Pardon me if it's starting to feel like you're reading an AARP blog, but I've gotta get this "foot situation" off my chest. This isn't a political post -- I'm not sure if so-called government-run health care, socialized medicine, Obamacare or whatever you want to call it is the answer -- but let me quickly explain why letting insurance companies (aka sanctioned organized crime) dictate medical treatment is so incredibly wrong, and ask my legal-eagle readers if I can sue for pain and suffering.
In October, I went to the podiatrist about my heel pain. I was diagnosed with plantar fasciitis and the first thing my doctor did was ask me what type of insurance I have.
From there, I began five months of treatment, which included:
As I was wearing the AirCast many people -- as people tend to do -- asked me what happened. Time after time when I would explain that I had plantar fasciitis, they would say, "Oh, I had that too. But my doctor just gave me orthotic insoles and I was good as new."
It was only then that I remembered what my doctor had said -- on my FIRST VISIT back in October -- when I got confused and told him I had Empire Blue Cross/Blue Shield (which I had had for years via my NY Times job, including Cobra in the months after getting laid off): "Oh, good. We'll get you fitted for orthotic inserts." Then I corrected myself -- remembering that I now had Aetna -- at which point he said, "Oh, they won't pay for those. What we'll do then is give you a cortisone shot and see if that helps ..." and thus the five months of torment began.
After limping around in that AirCast for a week and hearing everyone talk about insoles, I finally just bought some "over-the-counter" ones and guess what? I'm perfectly fine. (!) Of course I am FUCKING RELIEVED to be able to walk again, but part of me is kicking myself for not remembering what he had said in the first place and just buying the insoles myself. (At least I CAN kick myself again!) But then I think, HOW THE FUCK was I supposed to know? I trusted my doctor and did what he said -- which I now realize more clearly was being dictated by insurance companies, not what he felt was best for my well-being -- and as a result, the insurance company made what has to be THOUSANDS of unnecessary dollars, and I suffered pain that I had never known in my life.
I'm sure there are millions of people who have far more harrowing tales about this insurance racket -- god help the people with life-threatening problems going through this bullshit every day -- but there has got to be a better way.
7 comments:
I know exactly when you're talking about. My ex had several run-ins with our insurance, and it always left me befuddled.
Their big thing is that they try as hard as they can NOT to pay, but they're completely focused on the short-term.
A long-term fix like orthotics might cost more upfront, but then you're done for a long time (if you get a good one) and will reduce the overall cost.
But, as you mention, what's even more disturbing is how much sway they have over medical decisions without being there in the examining room.
The situation is hellish, especially for people who are even worse off than you. We really do have death panels here in America -- they're called insurance companies.
And I just got my COBRA notice from the job I recently left. A high-deductible ($3000 a year) ghetto insurance plan for someone with no pre-existing conditions will cost almost $400/month. That's $400/mo, plus I pay all my medical expenses until they reach $3000. And I'm one of the lucky ones.
Insane.
Hey Ken - I'm tight for time now but your tale rings terrible true to me - I saw a quack podiatrist - Dr. Juricisin on 58th St - he gave me @ 9 cortisone shots, infected my foot which literally exploded and I needed surgery. Since after all the hell and torment - 2 years - I healed - there is really no case - I didn't lose a toe, my job, etc. I work at a law firm and I had great counsel. This guy never should have given you more than 3 shots - he was obviously trying to milk the insurance company. If this is the same doctor let me know.
Peter
I'm not sure if your claim is against your insurance or your doctor. I have a similar ailment to your -- posterior tibial tendon tear. In my case, my podiatrist (actually 2 different podiatrists so I know I getting good advice) told me my insurance wouldn't pay for orthotics but that was the only thing that would help me. They fitted me and I paid out of pocket. It cost me $400 but it fixed the problem. The doc even suggested I try to OTC orthotics first to see if they helped. If they helped, I could keep them or pay for custom fitted ones.
I don't know what your doc told you but he should have at least presented the orthotics and the cortisone shots as options and given you the opportunity to choose / pay out of pocket.
The podiatrist told me that the only way my insurance would pay for orthotics is if I got so bad I needed surgery. They would pay for orthotics after I had surgery so the insurance companies are still rotten.
Nonetheless, your doctor was obligated to inform you about all of your treatment options and costs. I think he shoulders some of the blame here too.
@Dishy: sorry to hear about this. It was not the same doctor.
@Ed: You're right, but I think the environment is such that it kind of causes situations like this. Part of me wonders if he assumed (big no-no) I had already tried drugstore insoles. More likely, he thought he was doing me a FAVOR by coming up with a plan that did not require out-of-pocket payments. Obviously, this was a bad decision by him, but one he probably would not have made if he felt he could just DO what he thought was best from the get-go if not for my insurance company dictating what he can and cannot do to heal me.
@Danny: I know, right?!
That great gangster illustration says it all.
you got it right ... add Kemper and Unitrin to the list of crime figures. They still haven't paid $50k in legitimate medical expenses for two broken bones suffered by my husband.
what we need is a health care CEO equivalent to Michael Corleone ... one Don taking out the heads of his competing Dons ... at least, then, we'd only need to go after one criminal.
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