Thursday, January 5, 2012

Health Insurance .... or Lack of Health Insurance

As I was catching up in the land of blog this morning, I clicked on a new blog and read about the dilemma of scheduling medical procedures. I commented about life being simpler without health insurance ..........

Made me remember an incident about 10 years ago when I had health insurance through an HMO. With this plan you were required to choose a primary care group of physicians who would then "manage" your care.

On a Sunday while cleaning debris left from a building project in our back yard (it was one of those wooden play sets with a fort and I thought we should enclose the underside of the fort as a dog house for our Saint Bernard, Louise. She never, ever entered it. She would stare at me as I sat inside on a blanket with a hot dog in my hand trying to entice her into what would be a luxurious dog abode ..... but, that's another story).

Back to my story. I somehow managed to get stuck in the hand with a jagged piece of a 2 X 4. The board was about 3 feet long and was hanging from my person, firmly attached to that well padded part of my palm near my thumb. I stood there for a minute, just looking at it. It hurt, but I knew it had to come out and I debated with myself about asking he who had left the mess there to pull it out or just do it myself. I decided that he would hurt me, so I attempted to do it myself and a piece about the size of a kitchen match broke off and remained firmly embedded in my hand.

My hand was throbbing and I could not move my thumb without enhancing the pain. He who loves me offered to take me to an emergency room (happy that we had to stop the clean-up). Having worked as a nurse in emergency rooms and being annoyed at all the people using it as a clinic, I decided my hand with a stick in it was not an emergency and we drove to an urgent care facility that was approved by my HMO.

There had closed about 30 minutes before I needed them, so I went home and toughed it out until morning. I called my HMO approved primary care facility and they invited me to come right in and they would see me in between appointments. The chart indicated that I needed a splinter removed. One of the newer doctors strolled in and took one look at my hand and told me I needed a hand surgeon. Then asked me why I had not gone to the emergency room the previous evening. Really, it was not an emergency.

The hand surgeon she was sending me to was not in his office that day, but at the day surgery clinic downtown in ST. Paul. Great. It was my right hand and I was not going to try to navigate one-way downtown streets while trying to find this place. I picked up he who drives me around and off we went. We finally located the facility and then a parking garage and trekked in to see this surgeon of hands. X-rays were taken and the surgeon determined that I should go right to surgery where an axillary block would be administered and the "splinter" would be removed. I was all prepped, given a tetanus shot and an RX for antibiotics .......

And then told that my HMO would not approve the procedure. Seems I was sitting in a facility not associated with my HMO. So, I was told to meet the surgeon at the emergency room near my house after office hours. My hand had been manipulated and radiated and was throbbing by then. There aren't an over abundance of hand surgeons, by the way.

So, 24 hours after jabbing my hand, I went to the same emergency room I would have gone to the previous evening and was told that axillary blocks were not allowed in the emergency room, only a shot of xylocaine. By then, the tissue was inflamed and infection was beginning to set in. I felt every tug as he finally removed what felt like a full term baby from my hand.

So, you see, this would have been much easier had I not had insurance. Because had I not had insurance, I would have dosed myself with a pint of Jack Daniels, made an opening in my hand with an exacto knife and handed the needle nose pliers to my tool man and been done with it. Neosporin and a band aid.

9 comments:

ellen abbott said...

Years ago, my husband was walking on a wood deck barefoot and managed to get a 'splinter' (about 3" long, 1/8" thick tapering to a point) in his foot which broke off the deck. It went all the way through and out the other side. We pulled it out but it was obvious that there was some left in his foot so we went to a nearby medical clinic (the kind that don't exist anymore where you just walk in and they treat you for a reasonable amount of money). The doctor told him that he couldn't deaden the area because it would make it impossible to find the inch long piece of wood still in his foot and he would do more damage rummaging around in there looking for it. So it was go to the emergency room and surgery or let him cut the foot open and as soon as he saw it, he would inject pain killer in the wound. We opted for the quicker more immediate solution and I thought Marc would crush all the bones in my hand before he got the shot. But the doctor got it out quickly, I'm sure it was less than one minute. We don't, obviously, have any health insurance.

Sextant said...

Sad but true! My wife has broken about 27 toes (all but the big ones) due to a love for bare feet and probably a bit of clumsiness and bad luck.

Somewhere between toe break 11 and 12 she came to the conclusion that sitting in the e-r for 5 hours, getting an x-ray and then going home with a buddy wrap, and getting whacked with a $100 copay (back in the old days) could be replaced with a self applied buddy wrap, no radiation, and keep the cash. She has become a toe specialist. Not one (except the big ones) point in the same direction.

Brian Miller said...

omg i cant believe you were sent all over the world with this in your hand...where is the patient care in that...ugh

Joanne said...

After one go round like that I left HMO. You nailed the incompetent patient handling to a T. Do they still exist?

Linda O'Connell said...

Thanks for stopping by my blog. I signed on to follow you because I like your writing style! Hope you'll do the same.

Mamma has spoken said...

I had an HMO when they first came out and thought they were great. But as the HMO kept 'managing' my care, it got worse and worse, having to make phone calls after phone calls for medicine to help my 'female' problems only to be told that they don't cover birth control, even when I would tell them to look at my medical records to see that it wasn't for that. As soon as I could get off the HMO I did. And now when I look at what my employer offers, I make sure that I don't have to do that dance again.

Kathy G said...

We've never had an HMO, and I have no desire to. The PPO's we've used let us pick our own doctors, as long as they're in the "network".

The Good Cook said...

Don't even get me started on Health Insurance.

Pat said...

Ouch, ouch OUCH! We are so very lucky that Jim's insurance carried over when he retired. We are one of the lucky ones, for sure!