Legs Can Only Be Crossed For So Long

Here it is—the rant I have been trying to contain, but no longer can.

I don’t have a closed mind, and I’m completely capable of changing my viewpoint. I do it all the time. I receive information from others on a daily basis which makes me look at a subject with a different perspective.

Speaking about politics through my blog, seems to ruin my little sanctuary away from all the crap, and I really hesitate to type out these words, but I’ve had enough!

***The following is only my opinion***

I am an Independent with left leaning tendencies on all social issues. I used to say that I leaned to the right in regard to financial issues. However, each party finds a way to make the laws bend to insure they maintain their financial supporters, so in my eyes, neither party is financially responsible.

Originally, I was a supporter of the Affordable Healthcare Act, and I still am. I probably blogged about my feelings in regard to our healthcare system prior to this law. I’m specifically referring to the pre-existing conditions, and the affordability of health insurance. Both of my siblings were victims, who paid with their lives.

Anyway, my beef is with the insurance companies and how the Affordable Healthcare Act has created bigger monsters of them. Oh my gosh! Whatever happened, it created a crap load of changes as to how the insurance business operates. The decisions made between the doctor and the patient are no longer valid, and are poo-pooed by the insurance companies if the treatment doesn’t fit into their guidelines.Β 

I have another beef with the mega medical corporations. I’m sure most metropolitan areas—who knows, maybe even rural areas—have these major medical corporations that mandate what their doctors can and can’t do based upon the money reaped from our illnesses. Basically, a doctor’s hands are tied these days if they are a part of these major corporations. Each and every patient receives the same exact treatment, even if a patient or two doesn’t fit the mold.

What set me off today?

Medications. Specifically, what the insurance company deems is appropriate for an individuals healthcare needs. If the insurance company feels as if they should only cover a certain amount of pills, that’s all they cover. The insurance companies are dictating necessary treatments, not our doctors.

Who is taking care of me? My compliance to my doctor’s advice and instructions?

Or, my insurance company?

I turned in a prescription today. One I had looked over, and one I had a discussion with my doctor, due to a letter I received from our insurance company that stated I would only be allowed 30 pills in a 25-day period. The count for this prescription was for 45 pills.

When I picked up my prescription, I received 30 pills. I asked if I could have the rest of the prescribed amount and pay out of pocket for the remainder. This was what the letter from our insurance stated I could do.

If the pharmacy tech had nicely said no, that the prescription wasn’t written for 45 pills, I would have walked away and called my doctor to make sure I wasn’t as stupid as the pharmacy tech was making me feel. Then I would contact my stinkin’ insurance company.

But that tech behind the window pissed me off. She told me that the prescription was written for one per day, which equaled 30 pills. She has to be the Queen of Snarkiness, because I haven’t gotten that mad, that quick, since my kids were little and something threatened them. Her tone, her body language, and the look on her face made the mountain – me – begin to rumble.

Perhaps I was receiving this treatment from her because the prescription was for an anxiety medication. In her mind, I was possibly an addicted loony, trying to score some more drugs. Perhaps I was oversensitive—no, I may be crazy, but I don’t imagine things, and she was one big nasty person. (Oh, how I want to use vulgar language, but I won’t let her attitude make me do it).

I know that prescription was written for 1 to 1-1/2 tablets per day, for a total of 45 pills. I saw the count number was 45. I didn’t even have dirty glasses when I read that prescription, and this doctor just so happens to have pretty nice handwriting.

Unfortunately, I have seen more than a couple of prescriptions in my life, and I’m getting pretty good at reading them. Plus, I have to Google everything about the medication, even down to the shape, color, and markings to make sure I don’t get the wrong medication.

I made it to the car, and safely home before the lava flowed. I’m going to give myself a while to calm down before contacting my insurance company.

You see, it isn’t just the way patients are treated, or the cost of care that needed to be changed, we needed a law without loopholes to control the insurance company’s grip on us. Doctors, hospitals, and care facilities need to charge realistic fees for services rendered. Our insurance premiums should also be realistic. Why is that so hard to figure out?

I’ve always heard that one person can make a difference. I would like to make a difference, but I’m sure I would have to resort to vulgar language.

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About April

I'll come back to this when I find out who I really am. I've been through some extremely rough patches but they have made me a better person. I blog if my brain is functioning first thing in the morning.
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13 Responses to Legs Can Only Be Crossed For So Long

  1. Justin B. says:

    If vulgar language doesn’t make you feel good it may not help. I cannot fathom the amount of control you explain. It is not a democracy when people do not have a choice on how they are living. We are all constantly distracted by media and materialism. Personal health is apparently our own personal concern. I feel terrible that you had such a bad experience doing something that you need to do. The pharmacist who was rude to you probably went home to a bottle of alcohol. Or maybe had a bad day too. Its so hard for people with anxiety to not feel attacked when people are rude. When most of the time their behaviour has nothing to do with us at all. Hoping your writing and the comfort of home has relaxed you.
    Justin B.

    • April says:

      Oh, I’m much better now. As far as that tech having a bad day? I don’t think so. She wasn’t exactly rude to me, it was her demeanor. She acted as if she were a queen and I was one of her minions. My gripe is that our healthcare system is out of control. I’m sure Mr. Obama had a good start to an idea, but it didn’t really address the problem. There are parts to the law that I am thankful for such as being denied coverage for a pre-existing condition because I have two. I also like the cap on the amount charged because one of my conditions has a potential to bankrupt my family. I am living as healthy as I can, and I am tired of being held captive by my insurance company, and the thumb placed upon how far my doctors can go if I have an illness which doesn’t fit the mold they want to keep all their patients in.

      I have learned that spouting off in anger at another person is useless. It only makes a situation worse. However, I will find a way to work toward finding an answer to the issue of our healthcare problems. I may be a small voice, but maybe I can at least do something in order to channel my frustration into positive action.

  2. babso2you says:

    I love this rant! Not sure where you are but there was a news report on about Covered CA where two different folks went to their Dr.’s for issues and were turned away as the Covered CA insurance payment was less than what the Dr.’s office thought was acceptable payment.

    One time I went to the Dr’s office and they recommended surgery. I called the insurance company as I wanted a second opinion. They would not cover my going for a second opinion! What the heck? They were OK with covering a surgery that might not have been necessary?

    As for charging realistic fees? Why the hospitals would go broke if they could not charge you $8.00 for a single Q-tip! There was a news story about a 20 year old who had to have surgery for appendicitis. He was there for just one day and the cost of his hospital stay? $80,000!

    Your issue with the pharmacy would have set me off too. I go to the local Rite Aid and a few weeks back I had to get antibiotics. The Dr.’s office called in the prescription. Knowing how they are at this Rite Aid, I showed up 3 hours after the prescription was called in. Now mind you there was no one waiting in line, or sitting waiting for the prescription. I go to the window and I was told that I had to wait up to 30 minutes for them to fill it. I told them that the order had been called in hours ago and knowing how they are I hung around town, when all l really wanted to do was go home and crawl into bed. Apparently they had not checked “voice mail” in those hours. Now I am ranting!

    What should have been done instead of this affordable care act is to regulate insurance companies and take away that power that they have been given to make medical decisions which they are not qualified to make. And, controls should be put into place that puts a cap on what one can be charged. That $8 for a Q-Tip? One could buy 1,000 of these at Costco for that $8.00! Maybe we should bring in our own and tell the hospitals – no need, I have it right here in my back pocket!

    Have a great day and I enjoy your blog!

    • April says:

      We’re in Georgia. I recently read an article about one of those “mega” healthcare operations here. I can’t quote all exact amounts, except a woman who went to the ER for a serious gallbladder problem. Her bill at the end of it? $80,000. The annual wage of the CEO of the hospital she went to? $1.2 million. They retained an itemized list, and I was appalled at the costs. One quote that came from the CEO – which is something I have been complaining about for so long – (I’m paraphrasing) They have to treat people who have no insurance. The amounts allowed by Medicare and Medicaid are the same as they were in the 1970’s. They have to pass on the costs to those with insurance. This wasn’t my interpretation of what he said, this is what he said–I just don’t have the exact quote.

      I’m going to get involved in some way. Maybe it will make me feel better, I hope. I don’t want to become even more frustrated.

      • babso2you says:

        That’s exactly what these things are. They are money pits with a tax exemption that allows for a CEO to earn $1.2 million. Here in CA in El Dorado County, we have Marshall Medical. A couple of years ago the assets, and land is a small portion, was over $700 million. That is egregious!

        • April says:

          Managed health care. We are becoming numbers to be processed as quickly as possible. Some of us don’t exactly fit in the process, and we have to advocate for ourselves, and hope we get the care we need, and it doesn’t leave us homeless in the process.

  3. Gallivanta says:

    Insurance companies….grrrrr….don’t blame you for a volcanic explosion.

  4. mewhoami says:

    I read this late one night and never commented – I told my husband about the prescription issue and that’s just ridiculous. When did the pharmacy get more say than he doctor? I have not ever liked the idea of Obama Care, and would refuse it if we wouldn’t get hit with a fine. Now that our health insurance has gone up $200 more a month (which we expected), I like it even less. It irritates me that we have to pay for other people’s health care because they refuse to get a job and want to live off the government. For those people who can’t work, then it’s okay. But for those who are just too lazy and we have to pay for their laziness – that infuriates me.

    • April says:

      I hear you. I really don’t know how much the healthcare system changed because of the new law, and we have seen some benefits. EXCEPT we had 2 choices for insurance this year through the company my husband works for. One was an HMO the other a Georgia Public type of insurance. We have been down the HMO route before–hated it. It just so happens the other option is a half a step above an HMO. We don’t have to get permission through our primary care doctor for everything, but we are restricted to the doctors we use. Which was the same as we have had. If we go out of network, I don’t think our insurance will cover much of the bill if any at all. As far as the medication–I’m still fuming. The insurance company has also decided what type of inhaler they will pay for to help my asthma. It’s not what I discussed with my doctor, and I don’t know if the efficacy will be the same. I really don’t want to take a chance on my ability to breathe. It all boils down to the “managed” healthcare of the mega hospital conglomerates, and the insurance companies trying to maneuver around the new law.

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