I’ve been experiencing a tiny health care crisis myself. Sunday night, something or other happened to my knee—one of the body parts of mine that had always been A-OK till now.
I woke up in significant pain, and the pain increased day by day instead of decreasing, even though I was being very very careful. I’ve not been able to sit or exercise, and I limp rather badly. Steps are a nightmare.
Yesterday I went to the doctor, a knee specialist who fortunately had an opening so I didn’t have to wait. He initially thought I had sustained the most common knee injury of all, a tear of the medial meniscus cartilage. But when he examined me he said he wasn’t certain. It might be that; I had some signs and symptoms that indicated as much. But perhaps I had partially torn the medial collateral ligament, which can produce similar symptoms. Even though the latter is a less common injury, and usually the result of noticeable trauma (which I hadn’t experienced), he was leaning ever-so-slightly towards the ligament diagnosis. The exquisite pain I felt on the inside of the knee could be from either injury, but the location was somewhat higher than you’d expect if it was a cartilage tear.
But the only way to be certain which one it is would be an MRI. So he ordered the test, because cartilage tears almost always require arthroscopic surgery. Ligament tears, except for very major ones, almost always heal on their own, although it takes quite a few weeks. So the treatment of the two injuries would be very different.
I found out today, though, that my health insurance denied the request for an MRI. I just finished filing an oral appeal with them.
Despite the frustration of their initial refusal, I must say that my experience with the woman I spoke to for the appeal was extremely positive. First of all, she was kind and respectful. She even kept apologizing for a series of times she had to put me on hold for very brief waits. I dictated to her all the extenuating circumstances and details of why I thought an MRI was warranted, and she copied it all down and read it back to me accurately—these days, that’s a feat in and of itself. She even took the liberty of voicing her own (completely unofficial and completely meaningless, except in human terms) opinion that my reasoning made sense to her and that she thought they ought to grant my request.
Now I wait. It will take some time before they hear my plea and decide. Perhaps in those days I’ll get so much better the whole thing will be moot. Or perhaps they’ll say yes to the MRI. But perhaps not. If not, and I’m still feeling as lousy as I have been, I’ll have to decide whether to pay for it out of pocket, despite the fact that I already fork over so much money to my insurance company that they could give me a bevy of MRIs a year (perish the thought!) and still come out ahead.
But during this whole process, I’ve never for a single moment thought, “Oh, it all would have been so much better if the government were in charge!” At least with private insurance I have the threat/leverage of changing to another company. They have some sort of reason to think they must be at least a little nice to me (and millions like me) or lose my (our) business.
I can only imagine how a government employee would have handled that same phone call. I’ve had enough experience with those twin monuments to pleasantry and respect and efficiency, the IRS and the DMV, to know that it could have been far, far worse. Then there’s the passport office and the post office and various licensing boards, and almost any contact I’ve ever had with government when I want something from them and they don’t want to give it. Not good.
And I’m afraid that anyone who thinks the government would have been more likely to have allowed me to have that MRI more easily and more quickly is a dreamer. Likewise for Obama’s empty promises that of course, a public option won’t threaten private health insurance in any way. I’ve read far too much—that’s far too convincing—indicating just the opposite.