceptable if they’d been a St. Pete General employee, but since I didn’t go to one of their doctors I’m, politely put, screwed.

Me: "Isn't the radiologist- YOUR radiologist- who ordered the test an MD?"
St. Pete General: Er, yes... But your doctor ordered this.
Me: No. No, I found you off a list. YOU told me I needed a referral. Planned Parenthood agreed to provide one. YOUR radiologist asked for the follow up. Why can't he sign the order?"
St. Pete General: He won’t do that.

After 75 minutes, they received a fax from Planned Parenthood and I had the pleasure of a mammogram.

Here’s the kicker: three hours after my scheduled appointment, “Central Scheduling” called me. They book for St. Pete General and a handful of other hospitals, and it seems they had a signed prescription from a Planned Parenthood MD. The nice lady on the phone wanted to schedule my January mammogram at Health South. I pointed out that I don’t go to Health South and that I didn’t know that I needed a mammogram in January. She mumbled something and said she’d need to call me back.

My point? This would not happen if I had a regular doctor. I don’t because I haven’t needed one – I get the care I need, and the luxury of a general practitioner is an added expense (think over $100 a year to have someone look in your nose and ears and fax over referrals for mammograms). So when people get worked up over Obamacare, I only respond with, Obamacare doesn’t go far enough. I’m all for socialized medicine. You know, like veterans, the elderly, and the super-poor get.

Certainly the government can do this better. I’m pretty sure they can’t do it worse.

Contact CathySalustri at CathySalustri@theGabber.com.

 

 

 
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