Why Medical Care in the U.S.A. Sucks ASS

That's My Left Foot

And yes, I know it's pretty damned beat up. I have pretty good healthcare through my union, which when playing the healthcare game in the U.S. puts me way ahead of most of the population. Those scars and stuff are the cumulative result of many years of bad parachute landings, horse wrecks and other debris of an active life.

Several months ago I began having extra pain in the foot and leg. By extra pain, I mean that pain free walking has not been a part of my life since 1974. The last major surgery I had was a sub-talur fusion in 1994. Things were pretty workable, I've been able to walk within reason, ride a horse and function on a daily basis.

As these things go, I've been petty lucky. Things around traumatic injury happen slowly for the most part. First you go into twinge and little hurts, then, you go into good days and bad days mode. Several months ago I went into bad days and really shitty fucking days.

Using my good insurance I went to see my "gatekeeper" doctor. He looked at the ankle, listened to me describe my pain and problem, then he ordered a blood panel to rule out gout.

I said "Dude, I know that you're a nephrologist, but, will you please just fucking look at all those goddamned scars and maybe think about ordering X-rays?"

He said he would write me a referral to a Podiatrist. I said "Dude, I hate to sound all one note on you, but, Look. At. All. Those. Fucking. Scars. I don't need a Podiatrist, I need an orthopod who does feet."

He said that his girl would get back to me and she never did. I'm at the beach in San Diego right now, doing a semi-working vacation. One of my neighbors here is a retired NBA superstar who might be one of the few men in the world whose feet are more fucked up than mine. He saw me limping while walking the dog and hooked me up with one of his favorite doctors.

She turned out to be exactly the care that I needed. The problem is that she's outside my insurance. I just deposited a hefty check from my Jeopardy appearance, and I'm getting another hefty payday from working over the 4th, so I just said "Fuck the cost, I'll pay for it out of pocket."

My plan was to get my ass in to see the specialist, get an expert opinion, then use that to find a doctor who takes my insurance.

The good news is that there's nothing structural happening with the bones. The fusions are still solid, and the arthritis surrounding it is less than could be reasonably expected. She finally said, "I can inject the heel and the foot with cortisone and if there's instant relief from the lidocaine, we'll know it's a nerve or other soft tissue problem."

I said "Cortisone is my friend. Shoot the foot."
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There was about ten minutes of excruciating pain while she dug around with a needle the size of a goddamned shot glass. Then the lidocaine took hold. I've had the first bearable pain steps that I've had in months.

As I was checking out the front desk girl gave me the bill.

Office Visit: $150
X-Rays (8): 80 each
Cortisone Injections 3 sites: 200

The grand total was close to $1,200.00. I sighed and handed my Visa card over and the Doctor came out and told the clerk "He's a personal pay patient, call it 300 even."

I said "Thank you, there will be truffles come Christmas."

There are so many things wrong with just my simple little tale here that I'll just start with having to go through a "gatekeeper" doc. He's only there to keep costs for the insurance company down, just like claims representatives are there to deny claims. It's all about the bucks.

He, by specialty and training, is a nephrologist, so he naturally looked at my symptoms ready to treat to his specialty. Every minute I've spent with him for my ankle was wasted time and wasted money. I knew more about the causes of my pain than he did.

I have nothing but praise for my newfound hero doc who treated me outside the system. But, the sliding scale for the treatment of a patient who is not insured shows how much money is used to keep a profit margin viable for people who have nothing at all to do with making any illness better.

$300 cash, or $1,200 to an insuror. Who the fuck needs the extra $900?

Huh?

I've been in countries where the best available medical care is considered to be a basic human right, you know about those, stuff like haebeas corpus was until Bush.

While medical care remains a product in a marketplace we will never solve the problems. There are too many motherfuckers who are using part of the $900 cut they would have gotten from my case to buy lobbyists who then buy Congressmen and Senators (yes, that means hacks like you Diane Feinstien).

I rather be called a fucking commie socialist hippie bastard than deal with this shit any longer.