tricktster: infectedwithnyanites:Americans are kept deliberately in the dark about how uniquely terr

tricktster:

infectedwithnyanites:

Americans are kept deliberately in the dark about how uniquely terrible their private for-profit healthcare system is compared to international socialized alternatives if they were made more aware that things didn’t have to be like this that their sense of exceptionalism was misplaced and they were suffering for it there would be a lot less tolerance of the status quo.

I got really sick recently - like REALLY REALLY SICK - while I was visiting my brother, who lives near Boston. I live in upstate New York, about 2:45:00 away by car on a straight shot without traffic. I realized at some point during my stay at my brother’s house that I was now at a level of sick that would necessitate hospitalization. Do you know what I did?

I drove my ass home. It was not only the worst drive of my fucking life, it was the most harrowing, miserable experience I have ever ever had… but I did it. I passed several hospitals on my way home, each of which I seriously contemplated stopping at, but I instead elected to continue with this disgusting, excruciating, nightmare voyage, for one reason only:

I needed to get to a hospital with gastrointestinal doctors in my insurance network.

If I did not make it back to a hospital with in-network providers, I knew for a goddamn fact that my private health insurance- which is, by the way, about as good as the average white collar professional can hope to get in the USA - would deny paying the bill for any care or treatment any out-of-network providers gave me, and for any denials I failed to overturn, I would be on the hook for tens, if not hundreds of thousands of dollars.

I knew this because I work in a healthcare adjacent field, and at least once a week, I end up looking at documents detailing what someone’s health insurance has denied and they’ve had to pay out of pocket for. I also knew this because I’d been through it before seven years ago, the first time and only other this happened to me.

On that occasion, I transferred from a hospital network with a majority of gastroenterology providers in my insurance network to the one that could actually do the surgery the doctors initially concluded was necessary within the next 24 hours. As a result, I had to fight to get coverage for literally every single billing entry related to my care, because the providers of that necessary and life-saving care were out-of-network, and my insurer did not believe it was appropriate or necessary for me to recieve emergency treatment from out-of-network providers. Fighting this decision became a full time job for several months, which I could handle only because I was unemployed. I work 8-12 hours days now, and I knew I didn’t have the necessary resources for that kind of fight again.

So I did not stop at any of the hospitals I passed on my way to get the care I needed to stay alive. I drove for three and a half hours, pausing briefly at rest stops to sweat and tremble and whisper to myself “please. please. please.” and “it’s okay it’s okay it’s okay it’s okay it’s okay.” I made it home, met my dad, and was driven to the emergency room where I was promptly seen, admitted from the ED to med-surg, and then hospitalized for an entire week.

If you have experienced US hospitals, you know that you do not get admitted unless things are dire, and you do not remain admitted for any appreciable period of time unless you are circling the fucking drain.

I was circling the fucking drain in a major way.

I try not to get too dramatic about this shit, but it’s not a trivial situation. My condition made it impossible to keep down fluids or hang onto the fluids I had left in my body. I was rapidly approaching the point where my kidneys were in danger of irrevocable injury, which was reflected in the creatine levels from my ED bloodwork. As previously mentioned, this seemingly out-of-the-blue acute illness has happened to me twice in the past decade, and both times required a ton of physician/provider effort to keep me alive. Both times, the term “palliative care” was tossed around at one point. Both times also ended pretty inconclusively - the MRIs and CTs ruled out stroke, blockage, or brain tumor, the endoscopies didn’t reveal any active bleeds or chronic problems, my blood cultures didn’t grow any bacteria, but my bloodwork showed my white blood cell count was elevated a little outside normal limits, and I ultimately turned the corner after a lengthy period of necessary supportive care… so, my diagnosis both times was “probably a virus, but we’ll never know for sure.”

The issue with being diagnosed with “probably [x], we’ll never know for sure” in the USA isn’t just that it’s terrifying to go about the rest of your life dreading that it’ll come back. It is terrifying, incidentally, but there’s a bigger problem that crops up in the immediate aftermath of your discharge from the hospital: In a for-profit healthcare system, there’s a person who works for your insurer (if you are lucky enough to be insured, of course) who goes through your hospital bill and decides, line by fucking line, if each billing entry was REAAAAAALLLLY necessary for your condition. And my condition is officially…. “????”

The day after my discharge two weeks ago, I got a letter from my insurer in the mail, stating that they would not be covering my bill from the emergency department because the care I recieved was not necessary for someone with my diagnosis (which, again, was “????”). To get this denial letter on the day that I did, my insurer had to have arrived at that decision before I was even fucking discharged from the hospital.

I will reiterate: I have the best health insurance that a non-multimillionaire can reasonably hope to get in the United States of America. I endured a 3:30 drive back to my hometown, endangering my life, in order to decrease the likelihood that my insurer would refuse to pay for the care I needed to survive. At the time that my insurer decided that it had not been necessary for me to go to the in-network emergency department to receive care from in-network providers, those providers had not finished stabilizing me to a level where I could be safely cared for at home.

This system is absolutely fucked, and there are millions and millions of people who will fight tooth and nail to ensure that it never gets unfucked, for the sole fucking reason that they do not want their taxes to go towards healthcare for people that they believe are undeserving of getting healthcare.