A few weeks ago, I made an appointment to see a doctor for a basic checkup. Like many busy moms, it was something I’d been putting off for years. I knew it was time, though, so I got to work. I logged into my health insurance’s slow, buggy system to find a doctor near me. I spent some time reading online reviews of the doctors that were covered and made a list of doctors to call.
“That wasn’t too hard,” I thought to myself after about 30 minutes of research. I figured I’d call my top three choices in the morning to make an appointment. I chided myself for waiting this long to do something so simple.
You know where this is going, right?
I called every doctor on the list, and there was an issue with each and every one them. One wasn’t really covered under my plan even though the database listed him as covered. One was totally full and not taking new patients. And the other had moved to a concierge system for coverage, where you have to pay a monthly fee to see the doctor, in addition to insurance fees (I kid you not: this is a thing).
Another 20 minutes down the drain. I went back to the database for more referrals, made more phone calls, and then finally found a doctor who was covered and could see me. This was after being on hold with the office for over 15 minutes to verify everything.
After all that, it turned out I had to call my health insurance to make sure that this new doctor I was seeing was my official primary care provider (or PCP). This was also an endless process because I was told to do it online, which was unsuccessful. And then—get this—after I changed PCPs on the phone, I found out a few days later that they had changed my husband’s PCP and not mine. So we both had to get on the phone to switch things around. UGHHHHHH.
All told, it took me about four hours over the course of several days to make this one doctor’s appointment. No joke. And then I remembered why I had waited so long to see a doctor in the first place.
When I complained about all this on Facebook, not only did many of my friends chime in with similar stories, but I was reminded of how much more complicated and stressful this kind of thing is if you are a person who has a serious or chronic medical condition. After all, all I was doing was making one doctor appointment for my otherwise healthy self.
“I literally could not work because such a large portion of my life is navigating doctor’s appointments, various MS therapy appointments, insurance for those appointments, rescheduling appointments, tests, picking up prescriptions,” said Jeannine Hall Gailey, who has multiple sclerosis and other chronic health conditions.
Rachel Garlinghouse, who has Type I diabetes and is a breast cancer survivor, echoed these sentiments, explaining how she’s often spent five to ten hours a day dealing with medical red tape. Not only that, but she’s found that the stress of it all makes her health worse.
“The stress of talking to my insurance company or a medical office can make my blood sugar rise,” Garlinghouse said. “I can see the evidence of this on my continuous glucose monitoring app on my phone. Ironic that the places that are supposed to help me stay healthy can cause me to be more ill.”
Exactly. What kind of world is it where seeking medical care can actually make us feel worse instead of better? This is not how it should be. Not at all.
Let’s not forget that sometimes all the fighting with insurance companies, hospitals, and doctors isn’t successful. Last year, I spent many hours trying to get my son’s asthma medication covered by our insurance company. Contrary to my doctor’s wishes, the insurance company decided that my six-year-old had outgrown his need for nebulized asthma medicine and he should start using an inhaler.
For various reasons, this didn’t work for us, and we fought tooth and nail to get the nebulized medication covered—again, with recommendations from my son’s pediatrician. (I mean, shouldn’t his doctor be the one to decide what meds are appropriate for him, not the insurance company?)
Eventually, after spending about five hours dealing with this issue, we gave up. Thankfully, we were in a position to pay for the medicine ourselves. But at $300 for a box of meds, this is certainly not in the reach of many people out there.
There are folks out there who are rationing their medicine because of things like this (rationing insulin is one well known example). Folks who are skipping doctor’s appointments because they don’t have the time, energy, or know-how to deal with navigating the wild west of health insurance. Folks who are being saddled with ridiculous medical bills because of administrative mistakes and corporate greed. Folks who can’t afford their health insurance premiums, deductibles, and copayments in the first place and are going without coverage. Folks who are going into medical debt or bankruptcy over a trip to the emergency room.
And what happens when you don’t have accessible health insurance—when you don’t take your meds or you skip important doctor visits and screenings? You can’t stay healthy. Your quality of life suffers. And in some cases, you die.
Listen up, people. There is a huge fucking problem in this country when it comes to health insurance. I truly believe it’s one of the primary issues of our time. I don’t know what the solution is exactly, but I do know that in places where health insurance is a right—in the same way that every child in America has a right to a free education, and that we have government funded police departments and fire departments—quality of life is better, people live longer, and are healthier and happier.
We can do better, America. We can, and we must. Healthcare is a human right. Period. And none of it should be this damn complicated.