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Can we talk about how much the American healthcare system sucks?

So I have an ulcer. I dry heave at least once a day and I haven't eaten in 21 days. (Please do not give me advice, I hate it, I don't want medical advice from people over the internet. At best, if you do, I'll respond with a "thanks.")

I'm in a somewhat smaller town, not really small, about 80,000 people maybe. There is exactly one gastroenterologist in this town. I went to him when I hadn't eaten in 6 days. For a $50 copay, he said to take some Mylanta along with the Protonix I was already taking and call him in two weeks if I wasn't better. So I call him yesterday. I talk to the nurse. I tell her all my symptoms, none of which have changed. She sounds very concerned.

I hear nothing all day. This morning, I call again. The doctor hasn't even gotten to my information. So the nurse sends a message that I called again, which he probably also won't see.

I have tried to get a second opinion, or just another prescription for something, but there is not a single gastroenterologist within a 90 minute drive that would see me within three months. I'm pretty sure if I don't eat for three months, I'll be pretty dead. I mean, I'm living on Ensure and Gatorade, but I doubt that will get me to three more months.

Oh, and this is the second time this has happened. The first time, I had to take a bunch of tests like a CT scan and an X-Ray and a blood panel and they found nothing. I had a scheduled colonoscopy anyway, so they just went down my throat as well and that's when they found the ulcer. No one even suggested an ulcer before that.

Why am I saying all of this? I'm not even complaining about all of this. I'm complaining about the fact that this has cost me almost $2000 already and I feel lucky because I have good insurance. I'm not poor, but I don't really have $2000 to spare. I'm paying it off in installments, but god damn, I have to pay all of this money and they have stopped even giving a shit about me.

What would someone in my position without insurance even do? Die? That's what conservatives fucking want.

We need universal healthcare and a complete overhaul of the healthcare system now.

And any time you hear someone complain about how long a wait you have in Canada or the UK to see someone to help you and how America has the best healthcare system in the world and how people from other countries come here for treatment, send them to this post before telling them to get fucked.

TL;DR No one gives a shit about you in American healthcare except maybe the nurses and all they do is suck money out of your bank account.

94 comments
  • It's fucked and I'm sorry you're a victim to it.

    There are small pockets where it doesn't suck. My current company has amazing benefits where my youngest had to have major surgery and it literally cost $100. My previous company however my wife had to have minor surgery and 6 years later we still owe them $23k. We're paying it off slowly.....

  • I'll commiserate with you on the fact that the healthcare system is totally broken. My Mom has had a problem with one of her leg nerves for over a year and a half now, and she has been going in to see specialists, getting told "this is what you have, here's what we can do", getting the prescription/treatment, having it not work at all, and then gets told to get back in line for another appointment with several weeks, if not months, of lead time. Even when she gets put on a priority list for when there are cancellations, there's almost never a cancellation that let's her get in earlier than her original appointment.

    In her case, I'm not blaming the doctors. They are trying their best. I just don't understand how it can take 1-2 months per visit, or even upwards of 6 months, and meanwhile she is in agonizing pain whenever she stands or walks too long.

    Meanwhile, I just paid out $6k in dental bills this year alone because my regular dentist missed a cavity until it became bad enough that it required a root canal, but they tried to fill it first and it didn't work, so then I had to pay for the botched filling procedure (partially covered by insurance), and a root canal that sadly doesn't seem to have made the tooth any less sensitive, and copayment fees to other dental providers for second opinions because my tooth still hurts even after all they did to it and I want to know what else could do to help, and now I am looking at paying another $3000+ to have the tooth extracted and replaced with a prosthetic implant, which was an option in the first place but they encouraged me to try the fillings and the root canal to "save" the tooth first. Now, I'm trying to wait until January 1st to have my benefits reset so it softens the blow significantly, but until then I'm suffering with this zombie tooth rotting away in my mouth.

    The healthcare system in America is fucking garbage and needs to be destroyed and rebuilt with a human-first mindset, not a for-profit mindset.

    I hope you are able to get the treatment you deserve. Stay strong and stay positive.

  • I know you don't want advice, but I want to share some information that may be important and helpful for you: recent studies have shown ulcers are essentially an infection and antibiotics have some success in treating them.

    For too long doctors thought it had to do with stress or diet, but it's an infection.

  • This probably won't help you since you live in a small town.

    Finding a doctor in the united states sucks. Literally the worst experience I have ever had was transitioning to a PPO insurance policy after being in a combine managed HMO / healthcare group.

    People told me for years "oh, that health care provider sucks. You get sub par care and nobody ever knows your name." You know what else I got? Same day doctor visits and same day specialists, literally anytime I wanted or needed anything. I had reasonable medical care at a reasonable schedule for a reasonable price.

    When my insurance switched to a PPO, people told me "oh, you will love this doctor! He is so great!" And... every... single... time... it is exactly as you described. "New patients are 6 months out." And when I finally got a primary care doctor, they would recommend specialist who were their friends also in private practices with 6 months waiting lists.

    Private practice medical care is an absolute joke. It's another shitty system the boomers saw their parents use successfully that simply doesn't work today.

    The solution was to find a high quality medical group in my city. It took me nearly a year to figure it out. Same day doctor visits? Done. Same week specialists? Done. Same system / in network urgent care at the same price as a regular doctors visit? Done.

    I don't care which doctor I see, I just need medical care.

  • Wait, they didn't prescribe you anything when they found the ulcer?

    • They did. Protonix.

      • Huh. That doesn't seem like much for something that stops you from eating, but I guess I'm not a doctor, or privy to the details of your ulcer. I remember when I went in with an ulcer they acted like it was full red alert.

        Anyway, I sympathize. I still have to bounce around between gastroenterologists because I have the same problem getting in - and half the doctors in my area leave after a short time here. "You need a new gastroenterologist" invariably ends up with a lot of "We're not taking new patients, please call back in a couple of months".

  • Sorry to hear about everything you're going through and how much it costs for no treatment. I think a lot of doctors do care but they are overworked and have to constantly battle hospitals and insurance companies. A lot of them seem to be seeing less patients which is not going to be good, and many are retiring or burning out. There are also now more seniors than people under 17, the seniors require more care. Article on the doctor shortage: https://time.com/6199666/physician-shortage-challenges-solutions/

    • Thanks. I understand what you're saying, but when I tell a doctor I'm not eating twice and he says to me keep taking your pills before you eat, I don't think he gives a fuck. He seems like a nice enough guy, but he's apparently a terrible doctor. And I don't have anyone else I can go to. I mean I know why. This is one of the shittiest towns in the country, Terre Haute, Indiana, but still...

      • Yeah that doctor definitely is not doing their job. What do you call the person that finishes LAST in medical school? Doctor.

  • My problems aren't anywhere near as bad as yours, but I'll add my own complaints to comiserate at least.

    My wife is a type 1 diabetic. I have a pre-diabetic A1C (type 2) that i inherited from my mom. My insurance (Blue Cross Blue Shield) claims they cover preventative care. But they refuse to cover our regular A1C tests - it's not preventative because they already know what you have. As a BCBS support person told me, if they're throwing spaghetti at the wall, its preventative. If they're aiming for a spot - it's no longer considered "preventative". So thats like $600 - $1000 a year. Chump change compared to many in this thread, I know.

    Also, for some reason, they only offer coverage for one type of insulin - novolog - which happens to be the one insulin that causes my wife issues. She's type-1, so her immune system killed her insulin production at around 5 years old. She's dependent on insulin to survive and uses an insulin pump. Novalog is less effective than literally every other insulin for her - which means she has to take more - which means more risk of long term problems. This insulin also requires a pre-bolus (basically taking insulin) of 1-2 hours before every meal. That means every meal has to be preplanned and prepared for or she starts a rollercoaster of highs and lows. Humalog, aphidra, fiasp? All work more efficiently and within like 15-30 minutes.

    The local HMO my work used before offered tiered options. We could pay a bit more for a better option. I would have no problem paying double to get her Humalog. BCBS says no. Novalog or pay out of pocket.

    I have occasional headaches that start in the back of my neck that turn into bouts of depression followed by mania a few days later. My neurologist wanted to do a full MRI panel to look for issues. Insurance denies it - medically unnecessary. The neurologist appeals and they're like "fine fine, but we'll only cover the head, not the neck" even though the pain started from my neck. They don't find anything in the head. So the neurologist says, "well unless you want to pay out of pocket, we can't check the source so.....assume it's just migranes?"

    Oh and by "cover", I mean they paid a small part of it. It still cost me $1,500 to do the ones that were "covered".

    That's a smattering of the interactions I've had with my insurance that I can remember right now.

    My parents are retired and on medicare. They pay far less and get way better medical care than I do with one of the biggest private insurance chains in the country. Go figure.

    • I'm really sorry to hear all of that. It's ridiculous how expensive insulin can be. It's not that expensive in other countries.

      • Thank for your sympathy, friend.

        What's hilarious is that the government recently passed legislation to cap the cost of most formularies of insulin to $35.....for medicare recipients. I've checked, the vast majority of formularies are participating now.

        But if you are reliant on private insurance (because medicare is for seniors), you can fuck right the hell off. You pay what we tell you to. BCBS has not expanded their preferred formulary list beyond this one shitty formulary and I don't expect them to.

        Oh and if you're like my wife and your insurance only covers a formulary that causes you problems and a demonstratively higher A1C as a result, well you can buy vials out of pocket for $600 - $1000 for a month's supply.

        I'm glad that medicare is as great as it is and have no problem paying into it as a tax-paying citizen, but private insurance is the problem that most of us are dealing with and nobody is doing anything to address it.

  • OECD data actually puts the USA in the middle of the pack for wait times for specialty care for developed nations. I believe it could largely be solved by companies switching to advanced access/open access scheduling models, but most are too afraid to upend their business model.

    Lmk if you have any questions about navigating appointments, I’m actually in grad school studying healthcare business. My only real suggestion at this point is to use your doctor’s electronic portal for communication. In many cases it’s more effective than a phone call, plus you have written records.

    I know you said no medical advice, but I’d ask a doc about H Pylori. Always something that should by ruled out in cases like these.

  • My gastroenterologist story:

    Chronic GERD. Talk to family doctor, who refers me to a gastroenterologist (one that is "in network" for my insurance"). My insurance is from my wife's job, who works at a hospital, which you'd think was good. More on this tidbit later.

    Go to Gastro doctor (took 2 months to get in), recommends an Endoscopy, which is scheduled for 1 month later. Initial visit is covered (mostly/kind-of) by insurance.

    One day before Endoscopy, get a call saying my insurance won't cover the procedure there, and I'd have to pay out-of-pocket if I proceed ($5k estimate). I say no thank you.

    I call insurance company about better location, and am referred to another gastroenterologist. I tried to just get an Endoscopy at new location, but they refused to do so with an Gastro doctor visit with THEIR doctors. I schedule visit at new office (1 month to get in).

    Go to NEW Gastro doctor, recommends an Endoscopy, which is scheduled for 1 month later. Visit is covered (mostly/kind-f) by insurance.

    One day before Endoscopy, get a call saying my insurance won't cover the procedure there, and I'd have to pay out-of-pocket if I proceed. I say WTF. Turns out the Insurance company recommended me to a Doctor who was In Network, but their procedure location is NOT in network.

    Apparently, despite having a PPO insurance, there is "In Network" and there's "in IN network", since my insurance is through my wife's hospital plan. I have to have the procedure at an official hospital location that is part of my wife's hospital network.

    I schedule an endoscopy at a 3rd location (1 month out again). Finally get an Endoscopy completed.

    From initial referral to Gastro, until completion of Endoscopy, was 6 months. This was on supposedly good insurance (which was obviously a lie). We don't have that insurance anymore.

  • I live in a city, near a hospital and sort of medical district, so do have easier access geographically than most; also as a legacy of the time when Florida was more rational the insurance has always covered dermatologist, gynecologist, midwife, not just annual visit to GP.

    Even so:

    Dentist must be scheduled 6 months out.

    Dermatologist and almost any specialist 4-5 months wait (basically if you are going each year better to schedule a year ahead of you want to get an appointment).

    And cost-wise, the cost in total of insurance and out of pocket cost is batshit insane. Just have to hope nothing happens. Broke my finger, surgery & rehab $5,000. Status migraine, turned away from urgent care, they said I had to go to emergency room, $4,000. If you are designing a system to move money up away from people it's working as intended.

    And on top of the private insurance that only covers anything after I spend thousands of dollars in any given year, we also pay in taxes to cover the sickest and oldest. So insurers are cherry-picking populations. If we had ONE healthcare system it would be cheaper for us. But all my cost is someone's paycheck and those someones have lobbyists to keep their money coming.

  • That is awful. I am so sorry squid. I am glad they did find the problem hopefully before things get worse.

    • Thanks. They found out the problem in July. Now I need them to finally do something about it that works.

94 comments