45,000 dead Americans

What do you call 45,000 uninsured Americans who die every year for lack of medical care in the wealthiest country on earth?  

The price of freedom.  The cost of doing business in the Free Market, bitch.

At the risk of seeming to pile on the president I voted for twice, a charismatic man beloved by millions even as he killed American citizens by remote control without trial or charges (and gave that power to his unstable successor), even as he repeatedly lied about “transparency” and prosecuted those who exposed government abuses under a draconian law drafted in the hysteria leading up to American entry in World War One, a law designed to crush dissent, even as he did much for the wealthiest among us and little for the rest, while delivering inspiring speeches at every turn– I have to say, I really do hate the motherfucker.  Someone with his intelligence, expressed ideals and talent as an eloquent and convincing salesman should not be such a tool of the status quo— in my opinion.   Yes, I know, half of Congress are not unsympathetic to the Klan and all that, rabid partisanship and racism are off the hook and so on, but, still.

“If you like the doctor you have, you can keep your doctor,” was, of course, POTUS-speak for “I won’t come in your mouth.”  Most of us make promises in the heat of the moment, sometimes it’s hard to keep them, I certainly understand that.   The side-effect of this untruthful statement, for me, the deal sealed by the immensely complicated PPACA drafted by the affiliated American medical industries, is that I’ve had to change doctors several times, pursuant to changes in the ACA in New York State in recent years, though for years I had good doctors I liked and was able to easily see.

Slipping through the cracks the last couple of years, as I’ve been forced to change networks and doctors more than once, and largely my own fault, was a visit to a dermatologist for a skin scan.  I almost saw one a year ago, paid for the visit out of pocket, though I also had insurance.  What scared me were the unforeseeable lab costs and possible follow-up surgery costs.  In hindsight, very stupid.   I’ve already had skin cancers removed from my nose and my arm.  Why am I fucking around?

In less than an hour yesterday I was able to find the names of dermatologists (“providers”) who accept my current QHP (“qualified health plan”) and rule out one who appeared, by the many similar comments about him on the web, to be something of a complete asshole.   A young woman dermatologist in a nearby office seemed like a good bet, nothing good or bad about her on the web.  Clicked on her office to make the appointment, typed in my insurance and was notified:


out of network.JPG

After only twenty minutes on the phone with the insurance company I was assured that the doctor is definitely in-network for my QHP.  The woman at the insurance company sounded very confident, offered to call the doctor’s office for me and make an appointment, but it was already after hours.  

I called today to make the appointment.  I gave all my information and when it came to insurance there was a pause.  The doctor is not enrolled in the QHP with that insurance company.   I explained that I’d been referred to the doctor by the insurance company’s provider look-up, verified with the insurance company that the doctor was in the plan.   She asked me to hold and as I did, the Dr. Mengele String Quartet sawing away at an adrenaline-fueled classical piece scored for the highest registers of their instruments, I felt my blood begin to boil.

I calmed myself with the thought that it is truly nothing personal.  45,000 Americans will die this year for lack of medical treatment.  Some are fuck ups who just don’t go to doctors until their symptoms are overwhelming and by then it’s too late.  Some have no health insurance and are scared by doctor and hospital bills.   Some are just fucked.  No reason to take any of it personally.  There is nothing personal here.   I am no more special than any of the other tens of thousands of Americans who will die this year because profit for a few is deemed much more important than the lives of  enough American losers to fill a large stadium.  Fair enough.

The thought didn’t calm me that much, though.   When Melanie came back on the line she told me she’d contact the office that coordinates the dozens of insurance companies and QHPs the provider group currently participates in.   She said it was possible that the doctor had recently been added and that they hadn’t updated the system yet.  

I was relatively restrained in giving Melanie a succinct and dispassionate version of what I have written here.  Melanie was nice, she has offered to call me tomorrow to follow-up.   As I sit in the chair tomorrow on the last day of a multi-visit root canal I will think of Melanie, ready to call her as I stagger from the dentist’s office.  I will keep my fingers crossed that none of these things growing on my skin are anything to worry about.  Then I will continue my search for a participating nephrologist for follow-up about the progress of my kidney disease. 


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