You’ve undoubtedly seen the commercials on TV for healthcare insurance. I call them the “warm fuzzies,” since that’s the feeling they hope to exude. The actors are smiling, deliriously happy, content and thrilled with their coverage.
Let’s step back a bit and take a realistic look at what happens. Today, I had an appointment with my cardiologist. It was made 6 months ago. I know this because he expressly set up a 6-month follow-up with me. He’d also made an appointment for some tests which I’d had a week ago. I received a call last week from the doctor’s office, reminding me of my appointment.
I arrived, signed in and had a seat. After a moment the lady at the front desk called my name. It seems there was some question about my appointment. The staff was missing a referral. I explained the date had been made months ago and I’d even received a reminder from this office within the last week. “But we don’t have a referral from your primary.”
I decided to call my internist to find out if they could send a referral. The receptionist said she’d check on it and put me on hold. While the “elevator music” was entertaining, after several minutes I decided to call back. The receptionist explained the person that takes care of referrals was not in. I’ve seen a note in my internist’s office that there is a 5-day wait on referrals. I can understand last minute requests need to be discouraged. On the other hand, I was standing in the cardiologist’s office waiting for my appointment.
I explained to the staff that I could not get the referral. They were checking with the insurance company and finally offered to have me set up another appointment. By this time, 45 minutes had passed. My frustration was palpable, my blood pressure had risen and rather than have a cardiac event in the office, I left.
Once home, I called the insurance company — those people whose biggest thrill in life is to make me deliriously happy. The member engagement individual attempted to reassure me as she explained what is at best a convoluted system. When I make an appointment, like this one, 6 months in advance, I have to remember to have my internist send a referral. However, she can’t do that 6 months out, because it will expire after 3 months. That’s right folks, I have to wait 3 months and then have my primary doctor send a referral. My headache was increasing.
I have CVD, a diagnosis that isn’t going away anytime soon. One might even say it’s a chronic condition. It’s vital that I see a cardiologist at least once or twice a year. Apparently, my health insurance company knows better than my doctors, the American Heart Association, and the AMA.
My next call was to my internist. I explained I needed a referral so I could make an appointment with my cardiologist. “We need to have the date of the appointment.”
“I don’t have an appointment yet.”
“But we need the date before we can do the referral.”
OMG. There appears to be a conspiracy. The medical establishment has decided to do me in. Mind you, they are all very polite. If anyone was losing it, it was me – not them. They all told me how they regretted my plight, but as the words, “I’m sorry….” were uttered, a pause trailed off as if they knew to add the word “but” would indicate their total lack of empathy.
It was time to call the cardiologists office. I spoke with someone briefly, explaining what had happened. He put me on hold for a few minutes and then said, the first appointment we have with your doctor is in July.
“Do you not understand he wanted to see me today, six months ago? Maybe 3 months more won’t hurt, or on the other hand, maybe I’ll be dead by then.”
“I’m sorry, let me check further.” When he returned to the line, he said he was going to do some more work on this and would call me again in the afternoon. “Let me see if I have all your information…Oh, I just realized today is your birthday.”
“Yes, it is. And so far today, the medical establishment seems to be determined it will be my last!”
My 9:45 am appointment has long since passed. I received a call from the cardiologist’s office. I have an appointment on May 23rd. I’ve contacted my internist with the date so a referral can be prepared. The insurance company assured me that I can verify everything online. The time is 5 pm. What a fantastic way to celebrate a birthday.
Like George Bush, I remember a kinder, gentler time, when you could just make an appointment with a doctor and go see him or her. But now we have warm fuzzies — that only exist in your mind.