Barry on Health Care

Barry Ritholz posts some off the cuff observations about health care in the US - (which are nice) but the winning 'graphs are his personal experience he posts in the comments section:

I used to be a pitcher, and somewhere between college and last year I tore my rotator cuff. Never knew about it, never bothered me. One night, I wake up in pain, Can’t lie on the shoulder. Gets worse, and worse, and after a month I finally go to the orthopedist. X-rays in his office, “yep, it looks like a problem, you need an MRI.”

Here’s where we go down the rabbit whole.

I say, let’s do it, and the doc tells me he needs permission from the Insurer. So a 24 year old girl with a High School diploma sitting in a cubicle in Syracuse has to give approval to my doc, (Yale undergrad, Columbia Med school). That makes no sense.

Even worse, it takes a week to get permission, and then another week to schedule the MRI. This means I am in pain for 2 unnecessary weeks. Very annoying.

MRI comes back positive, and I say (right from Rocky) Doc, cut me. He warns me its a six month long rehab — grueling physical therapy (PX), very uncomfortable. Better alternative is to try Physical Therapy before hand. 3X week for 4 months — massage (not the good kind — painful and no fun), strengthening, stretching.

Further down the rabbit hole: It seems that every 4th visit, the insurer wants an evaluation done. This is a ridiculous waste of time — it seems as if they are trying to discourage the treatments. I speak to the insurer, get a colossal runaround. I speak to 5 different people, there is no way to waive this.

I have a simple solution — cancel the PX, and get the Doc to schedule the surgery. My insurer SUDDENLY becomes way more responsive. Senior VPs are calling me, trying to get me to try PX first. My terms are simple Evals after every 10 weeks, not 4th visit. I keep getting bumped up to higher VPs.
When we reserve the operating room for the actual surgery, they finally cave. I make them fax the pre-approval of the entire PX in writing. Surgery canceled, PX effective.

That is the sign of a very broken system . . .

Once again: rationing? Check. Bureaucratic delays? Check. Pointless suffering and run around? Check.

And that is our current system.