Health insurance became a personal issue when I wanted to start a family. Maternity coverage was either excluded from many insurance plans or carried stringent limitations. My husband was changing jobs, and maternity benefits didn’t kick in for a year on his new policy. However, since I became pregnant the month before he left his old job, I was covered under the old policy for the duration of my pregnancy. Coverage was limited to $500, but since I had a C-Section, my entire $1,500 bill was covered. Things have really changed. Now maternity expenses are covered like any other medical expense, and a round of blood tests for my CLL (an indolent form of leukemia) costs more than the birth of my son. Thankfully, the blood tests are covered.
After the obstetrician came the pediatrician. He was patient with my new-mother worries, and he genuinely cared about Christian. He let him play with his stethoscope, and he left the yucky stuff like shots to the nurses so there wasn’t any fear in the relationship between child and doctor. It’s no wonder that, by the time he approached middle school, Christian wanted to become a pediatrician himself. He had a new, more grownup doctor by then.
“I’m thinking about becoming a pediatrician. What do you think?”
His doctor was very straight-forward and honest. “If I had to start now, I wouldn’t do it. I spend so much time on forms and paperwork and so much money on malpractice insurance that it’s not fun anymore.”
Being a patient isn’t much fun either, and as the face of healthcare changes, it becomes even less so. When I had those childhood bouts of tonsillitis, Mom took me to the doctor. No appointment was necessary, and waiting time was usually minimal. Now doctors spend so much time doing preventative medicine, doing check-ups and running tests that you can’t see them when you’re actually sick. In the past couple of months I’ve had to see a physician’s assistant once and go to a night clinic another time when I had issues that needed immediate attention and the doctor was too busy to see me.
When I had my C-section, my doctors made decisions based on their education and experience. Now insurance companies are getting more involved in care plans and, ironically, the resulting changes sometimes cost more for everybody. I experienced this phenomenon several times as a caregiver. Mom and Dad each ended up in rehab for a while. They had to stay at least 21 days, longer than was medically necessary, in order for Medicare to cover the costs. In 2009 we got a letter from Dad’s cardiologist saying that proposed regulations would require tests currently done in the doctor’s office to be done in the hospital on an out-patient basis, and the fees would be higher. Medications are also subject to this kind of micromanagement. When I had Mom and Dad at home, I kept expenses as low as possible by ordering Dad’s diabetes meds from a company that waived the co-pay and ordering the rest of their meds by mail in 3-month quantities. When they went into assisted living, government regulations mandated that medications be ordered by the facility in 1-month quantities which was more expensive for everyone.
Government participation in healthcare is showing negative effects in other areas. At one point, Mom and Dad’s neurologist closed his private practice because of the cost of the government required computer system. The healthcare group he joined already had the system, and the first time we saw him there, the system went down while we were in the examining room. The four of us, two of whom had dementia and didn’t understand what was going on, tried to make small talk for 30 minutes until the system came back up. My new primary care physician in Texas has just gone on the system. His long-time nurse who was one of the stars of his practice retired rather than deal with the changes, and appointments take much longer as both nurses and doctors maneuver through computer applications rather than jotting notes in a paper file. The urologist I visited last month said he will have to cut his case load in half when he goes on the system.
The existence of this “big brother” database is a little disconcerting on a personal level. In April I went to re-fill my four regular prescriptions. I got two of them but was told it was too early to refill the other two. That’s not all that unusual, but under the circumstances, it was pretty jarring. I had just turned 65 and signed up for Medicare. The meds were the same, but the prescriptions were from a new doctor. The insurance and pharmacy were also new, but they still knew all about me. In addition, the urologist I mentioned earlier is not affiliated with my PCP, but when I called for an appointment, they asked for my name and date of birth, and instantly had access to all my personal information. I’m not generally a suspicious or paranoid person, but in this day of rampant identity theft, that is a little scary.
Healthcare used to be the last thing on my mind. Now it seems to be in the forefront of not only health concerns but also financial issues, political and privacy concerns and television commercials. Unless we can find more cost effective, efficient ways to delivery healthcare, we may all have to rely on the Great Physician.
Linda Brendle retired from the business world several years ago and has since inherited the love of writing from her son Christian Piatt. She has written a book called A LONG AND WINDING ROAD, RVing with Mom and Dad, and she is a frequent contributor to The Rains County Leader in Emory, Texas, The Burnside Writers Collective, Soul Sitters, and Don’t Lose Heart. She blogs about caregiving, faith, and family at Life After Caregiving and can be found on Twitter and Facebook.