I Wish I Could KNEE Someone

I need to vent. Just hear me out. I need a platform for which to vent my frustrations with the outrageousness that is our current health care system. Lucky for me, I already have this blog for posts like this, so I'm going to just vent away. It may seem like a random mess of thoughts. . . it is. And, I don't really care if my writing seems all over the place; it will only correctly portray my scattered thoughts at this moment. So without further ado, I step onto my soapbox:

Last year, only a day or so after Banner was born and the epidural from my C-section had worn off, I sat "criss-cross" (formerly "Indian style") on the hospital bed while hanging out in our room. I uncrossed my legs and felt a shooting pain down the outside of my right knee. (Maybe while in labor with an epidural my nurses positioned my legs in a funky way that hurt my knee?) I didn't think much of it, but every time after that when I would sit on my leg or sit in the criss-cross position, the same pain would come. I quickly learned to avoid sitting like that, even though that has been difficult with a young baby always on the floor playing. I just learned to deal with it until the day before our family's July 4th celebration. I was in the kitchen getting ready to bake my 4th of July cake (which was yummy, by the way!), and I squatted down to get to the cake pans below the ovens. I felt something in my right knee get tight, and then it was hard to stand up. Again, I tried to ignore it, thinking I just squatted "funny" but the next couple of days brought more pain and weird swelling. So, I told Sam I wanted to go see a doctor. He agreed I needed to go and soon.

The catch is the health insurance. See, we had health insurance through Sam's firm. Before he left his firm, he and his partners began signing up for insurance through the Bar Association. Due to the amount of paperwork continually needed by the insurance company, July was nearly halfway over and we still didn't have the insurance bound. The company wanted more information, more documents filled out by physicians, etc - and all of this was through snail mail - no faxes or emails allowed. (Not sure why that is. Can someone please tell me why these people haven't welcomed themselves to the 21st century?) Anyway, I was in pain. I called an orthopedist to make an appointment, but when the receptionist asked for our insurance information, I told her I didn't have the new numbers just yet, but that I would have it within the next week. She told me to call back the following week because the first appointment would be expensive with X-rays, and I for sure would want to be covered.

So, I waited a week. Still nothing from the insurance company. My knee was getting more swollen, and my limping was getting on my nerves. Plus, bathing Banner, crawling on the floor to play with him, getting up and down off the floor and in and out of the car was wearing on me. So, I told Sam I couldn't wait any longer. He said to go ahead and make the appointment and that we'd just pay out-of-pocket. If it was really expensive, we'd get insurance back from his former firm by utilizing COBRA. Since COBRA is retroactive as long as we signed up for it before the end of the month, we were safe.

As I paid my $238 to the doctor for my first visit, which included a self-pay discount, I texted Sam to "GET COBRA!" since the doctor wanted me to have an MRI and possibly surgery depending on the results of the MRI. So, that same day, Sam called his former firm and got signed up. Two weeks later, I'm still waiting for the cards to come in the mail with our information. . . which means I paid the $400 for the MRI out-of-pocket. Since the MRI results showed a lateral meniscus tear and lots of fluid in the knee joint, the doctor recommended surgery to clear everything up. So, I paid another $108 to the doctor for that visit, $250-something to the hospital for blood work, $1660-something for the doctor to do surgery, $3800 to the surgery center, $45 for crutches, $42 for my pain prescriptions, over $1,000 for the anesthesiologist, and who knows how much my physical therapy will cost.  And, we're still waiting for the damn cards from the insurance company (which is the same insurance we had in June, but apparently we can't use those cards because the group numbers and ID numbers and whatnot have changed since it's through COBRA*).

So, here we are still waiting, out this money that we SO don't have right now, and it's the worst timing for me to have surgery (tomorrow!) with two weddings on the way, bachelorette party, birthday parties, 2 wedding showers, and not to mention taking care of my almost-14-month old active little boy - all while my husband and I just quit our jobs (isn't that always how it works out!)! Now, all that stress I can handle and break down into manageable pieces. But, it's the money that's really got me peeved. I know we'll get a lot of it back from the insurance company, and hey, we met our deductible already through all this shenanigans! But, what really ticks me off is the amount of money these people are making!

Here's where the soapbox ranting begins. Let's JUST look at the $3800 going to the surgery center. Could someone tell me where that money goes? It's not to the doctors. Those are separate payments if you recall. I mean, I expect that my surgery costs help pay nurses, building maintenance fees, utility fees, etc, but $3800?? That's a lot of hundreds! 38 of them! Really? We only pay slightly more than that to school taxes in our area... and I KNOW where that money goes. It really does cost that much to run a district - paper, supplies, salaries, building upkeep, textbooks, equipment, library materials, desks, chairs, etc. I get that. But one surgery taking that much money?? I don't get it.

Let's look at the $1660-something I paid the doctor for a 20-30 minute procedure. Hell, as a school counselor, I earned that in two weeks - not 20 minutes. Is that really necessary? And, why the discount? Because I was paying in full right then? Because I didn't have insurance? Why the discount? Don't get me wrong... I am happy to pay less than full price, but if there is such a thing as less, then all the office staff is telling me is that the doctor they work for is willing to take less money in the beginning anyway. No... I know that's not right. I have enough medical system knowledge to know that the insurance companies are the ones screwing the doctors, so they have to charge more just to make up for the costs they lose to them. My dad and my brother would tell me that the discount was because they don't have the extra cost of working with an insurance agency, so they CAN charge me less. I get that, too.

I just don't understand this damn health system we have here. Other countries have found a way to make healthcare free or at least more accessible to all. If politicians would stop giving a $h#t about money, lobbyists, and big business, then maybe the American people would get the care, medicine, and respect that they deserve. Sam and I talked about this on the way home from my pre-op appointment today. As we passed a library, I vented to Sam about how we have figured out a way to make libraries free for all citizens. Maintaining a library is not cheap! Buying materials, paying employees, keeping the building cooled/heated, safe, and maintained, updating materials, repairing books, offering programs, etc - we've managed to make this free! How have we NOT managed to do that for our health care?

It's all about what we as Americans value. We "value" education, so it's free. Yet, our teachers make crap money. We say we "value" our health, but we complain about how much doctors make. We have some of the best doctors in the world here in America. Why then can so many people not afford to go to them? There's something so wrong here. In total, the amount of money I'm spending on my damn knee is over 2 months worth of what I'd be getting as a school counselor - and way more than most of my colleagues would earn after two months of hard, unending hours at school.

I'm always an advocate for paying teachers more. But, that's not what I'm saying here. I'm saying our health care system is ill and needs a good fix soon! Sam said that the politicians want the American people to believe that anything other than privately funded health care is evil. Well, I think what is evil is allowing millions of Americans to go without health care because they can't afford insurance, can't afford medical care, or both. What is evil is letting injured, ill, and/or dying people continue to be in that state because we can't let insurance companies suffer, we can't lower costs of care, or we aren't willing to examine how other countries provide care to their citizens for FREE! Tax me more. That's freakin' fine with me. Just figure out a way to make great care affordable.

Tomorrow, when I check in to have my surgery, I'll be grateful that I have a knowledgeable medical team, and hopefully caring nurses, to give me the best treatment. But, there's a part of me that wants to ask whoever I write that check to: Where is this money going?

Oh, and literally as I finish writing this... Sam just walked in with the mail. Included: our insurance cards.

(*Update: since the first draft of this post was written, we've learned that the insurance policy and member numbers are the same we had when Sam was at his previous firm... therefore, we could have already provided this information for all medical expenses we incurred. I'm frustrated about the timing of this, yet I'm glad my eyes are officially opened wider to the shananigans that is our awful system here in America!)