33 votes

Healthcare rant thread

So I don't know about all of you, but I'm pretty sick of terrible healthcare in the USA.

So I'm starting this thread for all of us to rant about our personal issues with healthcare. I'll be writing my rant into it's own reply later (it's a bit of a long one), but I wanted to start the thread now to give others a chance to start venting.

Rules of Rant Thread:

  1. Don't argue a rant
  2. Thread is likely going to be incredibly USA-centric. USA healthcare is assumed unless stated otherwise.
  3. Rants should involve people no more than 2 degrees of separation from yourself. This thread is to vent about your personal experiences, not hearsay from total strangers.

In order to foster further discussion, and include those without a rant: Here are some things I personally would appreciate and expect for replies, but others might not.

  • Explanation of how things would work out for you if you were in a similar situation
  • Advice for dealing with any ongoing or future problems

44 comments

  1. [2]
    kfwyre
    (edited )
    Link
    Good topic. Right now my current options for insurance are to go through my employer or my husband's employer. My employer: the contract through my employer is so ridiculously inflated and...

    Good topic.

    Right now my current options for insurance are to go through my employer or my husband's employer.

    My employer: the contract through my employer is so ridiculously inflated and employee-unfriendly that, should I take it, I have to pay $340 a week. This is not an exaggeration, and you're reading that number correctly. Three hundred and forty dollars each week. Multiply that by 52 to make your heart sink. This is NOT counting the employer-paid portion. The healthcare is so bad that most employees I work with don't take the healthcare and rely on a spouse, which only makes things worse down the line for those that are forced to take it. With less and less people on it, we lose negotiating power with the companies, so costs keep going up year after year (even more than they normally do). This, in turn, causes more and more people to drop off of it. Then, with less and less people taking the healthcare, our city is effectively saving a ton of money because they don't have to pay the employer-portion for those people, and of course there's no buyback. They've effectively externalized the healthcare costs of their teachers onto spouses. They get monetarily rewarded for not supporting us.

    My husband's employer: This option is much cheaper! $140 a week for both of us! Huge savings! Except for one teeny tiny detail: we have a $6,000 deductible. Per person. $6,000 is more than 10% of my annual salary (gross, not net). It's more than 10% of my husband's income as well. Neither of us are in particularly lucrative jobs. I remember when $1,000 was considered a ridiculously high deductible, and it wasn't that long ago.

    That's the state of things at present, though I have full faith they'll continue to get worse with time. Every year healthcare costs go up. Every year. Always. Even when we change providers and they renegotiate, they still go up. I feel like we're in a bubble.

    Furthermore, I'm also not receiving amazing, quality care for the increasing amounts of money I'm pouring in. Instead, I'm pretty much relegated to healthcare conglomerates that aggregate doctors and services into a one-stop shop. It's super convenient as they're often all under one roof or in the same complex, and they're usually all in-network so I don't have to do a bunch of legwork to find someone who will take my insurance. Unfortunately, they all seem to operate on an efficiency-first model, churning through patients as quickly as possible to maximize returns.

    With few exceptions, most of the doctors I meet remind me of myself, a burnt out public school teacher. They're doing too much, too quickly, and in ways they don't believe in. Some seem to be able to be genuinely personable, but others can't fake the enthusiasm, and I don't really blame them. I'm patient number, say, 17, or 32 for that day. Number, say, 114 that week. They know they'll be seeing me for all of five minutes and then copy/pasting some stuff into a computer before hopping to patient 18, or 33. Number 115 for the week.

    The demands of their job prioritize numbers and results over human connection and care, despite that being the draw for most of them to enter the field. I'm fully burnt out with how teaching has been compromised by testing, data, and a crumbling public faith in education as an institution. My passion and spark are all but extinguished. I want my job to be one that inspires kids and helps motivate them, but instead I'm stuck doing things I don't believe in for outcomes I don't believe in. Maybe it's complete projection, but many of the doctors I've seen strike me as feeling the same way. They wanted to help people, but not like this. Not like this.

    I've heard complaints from doctors about how they now have to prioritize insurance over care, with companies basically being the middlemen and gatekeepers for health. It's unsettling as well as patronizing. What good are their expertise, all their hard work, and their carefully considered professional opinions when decisions for patient care are ultimately in the hands of financial beancounters completely divorced from the situation? I've heard complaints from doctors about how rapidfire scheduling and a data-driven emphasis on numbers force them to effectively do continuous triage of symptoms instead of thoughtful and sustained longer-term care. How can you build relationships with patients and teach them about their complex personal health situation when you see them for so little time, and so infrequently? I've heard complaints from doctors about how healthcare companies are now starting to aggregate health data on their patients as a measure of accountability for the doctor themselves. Healthcare companies tie the hands of doctors then tell them they'll be measured by how well they use them. Should my dermatologist be judged for my extant eczema, especially when I had to wait eight months in order to see her in the first place?

    It all feels very familiar to me. How do you kill someone's passion? How do you extinguish their human, altruistic drive for a better world? Compress their role by optimizing it for efficiency and limiting the scope of their efficacy, then mandate data-based outcomes which are orthogonal to the point of the service and which are held to be more important than the actual service itself. This does double duty of burning out the professionals working within a broken system, all while decreasing faith in the public that the system works. Soon neither side will feel things are working, and both will be right. Who wins in this situation? Whoever the numbers are working for.

    I realize this is a pessimistic view, and likely an unfair one. Nevertheless, this thread asked for rants, and I'm not exactly in a place right now to give a more thoughtful, reasoned, or informed answer. From my limited, on the ground perspective as someone who receives healthcare in the United States, I don't feel like I receive quality medical care, and, even worse, at this point I don't expect it. I don't hold that against the doctors or nurses or people working in the field so much as I do the conditions they're working under.

    Ultimately what's frustrating is my own ignorance. I don't know enough to know why things aren't working or even who to be mad at. I don't understand how our health insurance works, much less how it doesn't work. I don't know and frankly, am too tired to care. Instead I just know that I'll have to wait weeks at a minimum (usually months) for any given appointment, will received short rushed care once I'm there, and will likely have to pay through the nose for the privilege. I am pleasantly surprised when this is not the case. That's about the most optimistic I can get with this whole situation.

    23 votes
    1. joplin
      Link Parent
      That is so frustrating and I'm so sorry those are your choices. 20 years ago I decided to quit my job and start my own company. I knew the hardest thing would be dealing with getting health...

      the contract through my employer is so ridiculously inflated and employee-unfriendly that, should I take it, I have to pay $340 a week. This is not an exaggeration, and you're reading that number correctly. Three hundred and forty dollars each week. Multiply that by 52 to make your heart sink.

      That is so frustrating and I'm so sorry those are your choices.

      20 years ago I decided to quit my job and start my own company. I knew the hardest thing would be dealing with getting health insurance. Luckily my spouse had a job, so we started out on her insurance. But eventually she needed to quit and move on to more fulfilling things that, unfortunately, didn't pay as well or have good benefits. We went on COBRA benefits for the maximum 9 months allowed. For those not familiar, COBRA is a law that requires insurance companies to continue to cover you for up to 9 months after you lose or leave your job. The catch being that you have to pay everything out-of-pocket that your former employer was paying. In 2000, we were paying $900+ per month for our continued coverage. I remember telling this to my mother, who responded, "You mean $900 per year, right?" I had to explain to her that, no, I meant $900 per month. (And also that I'd lose it in a few months and have to find healthcare on my own, with no employer to provide it. That was a fun journey I hope to never repeat.)

      Since then, healthcare in the US has increased in cost far faster than inflation:

      While the annual inflation rate in healthcare costs has declined in recent decades;[4] it still remains above the rate of economic growth, resulting in a steady increase in healthcare expenditures relative to GDP from 6% in 1970 to nearly 18% in 2015.

      I mean, there's a limit to how much people can pay. At the current rate, it will eventually be completely out of reach for the majority of people in the country. What happens then?

      10 votes
  2. [2]
    SantalBlush
    Link
    My partner cut her thumb in the kitchen, so I took her to an urgent care center to save her a few bucks. The nurse who was treating the wound told us that gluing the cut would be fine, and would...

    My partner cut her thumb in the kitchen, so I took her to an urgent care center to save her a few bucks. The nurse who was treating the wound told us that gluing the cut would be fine, and would cost about $500. The doctor came in and explained that it needed stitches, which would run about $900 - $1,000. When he left, the nurse assured us again that glue would be sufficient, it would save us a lot of money, and that if it were one of her own kids she would have just glued it at home and been done with it. She explained that this doctor was trying to make more money by marking up the procedure.

    After she left and the two of us were alone, I said, "If you just want to skip the stitches and glue it, don't be afraid to speak up." She did, and the doctor acted as if it was too risky, threw out some jargon, then eventually glued it together. It healed up just fine, of course.

    14 votes
    1. pseudolobster
      Link Parent
      Before I learned how bad it is in the US I used to complain about the time I cut my hand and needed to go to the hospital for stitches. I ended up needing to wait 4 hours to see a doctor. I...

      Before I learned how bad it is in the US I used to complain about the time I cut my hand and needed to go to the hospital for stitches. I ended up needing to wait 4 hours to see a doctor. I realize now what triage is, and how actually dying people would be helped before me, but at the time it seemed like an unreasonable amount of time. I also complained I had to pay bus fare to get home and they should offer some kind of shuttle service.

      Now I'm really grateful, knowing some people pay thousands of dollars for that. If I had to pay out of pocket at the time I'd probably have a big mangled scar on my hand for the rest of my life instead of having to endure waiting for four hours this one time.

      13 votes
  3. [4]
    eve
    Link
    I'm lucky enough to have Healthcare through work. HOWEVER someone thought it'd be a grand idea to not cover inhalers. I have two inhalers, and albuterol one and QVAR. QVAR is for long term control...

    I'm lucky enough to have Healthcare through work. HOWEVER someone thought it'd be a grand idea to not cover inhalers. I have two inhalers, and albuterol one and QVAR. QVAR is for long term control and relief and has worked wonders when I've been able to get it. But because this bitch isn't covered it's like $228 per inhaler!!! One you're supposed to use once or twice A Day and there's like 200 puffs in there! Fuck that! Fortunately the albuterol is only like $25. When I first found out my insurance doesnt cover inhalers I called them and they were like oh we can fax your doctor information about albuterol with a nebulizer. FUCK THAT YOU ASSHOLE. THEY'RE NOT THE SAME FUCKING THINGS AT ALL!! I guess I'll have to try to find a fucking alternative to qvar but it's incredibly frustrating. I've had asthma damn near all my life since I was a wee kid. I hate nebulizers, they make me feel like absolute shit. I just don't understand why you WOULDN'T have it included. I got the "best package" from my insurance too. Maybe if my SOs insurance is better we can get married and I can buy an inhaler without costing half a weeks pay.

    13 votes
    1. [2]
      Gaywallet
      Link Parent
      This probably won't help, but you can ask for an exemption. Chances are it'll still be more expensive than it should be (why should I pay $50-100 for a rescue inhaler when it's magnitudes cheaper...

      I called them and they were like oh we can fax your doctor information about albuterol with a nebulizer. FUCK THAT YOU ASSHOLE. THEY'RE NOT THE SAME FUCKING THINGS AT ALL!!

      This probably won't help, but you can ask for an exemption. Chances are it'll still be more expensive than it should be (why should I pay $50-100 for a rescue inhaler when it's magnitudes cheaper than a visit to the ED? insurance companies can be very stupid...) and they might deny your exemption, but it is the 'method' one would use with an insurer to get coverage on a medication that doesn't have an appropriate substitute covered.

      6 votes
      1. eve
        Link Parent
        I never knew about that! I'll have to look into it and see if I can get an exemption or an off brand Qvar or something. Thank you for the information!

        I never knew about that! I'll have to look into it and see if I can get an exemption or an off brand Qvar or something. Thank you for the information!

        5 votes
    2. Parliament
      Link Parent
      It's like insurers pick things not to cover at random. I'll still never understand why Medicare doesn't cover vision, hearing, and dental as if those are not medically necessary.

      It's like insurers pick things not to cover at random. I'll still never understand why Medicare doesn't cover vision, hearing, and dental as if those are not medically necessary.

      6 votes
  4. [4]
    moonbathers
    Link
    I hate that our shitty healthcare system is accepted or even wanted. Without going into too much detail I lost a family member to preventable illness because she couldn't afford to go to the...

    I hate that our shitty healthcare system is accepted or even wanted. Without going into too much detail I lost a family member to preventable illness because she couldn't afford to go to the doctor. I brought that up in response to "that's just the way the world works" and got scolded, even though it's literally not the way the world works, it's the way United States-an healthcare works because fuck everyone else, as long as I have what I want everyone else can go to hell.

    11 votes
    1. [3]
      SantalBlush
      Link Parent
      Some people love to take folksy truisms about life and pretend that they're somehow prescriptive statements. "Life isn't fair" is the most common one, which is apparently meant to imply that we...

      Some people love to take folksy truisms about life and pretend that they're somehow prescriptive statements. "Life isn't fair" is the most common one, which is apparently meant to imply that we shouldn't strive to make life better or more fair. Now imagine if we truly applied that kind of thinking; we'd still be living in shit huts and making human sacrifices. Every advancement of humankind is a defiance of life's unfairness.

      5 votes
      1. [2]
        moonbathers
        (edited )
        Link Parent
        Yeah, it kills me. If something isn't right we should try and fix it. I wonder if that difference is a generational thing. edit: I'm bad at words

        Yeah, it kills me. If something isn't right we should try and fix it. I wonder if that difference is a generational thing.

        edit: I'm bad at words

        4 votes
        1. georgebcrawford
          Link Parent
          Kind of, IMHO. The older I get, the more I realise that at some point we begin to see younger people as a bit precious. I like to think I'm self-aware enough to avoid it, but in the last year I've...

          generational

          Kind of, IMHO. The older I get, the more I realise that at some point we begin to see younger people as a bit precious. I like to think I'm self-aware enough to avoid it, but in the last year I've caught myself in a "kids these days" frame of mind and snapped myself out of it. I work with people half my age now, for the first time in my life. It's eye-opening.

          I think it comes down to most (all?) of us being self-centred, in a way. "After all, I turned out fine, what's the big deal? Shit has been happening for years and we're fine. Life isn't fair, move along."

          I dunno. I'm getting a little off track. It's just that more and more, I've been thinking there is a massive problem we have as humans - we can't think on a scale much longer than our own lives. I think I got the idea from David Wallace-Wells' book on cimate change last year.

          Like I said, off-track!

          5 votes
  5. [2]
    psi
    (edited )
    Link
    Over the winter I developed a pain in my right flank with no obvious cause. Despite my attempts to ignore it, after a week the pain became so immense that I could hardly drive. I decided to see a...

    Over the winter I developed a pain in my right flank with no obvious cause. Despite my attempts to ignore it, after a week the pain became so immense that I could hardly drive. I decided to see a doctor (well, nurse practitioner) for the first time in years, who told me that my pain probably stemmed from a kidney infection (rare for males) despite experiencing no urinary discomfort. I'm given a prescription for antibiotics and sent home. My pain subsides over the next couple weeks.

    About two weeks later, I get a call that the test was negative -- no kidney infection. Two weeks after that, I get a bill for about $350, of which my insurance covered less than half. So... what the hell is it? And why did I even bother to see a doctor? I realize my medical bill is much smaller than the horror stories you read about in the news, but the nearly $200 I'm responsible for is a lot for a grad student like me. And worse, the expenditure feels pointless. The office called to ask if I'd like to make another appointment to figure out what was bothering me, but why should I gamble my money again for the possibility of a correct diagnosis? If the pain flares up again, maybe I'll see a different doctor. Until then, I'm just going to ignore it.

    10 votes
    1. userexec
      Link Parent
      This one really resonated with me. I don't think I've ever seen my doctor for more than five minutes, even when I've come in with specific concerns. I was getting random dizziness one time and it...

      This one really resonated with me. I don't think I've ever seen my doctor for more than five minutes, even when I've come in with specific concerns. I was getting random dizziness one time and it was happening so often I finally broke down and decided to pay for a visit. I got to see her for all of two minutes. She said it was vertigo, prescribed some meclizine, and rushed me out the door basically. I left with almost no more information than what I came in with. Ultimately Dr. Google fixed that one by letting me narrow down when I was experiencing vertigo, providing steps I could take to replicate the issue, and describing the "canalith repositioning procedure" which was a simple series of head movements that fixed the issue entirely in a couple of days. I hate that I had to be "that person" who diagnosed themselves on a search engine. I feel like that should never, ever be a more accurate and effective solution than seeing a professional. I was very lucky I was only gambling blindly on a benign issue, but I honestly don't expect my odds would be any better if I was actually in trouble.

      8 votes
  6. [6]
    vord
    Link
    Late to my own thread...go figure. So, let's start with some context. By most accounts, I have amazing health insurance by USA standards. I only pay 5% of my wage, and I have better health...

    Late to my own thread...go figure.

    So, let's start with some context. By most accounts, I have amazing health insurance by USA standards. I only pay 5% of my wage, and I have better health insurance than many of my peers who make 50% or more than I do, let alone anybody making less. I have $20 co-pays for any visit, $40 for specialist visit, $50 for urgent care, $100 per hospital visit. I don't need to get referrals from a primary doctor to see a specialist. No deductible, well sort of. We'll get to that.

    After reading all of the other stories posted so far…I don't have a fraction of these problems, and I'm sorry that you're all stuck with that shit. I've decided cut this rant much shorter...and it's still too damn long. I still hate my health insurance and would give it up in a heartbeat for M4A. Not because of costs, or general lack of care, but because of the insane mental load that is caused by this broke-ass system.

    I pay a tiny percentage of drug prices. But if I get a scrip for the same med and dose too many times, it gets declared as a 'maintenance medication' and will no longer be covered unless it's a 90 day scrip and fulfilled by CVS… no other pharmacy. I have 3 other pharmacies much closer to me than CVS, and 1 is a small family business. Sorry, can't go to the mom-and-pop pharmacy for most of my drugs, gotta go to the mega-corp or my costs skyrocket, especially if I dare to take a medication that isn't a generic.

    In network vs out is the biggest scam of all time. It's basically a lottery of whether a doctor is covered in network, especially if you find yourself in a hospital. The best was when we got sent a bill for over $5,000 for a doctor who saw me for about 10 minutes in an in-network hospital, but that particular doctor (who I didn't get to choose) was out-of-network, so therefore I obviously chose wrong and was liable for a $5,000 bill. Luckily was able to dispute, but again: stupid bullshit that shouldn't ever happen. Speaking of out of network, I have no deductible unless it is out of network. Then it's $500.

    So, I go to a hospital where I see one of my doctors. I need a blood test. But I can't get a blood test at the hospital, because my insurance only covers blood tests by LabCorp, which means I have to make a separate appointment on a different day, in a different nearby town in order to go in, wait for 20 min or more, and spend 30 seconds getting a needle stuck in my arm and have to wait for them to send the results back to my doc.

    My coworker told me the best one for our particular insurance plan. His doc recommended a routine test. Insurance company does require pre-approval for this test,and naturally they deny the request. So he starts shopping around to find the best cash price. First place quoted at $500. Second place quoted at $600, but they did inform him of a major loop hole that almost nobody tells you:
    If you go to get an uncovered treatment and say you're paying cash, they will charge the full price. However, if you go to the treatment and have them try to bill your insurer, and the insurer denies, then you only have to pay the price that your insurer would have had to pay out instead. In this case, that dropped the price by almost $300.

    My one doctor and I talk about his problems dealing with insurance companies frequently. He bills at $200 per hour. If he wants to accept his patient's insurance, they will negotiate down, but their first offer is often take it or leave it. The company he was trying to work with used the phrasing "we'll allow you to get paid $160 per hour," which really shows how much hubris they have regarding dictating their payouts. This process must be repeated for every single insurance company, and possibly for different tiers of plans within those companies. He is a solo practice, but he has to hire a dedicated biller because of the sheer complexity and time required. He wants M4A, because even if he only gets paid at medicare rates, it'll still be a net win.

    Even in a best case scenario, dealing with a medical insurance company is roughly as pleasant as trying to buy a used car with cash from a payday loan company for every single thing you try to do.

    10 votes
    1. patience_limited
      Link Parent
      Understand that many medical institutions use billing of cash patients to subsidize the discount insurance companies force on them! This horrible practice (see, for instance, hospital...

      Understand that many medical institutions use billing of cash patients to subsidize the discount insurance companies force on them!

      This horrible practice (see, for instance, hospital chargemasters) means that those uncovered and likely least able to pay are stuck with artificially inflated list prices to compensate for insurance discounting.

      I once had a minor medical procedure where the physician billed $5,000. Her staff had mistakenly told me she was in-network with my insurance company. My cost would have been the whole bill, as out-of-network treatment had a $6,000 deductible. Because of the staff mistake, the doctor ultimately charged $500, which was what the truly trivial 10-minute procedure should have cost in the first place. I did some research afterward and found community prices varied from $300 - $8,000 for the same common treatment - that's another rant.

      5 votes
    2. joplin
      Link Parent
      This is so frustrating! My wife needed some blood test that has to be taken at 8AM, and there's only leeway of about a half hour. Well the lab she normally uses opens at 8AM, and they won't allow...

      I can't get a blood test at the hospital, because my insurance only covers blood tests by LabCorp, which means I have to make a separate appointment on a different day, in a different nearby town in order to go in, wait for 20 min or more, and spend 30 seconds getting a needle stuck in my arm and have to wait for them to send the results back to my doc.

      This is so frustrating! My wife needed some blood test that has to be taken at 8AM, and there's only leeway of about a half hour. Well the lab she normally uses opens at 8AM, and they won't allow you to make an appointment ahead of time. Also there's no human when you walk in so that you can tell them your test needs to be done within a certain amount of time. (It's like the physical embodiment of trying to contact Google.) They now make you sign in on an iPad and routinely ignore people in the lobby who need to speak to a human about their test before their time arrives. And of course, everyone else is trying to get their test done immediately so they can get to work by 9.

      But god forbid we have single payer healthcare because then you'll have to wait in lines to get things done!

      5 votes
    3. [3]
      jwong
      Link Parent
      That’s interesting, j always assumed insurance would get billed crazy high in comparison to cash price. Even though I have insurance I’ll often just pretend I don’t have it to avoid billing...

      That’s interesting, j always assumed insurance would get billed crazy high in comparison to cash price. Even though I have insurance I’ll often just pretend I don’t have it to avoid billing headaches of not knowing how much something really costs and it coming back later. I really hate calling back and forth between doctors and insurance.

      1 vote
      1. [2]
        vord
        Link Parent
        Oh yeah, insurance companies never pay sticker price. One tip there my doc demonstrated for me: if he calls the insurance company with me, and he informs them he is with me, all of a sudden he can...

        Oh yeah, insurance companies never pay sticker price.

        One tip there my doc demonstrated for me: if he calls the insurance company with me, and he informs them he is with me, all of a sudden he can cut through massive quantities of red tape in short order. Insurance companies suddenly get a hell of a lot more efficient when they'll have to pay more for the same co-pay because they stick to the script.

        He learned that trick over time. Without patient in the room, he has to deal with the same sort of ISP-level customer service that we do.

        5 votes
        1. jwong
          Link Parent
          I will have to give that a try next time and see how it fares. I postpone a lot of issues I have because I get so angry dealing with insurance and doctors that barely pay attention to what I’m...

          I will have to give that a try next time and see how it fares.

          I postpone a lot of issues I have because I get so angry dealing with insurance and doctors that barely pay attention to what I’m saying.

          Though I’m fairly lucky in that my deductible isn’t so high ($3k), and it’s “free” for my portion, I’m still hesitant to use it from the few bad experiences I’ve had even trying to use it.

          2 votes
  7. [8]
    reese
    Link
    I wouldn't say this problem is necessarily USA-specific, but I live in the USA, and haven't mentioned this online before. So I've had this thing on my face for about two years, on my left cheek....

    I wouldn't say this problem is necessarily USA-specific, but I live in the USA, and haven't mentioned this online before.

    So I've had this thing on my face for about two years, on my left cheek. It flares up, gets itchy, turns red, black, blue, and brown, almost appearing like a small bruise. It's never bigger than the size of a dime. It heals, or mostly heals, after about a week. It seems like stress and sunlight can cause it to flare up, but sometimes there's no stress to speak of, and now I try to wear sunscreen whenever I go outside, and yet I'll have another flare-up. Normally the flare-ups occur over night, but I recall one occasion where it must have occurred while I was doing yard work all day. Usually I experience the flare-up once a month, but it's variable. Last time it flared up two weeks in a row.

    I consulted a dermatologist about this a year ago, who performed a "punch biopsy," costing me an arm and a leg (most USA-relevant part), and determined that that it was just, I quote, "varicose veins." No further explanation. Okay, whatever. Thing is, it still flares up. I've mentioned this to a couple different doctors in the meantime, and they all dismiss it as a purely aesthetic issue. None of them seem at all worried about it, perhaps because by all other indications I'm (reasonably) healthy. Plus they don't get to watch the spot change over the course of a week or month. I trust the doctor I have now, and he seems great⁠—but at the same time I'm a little pissed that the root cause isn't worth finding.

    As a programmer, I prefer finding out the exact mechanism by which things occur, because otherwise I end up making baseless assumptions that often bite me in the ass.

    If this happened to any of the people I've mentioned this to, I assume they'd be freaked out and at the very least annoyed. If I've had this for so long now, I can only hope it's not a problem, but it always bothers me. I'm told that sometimes parts of your skin are just more reactive than others in certain conditions, but that's a pretty dissatisfying explanation, provided what I have doesn't present itself like other common skin conditions, or at least ones I'm aware of.

    If somebody has some idea about wtf this is, or any advice at all, I'm open to it.

    8 votes
    1. [3]
      joplin
      Link Parent
      Oh man, I know that feeling so well. I have to keep reminding myself, "Nobody designed our bodies, and there's no manual. There's a bunch of shit in there we still don't understand. Not everything...

      As a programmer, I prefer finding out the exact mechanism by which things occur, because otherwise I end up making baseless assumptions that often bite me in the ass.

      Oh man, I know that feeling so well. I have to keep reminding myself, "Nobody designed our bodies, and there's no manual. There's a bunch of shit in there we still don't understand. Not everything can have an answer, unfortunately." It rarely makes me feel better, but at least lets me forget about things for a while.

      10 votes
      1. [2]
        reese
        Link Parent
        That's a helpful way to think about it. I find it perplexing how much we collectively don't know about the human body in 2020, and I don't mean that as an insult to those in medicine or related...

        That's a helpful way to think about it. I find it perplexing how much we collectively don't know about the human body in 2020, and I don't mean that as an insult to those in medicine or related fields. The advancements we are seeing every year are crazy. There are so many horrific diseases that used to kill people, and now they don't, or at least those afflicted have a fighting chance.

        Furthermore, there must be endless opportunities to distinguish oneself professionally in medicine if seemingly basic issues, that many people experience, are a complete mystery. Forget the human brain and consciousness—why does Dave only shit on even-numbered days of the week, but otherwise seem completely healthy?

        7 votes
        1. joplin
          Link Parent
          Ha! Classic Dave.

          why does Dave only shit on even-numbered days of the week, but otherwise seem completely healthy?

          Ha! Classic Dave.

          1 vote
    2. [5]
      Comment deleted by author
      Link Parent
      1. reese
        (edited )
        Link Parent
        Interesting. I'll try that! Thank you! Edit: And by the way, similarly to you, I tried using a topical cream on the spot, and it went away for a while, but then came back. It's nearly on my facial...

        Interesting. I'll try that! Thank you!

        Edit: And by the way, similarly to you, I tried using a topical cream on the spot, and it went away for a while, but then came back. It's nearly on my facial hairline. Maybe I have kind of the same problem you had. 🤷 And it didn't start until shortly after I moved to a much more humid climate...

        5 votes
      2. [3]
        no_exit
        Link Parent
        I've been dealing with something similar for a while. It started as a single spot on one side of my nose, but now I have it on both sides and right in the middle of my forehead. I've tried...

        I've been dealing with something similar for a while. It started as a single spot on one side of my nose, but now I have it on both sides and right in the middle of my forehead. I've tried cortisone cream, cetaphil soap, and the CVS store brand dandruff shampoo. The soap with light exfoliation and regular moisturizing after showering has seemed to be the most effective, but I still haven't been to get rid of it entirely. It's super frustrating because I can't figure out a definitive pattern of what makes it worse or better. I've had issues with dandruff before, so my best guess is that it's seborrheic dermatitis. I really need to go to a dermatologist but it's hard to find the time. :\

        3 votes
        1. [2]
          no_exit
          Link Parent
          little update: I forget who recommended the 1% selenium sulfide head & shoulders but I've been using it daily for the past week and it's cleared up almost entirely! just some very minor redness...

          little update: I forget who recommended the 1% selenium sulfide head & shoulders but I've been using it daily for the past week and it's cleared up almost entirely! just some very minor redness left, no flakes or scaly-ness at all. the cvs generic brand probably would've worked too since it's the same active ingredient, but I only used that a few times on and off because I was worried it might have been making it worse. so thanks for the nudge in the right direction, it's a big relief.

          3 votes
          1. reese
            Link Parent
            I too have a good update. For those coming across this post, maybe from a search engine (?), you may be confused. The user who originally responded to me deleted their comment. As @no_exit...

            I too have a good update.

            For those coming across this post, maybe from a search engine (?), you may be confused. The user who originally responded to me deleted their comment. As @no_exit mentioned, the suggestion was to try 1% selenium sulfide. I personally chose "Selsun Blue Medicated Maximum Strength," and the flare-ups have stopped. My spot has disappeared. For like $6. Just to be safe, I'll keep applying the stuff to my face for a little while longer.

            Now, I still have a slight freckle-sized scar where the spot was biopsied by the Mayo Clinic for $800 out-of-pocket. I actually had two dermatologists look at my face in one session a while back, along with a nurse. The dermatologist seeing me actually had another, educated at Princeton, take a look for a second opinion. Final result? Varicose veins, which was good news they said, because it looked like a tumor. Other doctors I've seen since said it was nothing.

            Well, apparently some random anonymous Internet non-doctor can treat the problem better than prestigious medical "experts" without ever seeing me, taking a photograph of my spot, and cutting into it. Holy goddamn shit. Sorry, next time I have what appears to be a non-emergency, I'm asking people on the Internet about it. I can't afford for the American healthcare system to siphon wealth from me for nothing in return. It's happened too many times now, trust revoked.

            As for what exactly the spot was, the one that was on my face for TWO YEARS until recently, I don't know. My running hypothesis is that it was probably a fungal infection (selenium sulfide is anti-fungal). The reason my spot usually flared up at night, I think, had to do with my pillow. The flare-ups started immediately after I moved to a much more humid climate, and I tend to sleep on my left side a lot (or at least fall asleep that way), and the spot was on my left cheek. I'm betting the fabric or material in the pillow and/or pillow case I've been using, despite my cleaning them weekly, retained spores somehow. Come to think of it, I bought my mattress and that pillow after moving, and now I'm wondering if they both came this way or were affected during shipping. Hmmmmm.

            4 votes
  8. [4]
    DanBC
    Link
    I've had repeated ear infection in one ear. I went to my GP and there's not much they can do, but they did give me antibiotic ear drops. Then I got a severe infection and I lost hearing in one ear...

    I've had repeated ear infection in one ear. I went to my GP and there's not much they can do, but they did give me antibiotic ear drops. Then I got a severe infection and I lost hearing in one ear so I went back and they gave me advice about healing and told me to come back in a few weeks for a hearing test. I went back in a few weeks and told them I had tinnitus and hearing loss, so they referred me to an audiologist. (I had a choice of providers - a local hospital trust or a local community care trust, so I picked the one that was most convenient for me). I had an unacceptably long wait of 5 weeks for that. They gave me a hearing test, took a history, explained what was going on and told me that they'd fit me for a hearing aid, but that I needed an MRI first. So they arranged an MRI. Because it's not cancer I had another long wait - 5 weeks. I had the MRI, and then a week later I went to the hearing aid dispenser who fitted me with a behind the ear, thin tube, hearing aid (Phonak) - he did some in-ear testing of the hearing aid to make sure it was working, and ran through how to look after it and how it worked. He gave me a pack of batteries and told me how to get new batteries.

    Six weeks after I had the hearing aid fitted they sent me a letter asking how I'm getting on with it and if there's anything I need help with, and giving me some hints and tips about looking after my ears and my hearing aid.

    I didn't have to pay for any of this, and I don't need to pay for hearing aid batteries or accessories.

    I haven't had to pay anything for this.

    8 votes
    1. [3]
      Algernon_Asimov
      Link Parent
      What country are you in?

      I haven't had to pay anything for this.

      What country are you in?

      1 vote
      1. [2]
        DanBC
        Link Parent
        England.

        England.

        1 vote
        1. Algernon_Asimov
          Link Parent
          Thanks. That's important context for people reading this thread.

          Thanks. That's important context for people reading this thread.

  9. Algernon_Asimov
    Link
    I'm sorry to be contrary, but I don't have a healthcare rant. I have an un-rant, though. Does that count? A few years back, I fell over and fractured my elbow. Ow! The pain was intense, but it...

    I'm sorry to be contrary, but I don't have a healthcare rant. I have an un-rant, though. Does that count?

    A few years back, I fell over and fractured my elbow. Ow! The pain was intense, but it came and went. When it hit, I literally couldn't think through it.

    I was unemployed at the time. And I was broke. I literally could not afford anything more expensive than a pack of painkillers.

    I had to get to a hospital. I could have called an ambulance. If I had been employed, I would have been required to pay full fare for the ambulance, which would cost in the vicinity of $1,000. Or I could have paid an annual ambulance membership fee of about $50, for which I would get to ride for free. So, for most people, an ambulance ride costs about $50. I forgot that, because I was unemployed, I had a concession card which entitled me to free ambulance transport.

    So a friend drove me to the hospital.

    We arrived at the emergency room, with me shifting in and out of agonising pain. The nurses gave me some strong painkillers on the spot, while my friend filled out the paperwork (me being unable to write because I was carrying my fractured arm in my other arm to stop it moving and triggering the pain).

    I had to wait a few hours. During the wait, they took me in to have X-rays done and an MRI scan done, to help diagnose the problem.

    Then they admitted me to the hospital and put me in a room.

    This was a Friday night. They told me that an orthopedic surgeon would be visiting the hospital on Sunday, and I would be operated on then. I stayed in the hospital for two nights, and had an operation on Sunday. I was then kept in the hospital overnight and discharged on the Monday.

    That whole experience cost me exactly zero dollars. It was all paid for by our Australian national healthcare scheme: Medicare. Everything, from the scans to the room to the surgeon, was all covered. I paid nothing.

    The only thing I had to pay for was the physiotherapist appointments over the next few months, while I restored the functionality of the arm. And, because my fall happened on a business's premises and was caused in part by their own negligence, they agreed to pay for that.

    In short: I fractured my elbow, went to hospital, stayed for a weekend, had an operation... and paid nothing.

    8 votes
  10. [6]
    Hidegger
    Link
    I live in the US and don't have any health insurance, haven't had any sort of insurance coverage for something like 12-14 years. After I grew out of my mother's policy I only acquired insurance...

    I live in the US and don't have any health insurance, haven't had any sort of insurance coverage for something like 12-14 years. After I grew out of my mother's policy I only acquired insurance for 2 months before I quit the job that was providing it and got a much higher paying job.
    In that time I've only went to the 7 day clinic once to get a prescription for some antibiotics for poison ivy that had progressively gotten worse over a week. The doctor there gave me 30% off the clinic fee and a card for 30% off the prescription at the pharmacy. In total I spent about $100 between the 2 and another couple dollars on calamine lotion and spray.

    Aside from that, if it wasn't going to make me go broke I would have sought professional medical assistance maybe less than 10 times for things that I just decided to hope would go away. The worst being neglect to mental health through all of my teenage years and through most of my 20s. A therapist/psychiatrist might have been very helpful for that decade of my life, but I also didn't want to be put on medication for mental health, because that wouldn't have been a solution to my problems, but seemed to be the solution they offered everyone around me.

    In the near future, I don't see myself buying private insurance, I dug myself into a financial hole that I am working my way out of. If I stack insurance costs on top it will prolong paying off those debts which have interest accruing against me, I'd rather die then spend an additional 5 years of my life working off debt before accruing savings and equity. No point in living if I'm not ever going to be able to have any fun living.

    6 votes
    1. [2]
      patience_limited
      Link Parent
      Going without health insurance is fine... until it isn't. Please consider a catastrophic care plan, at least - an old friend who thought he was healthy, and earning enough to self-insure, wound up...

      Going without health insurance is fine... until it isn't. Please consider a catastrophic care plan, at least - an old friend who thought he was healthy, and earning enough to self-insure, wound up with a $150,000 bill for emergency surgery and subsequent hospital care.

      5 votes
      1. vord
        Link Parent
        Yea a spontaneous appendix burst is exactly what I'm thinking of. Incredibly painful, will kill you if left untreated. Two different people I know dealt with that, and if they were uninsured...

        Yea a spontaneous appendix burst is exactly what I'm thinking of. Incredibly painful, will kill you if left untreated. Two different people I know dealt with that, and if they were uninsured completely they would have been facing similar debt burdens.

        3 votes
    2. [3]
      vord
      Link Parent
      Count yourself amongst the lucky. Also if you have a chance to get remotely decent private insurance that won't utterly destroy your budget, I would advise getting it. There's a lot of trivial...

      Count yourself amongst the lucky. Also if you have a chance to get remotely decent private insurance that won't utterly destroy your budget, I would advise getting it.

      There's a lot of trivial shit out there that can kill or cripple you easily without medical care. And without insurance, you're basically playing a lottery where the prize is bankruptcy or death.

      4 votes
      1. [2]
        Hidegger
        Link Parent
        "And without insurance, you're basically playing a lottery where the prize is bankruptcy or death." That's what life is with or without insurance. You're fooling yourself if you think insurance is...

        "And without insurance, you're basically playing a lottery where the prize is bankruptcy or death."
        That's what life is with or without insurance. You're fooling yourself if you think insurance is going to save you from dying or getting crippled in a tragic accident. And we all definitely gamble the use our earned money in different ways that don't always lead to fortune or improved health.

        Honestly maximizing prosperity at this point is the only thing I need to do to attempt to achieve my goals, you aren't going to sell me on a health insurance that is worth deviating from my goals. My goals are more important.

        1 vote
        1. vord
          Link Parent
          Fair enough, godspeed. o7

          Fair enough, godspeed. o7

          2 votes
  11. Kuromantis
    (edited )
    Link
    As a pretty poor (1 working parent at somewhere around minimum wage for 3 people) Brazilian who nearly exclusively uses our public healthcare program I will gladly take 8 hours waiting for a...

    As a pretty poor (1 working parent at somewhere around minimum wage for 3 people) Brazilian who nearly exclusively uses our public healthcare program I will gladly take 8 hours waiting for a supplement because someone got our number wrong over any of these stories, holy spirits.

    6 votes
  12. [4]
    patience_limited
    Link
    My brother nearly lost his thumb a few weeks ago because of shitty insurance and the way he got broomed out of an urgent care clinic in 5 minutes, when they should have gotten orthopedics and...

    My brother nearly lost his thumb a few weeks ago because of shitty insurance and the way he got broomed out of an urgent care clinic in 5 minutes, when they should have gotten orthopedics and infectious disease specialists involved immediately.

    He'll be having his third surgery shortly, to functionally repair his thumb after the amount of tissue and bone which were removed in the two prior surgeries to control the infection. He had to argue the doctor out of just amputating it to control costs.

    Despite having insurance and the Affordable Care Act's regulations, I've been paying out-of-pocket for uncovered mental health care, to the tune of about $3,000/year including medications. My spouse and I have been doing all the "right" things to try and stay healthy - exercise, diet, meditation, reducing job stress... and I still got broadsided by rapidly degenerative arthritis. The nearest rheumatologist accepting new patients is 150 miles away, with a 3 - 6 month waiting list. The best drugs for treatment are $12,000/dose if insurance decides not to cover.

    The hospital's bill for the first hip replacement was $45,000 - a procedure that costs about $8,000 - $10,000 in other developed nations. I waited three months to get the replacement. It's the only hospital system in a 100-mile radius region. Though the doctor wanted to do the procedure at an outpatient surgery center because he's had problems with the hospital's care, insurance wouldn't pay for it. I got a hospital-acquired infection (thankfully, it went away on its own).

    Frankly, I wish I was old enough to qualify for Medicare, and that it was available for everyone. At the same time, I'm also aware that current Medicare/Medicaid reimbursements don't cover costs in the system that exists now - drug pricing and unnecessary treatments need to be addressed.

    I've worked in private healthcare IT for most of my professional life, and the incredible amount of waste, dangerous systems complexity, lack of systematic analysis for anything but costs, and tolerance for bad outcomes make my head explode. I've had to work on records systems with 1,000+ billing interfaces for various insurers. I've seen critical records and images get lost because the programmers just spent less time on the functional parts of systems than the billing parts.

    I've worked with office-based practices where there are 3 - 5 billers for every clinical practitioner. I've listened to doctors and other clinical staff rant that they're spending half of their working hours dealing with insurance companies. I've worked with hospitals that profit handsomely from lots of "million-dollar babies" in their NICUs, because their mothers can't afford pre-natal care.

    The statistics on clinician burnout are approaching 50%, largely because they're dealing with all this unnecessary complexity and waste instead of taking care of patients as they've been trained to. I've been in the room while doctors were having nervous breakdowns, because they're exhausted with fighting poverty alone and can't afford to keep their practices open. I've had to pull systems out of rural hospitals that are closing because they can't afford to stay open with all the uninsured patients they carry. I've worked in hospitals that are decked out like cathedrals, that (illegally) turn away patients without insurance.

    I could carry on with this rant for a very, very, long time.

    5 votes
    1. [3]
      joplin
      Link Parent
      This is becoming a huge problem in rural states. In places like Idaho, they have to pay doctors to come from other parts of the US to practice because nobody will do it voluntarily: The pay is...

      It's the only hospital system in a 100-mile radius region.

      This is becoming a huge problem in rural states. In places like Idaho, they have to pay doctors to come from other parts of the US to practice because nobody will do it voluntarily:

      Like many other rural hospitals, it was beset by challenges, including chronic difficulties recruiting medical staff willing to live and work in remote, sparsely populated communities.

      The pay is just too low and the student debt these doctors acquire learning their trade is too high. So they'll rotate a doctor in for a year or two, and then they'll leave for greener pastures. There are fewer and fewer hospitals because the people living in rural areas can't afford to keep them open. And it's not just medicine. Apparently there's also a shortage of lawyers in Nebraska.

      In Nebraska alone, there are 11 counties without a lawyer

      4 votes
      1. [2]
        patience_limited
        Link Parent
        The community I'm in isn't in impoverished decline, or devoid of the quality-of-life amenities that otherwise encourage physicians to cluster in big cities. There are shortages of some physician...

        The community I'm in isn't in impoverished decline, or devoid of the quality-of-life amenities that otherwise encourage physicians to cluster in big cities. There are shortages of some physician specialties because the town and surrounding region aren't populous enough to fully employ them. The hospital monopoly is due to intentional business activity, not just inadequate funding. Hospital system consolidation creates service oligopoly or monopoly, which grants pricing leverage over insurance companies. This is yet another factor in the horribly costly and inefficient American healthcare situation.

        A great deal of rural specialist care, including emergency room services, is taking place via telehealth technology. This obviously doesn't cure shortages of qualified hands-on clinical staff, yet many specialist clinical services, particularly continuing or chronic care, don't require a doctor to touch a patient.

        I got my approval for medical marijuana certification by video call. That's a mildly sketchy business that doesn't exactly require intensive diagnosis. Continuing mental health sessions took place through video, too.

        In my latter days with the company I worked for, I was managing quite a few telehealth projects, including a pilot project with a telepresence robot, and multiple remote radiology offices.

        Telehealth is a potential contributing factor in clinician burnout - I was setting up various forms of laptop and home computer remote access because doctors are expected to cover on-call shifts and emergency consults 24/7/365.

        Telehealth, to use a gruesomely corporate-speak phrase, "maximizes clinician utilization". It's an easy way for clinical services organizations to increase RVUs for payment. It's an obvious partial solution for providing care in rural areas, but many U.S. states don't pay equally (or at all) for a clinician's time if they're not in the same room with the patient, whether the quality of care is equivalent or not. [One physician group I worked with covered a 200-mile radius of outpatient clinics and rural hospitals. They had dedicated staff to drive them around, while they did all of their clinical dictation and record-keeping in the car between visits. State rules basically ensured no public payment at all for telehealth.]

        Telehealth is both more expensive and less reliable than it should be. Aside from telepresence devices, it's just secure video conferencing and storage, sometimes with interfaces to records systems. Yet service costs range up to $2,000/provider/month. One of the most serious obstacles to rural telehealth is the atrocious quality and expense of bandwidth - that's a rant I've had repeatedly here. Many remote communities are trying to roll their own Internet specifically to improve medical services. I'm currently applying to work for a regional community fiber company that's circumventing the lousy local cable monopoly, so there's some progress on that front.

        2 votes
        1. joplin
          Link Parent
          Glad to hear you have those options! And really glad to hear about the community fiber. (FWIW, I live in a very large area and have multiple choices for internet and would still go with municipal...

          Glad to hear you have those options! And really glad to hear about the community fiber. (FWIW, I live in a very large area and have multiple choices for internet and would still go with municipal fiber if they installed it. Cable/phone companies are the worst.)

          2 votes