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.
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.