How to Fall Through the Cracks in 10 Easy Steps!

I officially fell through the cracks today. * After much consideration, I ultimately decided to forgo telling you every single detail of my feelings, because it’s overwhelming. I also decided not to tell you much about the diagnosis involved, because it shouldn’t matter (just know I’m not dying, so don’t worry). I’m going to more or less list the facts, because they apply to way too many people and it’s unacceptable. He’s how it all went down:

1. After a ridiculous amount of procrastination (Don’t judge. You’re probably reading this instead of whatever you’re supposed to be doing)...(Thank You!), I finally made an appointment with my doctor to discuss a long-running issue he had been trying to talk to me about for years. When we parted ways, he said someone from his office would research my insurance and contact me with a referral in a day or two.

2. A little more than a week later, I called the doctor’s office because I hadn’t heard from them. No one answered, so I left a message.

3.Two or three days latter, I called again and had the following conversation:

Me: Hi, I was expecting someone to call me about a referral two weeks ago?

Her: Ok, let me look at your chart. Ok….your insurance is XYZ, you have to call XYZ Company for your referral.

Why couldn’t they tell me that before I left the office?

4. I called XYZ and recited what the doctor’s office told me:

Her: I don’t know why they sent you here. It looks like XYZ is your secondary insurance. You need to call your primary, ABC.

5. I called ABC and told them all about it. After a 20-minute hold and some odd questions, this happened:

Him: You don’t need a referral. You can go to our website, chose a network doctor in your area and make your own appointment.

6. I was pleasantly surprised to see quite a few options on their site, so I printed off the list and started calling. The majority seemed surprised to learn they were on the list and didn’t accept ABC. The rest didn’t answer and never called me back.

7. A week or so later, I found that I could contact the doctor’s office by e-mail. So I did, detailing steps 1-6.

8. To their credit, they promptly responded the next day, reminding me about my phone call and how they connected me with the XZY Company. I wrote them back immediately, calling their attention to my previous e-mail and how that didn’t work.

9. The next day (I feel like they redeemed themselves with their uncommonly good response time), someone from the doctor’s “referral department” called me and listed my only three choices in the entire county. One wasn’t taking new patients. The next one had a waiting list through October. The last one would accept my primary insurance but not the secondary, and even though XYZ would pay 80%, the remaining 20% is WAY out of my budget.

10. I spend a couple more weeks pretending to accept my current state as my new normal so I could avoid the insane absurdity of this situation. My symptoms now exacerbated, I started researching a county program that might provide some direction at least. I called them today. The lady on the phone was super nice, NOT I count on when dealing with any large agency. I explained the situation. This happened next:

Her: We have a very rigorous screening process. The first step is a phone interview. It takes about half an hour to 45 minutes and is designed to make sure only people with the most extreme symptoms get through to the next step.

Me: What’s the next step?

Her: An in-person interview. It takes about three hours.

Me: That’s the approximate wait time?

Her: No, that’s the interview time.

Me: But that’s not the actual doctors appointment?

Her: No, just screening interview

Me: Ok, how do I get started?

Her: I can schedule you right now….

Me: Wow really?!! That’s amazing !

Her: The first available phone interview is in about 8 weeks.

Me: Please put me on your list, but I’m going to give my GP another try. Maybe he can come up with a sub-standard, cheaper version of the treatment he really thinks I need a specialist for. I guess specialists are for people who can afford better insurance.

Her: Ok, I think that’s a good idea. (I’m paraphrasing here, but not very much) You don’t sound like your symptoms are severe enough for this program anyway.

This scenario is all too common, and there are many factors involved, not the least of which is poverty. Let me tell you this much, neither ABC nor XYZ stand for Kaiser Permanente or Blue Cross. Blaming it on Obamacare demonstrates ignorance of how the government works, how the reform was intended to work, and how that differs with the way it's playing out in real life.

Don’t think for a minute that my chronic lack of financial resources correlates in any way but inversely with my preparedness, desire and initiative to improve my situation.

I don’t know how to end this, because I think the answer boils down to greed. Yes, we certainly have political problems in this country, but that’s only a symptom of our spiritual problems and our tendency to justify the darker angels of our human nature. Until we can get real with ourselves about that, and recognize our laws are bent to serve the wealthy minority, we will continue to suffer in unacceptable, unnecessary ways.

*I really looked for a way to make this more fun to read. Sorry.

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