I am so frustrated right now with the health care system here! I took Drew back to that a..hole doctor today for follow up, now that we are on Medicare. The lab results showed he has“potent” bacteria and we now have ear drops to take. He recommended we get on private health coverage as soon as possible and then see the ENT specialist. Basically, if you need any issues dealt with regarding ENT, if you are in the public system, the wait is about two years. Lovely—why even have a public system then? I called the office of the specialist we were referred to, and the woman was very nice and patient with all my questions, trying to figure all this out. There is a way we could get tubes in again (if that is what is recommended) through the public system, in February at the earliest, and would pay close to $1000 out of pocket once all the doctor visits to maintain his ears in the meantime are added to the costs of the procedure itself.
If we get private insurance, we can get the procedure done within a week, and out of pocket costs will be anywhere from nothing to $500 depending on what type of coverage we pick.
This is the part that sends me over the edge—IF we see the ENT doc before getting private coverage and he does recommend further treatment and we THEN apply for private coverage, no company will cover any ear issues that Drew ever has, because it is a pre-existing condition! The initial doctor was a complete jerk to me when he told me that because I was so dumbfounded. I think he feels I am being rude and condescending, but I am only trying to understand this system and make my kid feel better, and I cannot believe that insurance would refuse coverage because of EAR infections in a child!! He insisted that the U.S. is the same—I have heard of people being refused coverage for serious, ongoing, life threatening illness, and I agree that is sick and wrong, but refused coverage for EAR infections?! Would we really do that?! I am actually asking for an answer, if anyone reading this has it.
I told him to please give us the referral and I would discuss with my husband our options and he got really mad, telling me HE is the one who knows about this, HE is telling us what’s best for Drew and this is his recommendation.
Of course, I started crying for real this time in the pharmacy when I picked up the ear drops. Both kids were running around crazy, exhausted, and the pharmacist came out to explain the med (which is not covered by Medicare by the way—really, what is?) and asked if I’ve been giving him pain relief and I just couldn’t speak or else I would have bawled. Her assistant started watching the boys for me, so I could get through the transaction!
As I type this, I am realizing that our out of pocket costs, even if we stay on the public system, will be much less than anyone having this procedure done in the U.S. without health insurance (we have it—the public option, but in the U.S. we don’t have a public option so that’s why I’m using uninsured as the comparison). Also, when Steve called today, he told me we should first visit a general doctor (for free, as this visit was) that people actually like, and say good things about, instead of this a..hole, and then decide. That seems reasonable to me.
He said he was totally thrown by the U.S. system as well, so understands that this is all frustrating to me. I love this blog—it helps me put things into perspective by typing it out and thinking about it, instead of being an angry, crying basketcase all day. From my understanding, the U.S. system is horrible if you don’t have good health coverage, or none at all, and a public system would really help people like that. I have grown up in a family with means to pay for insurance, and then since I have been on my own, have always had a job that included health coverage (with most of my jobs the coverage was included for free completely except for small payments at offices—of course we get paid less in the U.S and the costs of the company to provide health coverage to employees are factored into the salary consideration). I have typically had good doctors, good guidance. I have not had to struggle at all in the U.S. system. I have to remember that I have seen people and heard about people who have. Right now, I guess my best impression is that no system is “perfect” (what is perfect, really?).