Saturday, January 28, 2012

I posted this on facebook and I will elaborate on it more here:

How can anyone think that health insurance/care should be a privilege and not a right?  I know how.  By turning a blind eye and not even considering what goes on with people without health coverage.

My husband and I both work full-time.  Do we want to work full-time?  Heck no!  Do we have a choice?  Heck no!  Do we have health insurance?  Yup.  Do we pay an arm and a leg for it?  Sure do.

Now.  I am a nurse (if you don't know by that, you need to start paying better attention..hehe!).  When I worked in the in-patient setting, patients without insurance was all handled by the social worker so I had very little insight to what went on, I just knew we had A LOT of uninsured patients.

Now that I do out-patient, I am the nurse AND the social worker.  And ALL of my patients either have cancer, or are recovering from cancer.  These are VERY sick women.  Last week, I had a case where a chest x-ray was ordered to check for metastatic disease (these gynecologic cancers spread fast) and an incidental finding of a potential aneurysm was found.  This warranted further testing to see how bad the aneurysm was and if it needed treatment or just surveillance.

I kid you not, I spent DAYS working on this case.  Was I trying to get insurance to approve for some huge, lengthy surgery to open up this woman's chest and analyze it?  No.  Was I trying to get some super expensive drug to help "treat" her?  Nope, not even that.  Wanna know what I needed?  A freaking CAT scan.  That's it.  It didn't even involve contrast.  A 15 minute scan to analyze this aneurysm.

Wanna know what got her case denied?  The fact that she wasn't having any symptoms.  Now, I know I am a nurse so I have a little more experience with different medical conditions, but I don't think it takes a rocket scientist to know that there won't BE symptoms of an aortic aneurysm.  Wanna know what the only tell-tale symptom will be?  DEATH.

I had to jump through hoops, spend HOURS on the phone, send and receive faxes, and FINALLY they let it go.  Do I think they finally approved it because they finally understood how important it was?  No.  I think it was because I was annoying them because I was absolutely relentless.  I wasn't going to let this go without insurance approval.

One more case (this one is much shorter, don't worry).  This patient needs surgery for her cancer.  She is progressing and her legs are starting to swell.  She is elderly, so for her to understand exactly what she needs to do on her half to get some charity care is a little overwhelming, but between myself and a financial advisor at this hospital, we are walking her through it.  The problem?  It's taking for-ev-er to get the process finalized.  By the time it's complete and she gets on the table, they just may open her up and see her cancer has gone rampant.

Why does it have to be so hard?  I just don't get it.  It's sad to know that peoples lives are being lost simply because they have zero means to be treated.  Hospitals will say they won't turn away the uninsured, but I assure you....it happens regardless.  Have you ever seen a hospital stay with surgery involved broken down into payments?  It is astronomical.  Literally, it will take your breath away.

It's so sad.  I wish there was a quick fix, but unfortunately, there is not.

1 comment:

Anonymous said...

"obamacare" or "hillarycare" as some have coined it will prevent things like this from happening on a consistent basis.