My Doctor Doesn’t Care If I Live or I Die
Human life in America has no value beyond what our corrupt healthcare system can squeeze out in the form of profit
My doctor doesn’t care if I live or I die. I’m just a source of passive income for him. He doesn’t care if I’m suffering or I can’t breathe or I don’t have access to the medications I need.
He didn’t get into medicine to help people. He got into medicine for the money. He loves that my family has to pay a significant percentage of our total income for insurance, and he loves that he can charge us again every time we come in for a visit or need medication.
He’s not so interested in actually talking to me during those visits. In fact, he’s mildly offended by the idea that he has to see me at all. He’s got better things to do. Plus, even when he sees me for five minutes, he can charge me for the whole hour. He walks in, he cuts me off, he won’t listen to my questions or protests, then he’s out the door.
He becomes angry when I try to call his office. He won’t respond to my messages. He’d rather be out golfing or something.
American society conditions us to believe we only have value as human beings so long as we are able to work to cover excessive healthcare costs. Once the value of our labor diminishes, they’d prefer to see us wither and expire in terrible agony.
I realize I’m one of the lucky ones. I have insurance. I’m not without resources. But doctors are on a different socioeconomic level than I am. They’re making six figures. They probably have lawyers on retainer. I need to know my place and be grateful for the kick in the face because he’s a great man with money and I’m a worthless, loser nothing that doesn’t deserve to be treated with basic human dignity.
That’s the clear message anyway.
The setup
Okay, let me back up and tell you all what’s going on.
A year ago I went to my doctor with breathing issues. I’ve had asthma all my life, but my medications weren’t working.
I had all kinds of crazy thoughts about how maybe I’d had a mild case of COVID or something. But the doctor quickly told me that this was an insane thing to think and that the truth was I had COPD.
I asked if maybe I’d just developed a tolerance for the Asthma medications I’ve been using for the last 30 years, but she (there are two doctors in this story) thought that line of inquiry was completely absurd. I mean, she’s the medical professional and I’m just a complete moron, so I should listen to her right?
“Are you a smoker?”
“No, I’ve never had a cigarette in my life,” I said. “I told you, I’ve had Asthma since I was 13 and the doctor was very clear that if I started to smoke it would be terrible for me.”
She didn’t seem convinced. I think she’d been watching too much Dr. House and assumed I was a liar. She decided to put me on a COPD medication.
“What, if any, are the long-term risks associated with this medication?”
“I don’t have time to answer that. Get out of here!”
The medication seemed to work but…
I tried the medicine and it seemed to help. The problem was with the insurance. We get our insurance through my wife’s employment. Unfortunately, there’s nobody at her place of work who is informed enough to talk about it.
With insurance, you just go into the doctor and cross your fingers. Sometimes you get a bill for a couple thousand dollars, sometimes you don’t. You just never know.
You can try going onto the web page or calling, but all you get are broken links and automated messages. When you do get to a person, it’s usually a phone operator who is sympathetic to your suffering, but who doesn’t have access to any of the answers you need.
The insurance didn’t cover the medication, but we started receiving reimbursement checks for the cost about three weeks after the purchase. The checks didn’t come from the insurance company, they came from some benefits organization that doesn’t have much of an internet presence. There’s absolutely nothing listed on the insurance card about this company.
Well, it worked for a while so I didn’t question it. Health care in America is just throwing spaghetti at the wall. But then they stopped sending the checks, so I needed a new medication.
Making an appointment
My wife and I have noticed that even though the hospital in our city is part of the same medical group as the hospital in a larger, nearby city, the bills are less expensive when we go to the larger city.
I know that my doctor wants to see me once a year to continue to prescribe me the medication and verify that I still have the breathing problems that I’ve had all my life. The consult never takes too long, and she doesn’t listen to me, but it usually ends up costing me around $300, so I’m just psyched about going every year.
Well, this time I decided to make an appointment with a doctor in the larger city based on the hope that the trend of not being charged as much would continue.
Now, before I go any further, I don’t want to hear any nonsense about how you can check where you can go on the website or by calling anyone. The people I talk to have never given me accurate information. Everyone is intentionally uninformed and incompetent and you never know what you’re going to have to pay until the bill arrives. Let’s not pretend the reality of healthcare in America is other than that because that would be dishonest.
It’s a broken, horrible, exploitative system that cares nothing for human life. Just say it. It’s the truth.
So, I made an appointment. Making an appointment requires being on the phone for a half hour navigating a bunch of automated messages. Then you have to say your birth date and spell your name to at least 5 different people.
This isn’t just an identify verification. You have to have the exact same conversation over and over and over with people who at least put on a show of taking notes, and by the time you get to the actual doctor, you just have to start the process again. Who are all the notes for? Can’t anyone reference the notes and spare you having to endlessly repeat the same story?
The new doctor was even more indifferent than my previous doctor
So, I finally got in to see a doctor. I explained how I was out of medication and that I came in because we tended to get charged less when we went to that hospital.
“But that doesn’t make any sense,” he said. “We’re all part of the same health system.”
Really? That was what this guy wanted to talk about? In his opinion, nobody has ever been charged more for a medical expense because the bill was sent from a different zip code?
Right away he’s being skeptical and weird over something that’s completely irrelevant to what I needed. He wasn’t the guy who’d had to navigate this insurance for years. He wasn’t the one who had to pay the bills.
What in his experience with insurance led him to believe that insurance companies never messed around with covering medical expenses?
What I expected was a basically rational human being who would shake his head and admit, “Yes, our system of healthcare insurance is completely broken.”
Instead, I got an insane person who seemed to act like nobody in the history of our country has ever failed to have a medical bill completely covered.
Why did he even have to contest it? Why assume I’m wrong about something like this? Just shut up and move on.
Why not focus on the fact that I was almost out of medication and my situation was growing urgent?
So, it was a bad start and it got worse.
“This is an insurance issue, it has nothing to do with me”
Doctors will let you talk and talk, but they’re only waiting for you to say something they can fixate on so they can act like you’re stupid and a liar.
Now, I was a little more prepared than I’ve been letting on. A few months ago the pharmacist (one of them is pretty decent), told me I had to consult with the formulary (it’s the list of covered drugs) of my insurance.
Well, I did an online search and the only formulary I could find that was connected to my insurance hadn’t been updated since 2016. Nevertheless, I printed it out and brought it in.
My hope was that the doctor could write me a prescription for something else that was on the list, then I could go down to the pharmacy, cross my fingers, and hope I could get some kind of equivalent medication for a reasonable price.
So what we have is this network that’s designed for confusion:
The insurance will cover certain drugs, but they make it difficult to find out which drugs they cover
The pharmacist can find out what drugs are covered by sending in requests, but they won’t do that without a prescription
The doctor has to write a prescription, but he wants to hear from either the insurance company or the pharmacist about what is covered
Looking at this system, I can’t help but come to the conclusion that it’s been specifically designed so that people who are covered by health insurance don’t have access to the medications they need.
Also remember that any phone conversation with any of these groups takes at least an hour (per conversation), because you’ll be put on hold or you’ll have to sit through automated menus (too bad if you have to work for a living… right?).
One time when I called my insurance the automated answering service hung up on me after requesting a fax number.
Who is asking for a fax number? They were going to fax me the information I wanted? What?
During my appointment, the doctor said, “Oh, this is an insurance issue.” For a brief, flickering moment I was hopeful that maybe he understood. But that hope quickly died.
“Well, you have to figure out what medicine your insurance will cover and then request it of your primary doctor, the one in your home town!”
Disaster
It’s just stunning that doctors like to act like they’re oblivious to the cost and the inconvenience of everything in the health industry. Did this new doctor really not understand that my old doctor wasn’t going to give me a prescription to a new medicine without making me submit to the cost of another consult?
Also, that entailed:
Sitting through another round of automated messages and being put on hold
Waiting for the doctor’s schedule to clear up (it might have been a delay of weeks)
Having to pay an absurd amount for going in to get prodded, disrespected, and ignored
Meanwhile, I was in a doctor’s office right then. He could just send in the prescription whenever he wanted. He’d seen me. What was the problem? He could spare me the waste of time and expense.
At what point is it fraud to pretend like you don’t know the reality of the situation? “Oh, just go see your other doctor!”
“Do you think that’s free or something?”
“I know it’s not free! HAHAHAHAHA! But you want to breathe don’t you? What else can you do?”
I insisted that he had to help me
At this point I was very frustrated. I said, “This is a never ending circle, the doctor tells me to ask the pharmacist, the pharmacist tells me to ask the insurance, the insurance tells me to ask the doctor. I need more direction.”
“You have to go and ask your pharmacist to see what the prices are for various anticholinergics.”
“How do you spell that? A-N-T-I,” I said. But the doctor interrupted me.
“Look,” he said. “I can’t teach you medicine in five minutes.”
This was yet another stunning statement. To be honest, this all seems like malpractice to me. It should be the responsibility of a doctor to make sure his/her patient is on the correct medication. I was flat out uncomfortable with wandering around with a pharmaceutical book of potential medications for exactly the reason the doctor said. I AM NOT A DOCTOR! That’s why I am enduring the expense and the inconvenience of VISITING a doctor!
Yet, this doctor was irritated. He wasn’t irritated with the corrupt medical system, he seemed to think it wasn’t his problem that I had to figure out what medicine was actually available to me. How is that not part of his responsibility? He was indifferent to the chance that days or weeks could go by and I wouldn’t find the medication I needed.
I showed him the list. “Which ones on this list are in the same family…”
“You’ll have to ask your pharmacist that. Ask them to submit requests to find the prices.” he said flatly.
“Then what, I have to call you…”
“Call your regular doctor.”
“Can’t you do it to spare me the cost of another consult?”
“Fine,” he said irritated. “Have them submit a prescription request. That’s our plan.” Then he got up to leave.
“Wait, how do I contact you?” I glanced around the office and noticed a display with his card. He seemed irritated that I took one.
“I just figure out what medication they cover and I call this number?” I asked.
He just waved his hands and grumbled and walked away. I’d wanted to ask about a few other issues, but I guess he didn’t want to hear it.
My kids were with me, so I have witnesses to all of this (assuming any of you think I have grounds for a legal case here).
Off to the pharmacy
So, I went to the pharmacy with my outdated formulary from 2016. I wasn’t going to waste my time on the telephone anymore.
I was feeling very frustrated, like to the point of tears frustrated. At this point, I’d like to emphasize that I’m uncomfortable without my medication, but I can survive. I started thinking about people who needed to navigate all of this nonsense when they’re really sick.
We’ve all been really sick right? We can have empathy for our fellow human beings who are suffering. You know what it’s like to try to do anything with a fever and a splitting headache. Do you have the energy to sit and be put on hold and listen to automated menus that eventually connect you with a real human being who has no idea what you’re talking about?
Even if you can get to a moment of strength, all Americans are perpetually doomed to take on an enormous and unnecessary medical cost in a moment of desperation.
Fraudulent claims?
I think frustration sometimes comes across as rage unfortunately, so I wasn’t at my best when I had to explain the whole complex situation to the pharmacist. I ended with, “Here’s the formulary, can you check some of these prices?”
She looked at me like I was nuts, “You want me to submit fraudulent claims to your insurance without a prescription?”
Remember, this is what the doctor had told me to do! Now I’m being accused of fraud? The doctor doesn’t know that IT’S NOT LEGAL to follow the plan that he sent me out of the office with?
How can a medical professional be so incompetent in the nuances of our medical system?
“That’s what the doctor told me to do.”
“I can’t do it.”
I took a deep breath. “Can you at least look at this list and tell me the names of other medications so I can call my insurance and ask them?”
“Oh, you mean the other anticholinergics?”
At least she wouldn’t deny me the spelling of the word.
“Can I write on this paper?” she asked.
“Please do.”
She indicated the other options.
“I apologize if I was rude, I’m really, really frustrated,” I said.
“I understand completely, we have to deal with this kind of thing every day.” In the back of my mind I’m thinking, why isn’t anyone else furious about this? This system is a mess. It needs to be fixed. It needs to be fixed yesterday! What are we doing!
The pharmacist took my insurance card and looked it over. “Here’s the number you call. Good luck!”
So, I went back home with my marked up, outdated formulary and resigned myself to being put on hold and listening to mechanical voices say, “Please press one…”
Of course it wasn’t the right phone number
Now I’d received inaccurate information from my doctor about asking a pharmacist to run price checks. I was about to find out that the pharmacist was also wrong about which number to call.
I learned this only after I’d called the number, sat on hold for about an hour, and finally connected with a nice woman with a Southern accent who told me that there was no record of me or anyone in my family within her system. So, I hung up the phone in disbelief. Time wasted, nobody to bill it to.
Here I was assuming that a pharmacist could interpret the information on an insurance card, guess not.
So, I scoured the card with a magnifying glass and saw the name of another medical service. There wasn’t a phone number, of course, nothing useful like that. But there was a business name, so I searched the business name and eventually found the completely different company that handled the prescription side of my insurance claims.
After another hour on the phone talking to robots, I finally contacted another human being who admitted that, yes, I did indeed exist. She was nice, but she wasn’t a doctor or a pharmacist so she didn’t really know what she was talking about.
At first she told me that my current medication should only be costing me $18. But eventually we figured out that this was a price per day.
Then, we went through the out of date formulary from 2016 and I had her plug in the five alternatives the pharmacist had indicated. These were either denied or were more expensive than my current medication.
Finally, we found one that appeared to be less expensive. “Great, thank you, you’ve been very helpful.”
“My pleasure, please note that I’m legally required to state that the price you receive may be other than what I’ve mentioned.”
Of course…
Calling the doctor’s number
I fished out the doctor’s card to call the number. You guessed it, once again I was put on hold. This time, nobody answered.
“We’re experiencing a heavy call volume…”
After waiting for twenty minutes, I left a message requesting that my doctor submit a prescription for the medication the insurance company had suggested. The message assured me that somebody would respond to this message.
Three days passed. I received no response.
Again, how is this legal? What if somebody calls and leaves a message that they’re dying or something? Yes, the message says, “If this is a medical emergency, please call 911” but come on! Sometimes you’re not thinking clearly when you’re literally dying.
How is it acceptable that you can call a hospital and leave a message and they pretend like you don’t even exist?
I’m trying to get medication to help me breathe! I’m not getting painkillers or anything like that. If they replied with basic competence this should be a done deal. There’s no science behind this. All the medical industry has done my whole life is try out new drugs on me like I’m a hamster.
“Does that seem better?”
“I guess so.”
“Then let’s stick with that.”
They put the responsibility on MY shoulders to find new medications even as they lecture me about how I’m not a doctor.
I have a reason to be frustrated here. This system is insane!
The plot thickens
I was so mad at this point that I decided to just not think about it for a few days. But eventually, I decided to call the pharmacy to see if the doctor had sent in the prescription I’d requested… but of course he hadn’t.
That’s when I figured out that perhaps I could find an accurate formulary now that I had the name of the business affiliated with my insurance that covered prescriptions. The person I’d talked to on the phone also said that there was a web page where I could check costs.
I went onto the web page and found out the medication the person on the phone had suggested wasn’t, in fact, covered. So I was now three for three. The insurance, my doctor, and my pharmacist had all given me inaccurate information.
Again, everybody in America just accepts this is inevitable. When is the public going to figure out this is only inevitable because we never hold anyone accountable?
For the love of god, this is your life!
Maybe unqualified people shouldn’t be obligated to run around making prescription requests?
I couldn’t find anything on the web page. Of course the web page hadn’t been built to suggest the name of a medication that was actually covered. Nope! Can’t do that! Instead you have to randomly type in the names of various drugs and cross your fingers.
I found nothing.
So, I printed out the relevant page of the formulary and went back to the pharmacist.
There was a new pharmacist in that day. He looked over the list. There were only 5 items. He indicated one wasn’t a brand name, but that I’d have to take it with a nebulizer.
“Can you send in a prescription request?”
“Sure!” he said.
That was three days ago
So now we’ve come full circle. I did exactly as the doctor asked. I figured out the medication that, I think, my insurance will cover. I sent in a prescription request to the doctor.
I waited two full nights. Finally, I called the pharmacy to ask if they’d received the prescription. Of course they hadn’t. Then, I called the doctor again and this time got to talk with somebody who assured me she’d pass the message on to the doctor’s nurse. That was yesterday. They said the nurse would call me back.
“When will they call me back?”
“We try to call back on the same day.”
They never called. I decided to give them until noon today and then I’ll call again. Meanwhile, I thought I’d take advantage of my anger by writing down the whole sorry saga that you’ve just finished reading.
I’m not the problem, our health care system is the problem
Again, I just want to emphasize that there are people in the world who are dealing with health issues that are far more severe than mine. There are people who don’t have insurance and who don’t have the resources at my disposal.
I can only assume that our health care industry absolutely tortures those people.
I have to assume that there are people who live with discomfort, pain, and agony every day even though they should, by all rights, be entitled to medications that would instantly put an end to their suffering.
Our system is designed to have obstacles that prevent you from obtaining the service you’re forced to pay an excessive price for. When you confront these obstacles, health care professionals are more likely to get frustrated with you than help you navigate the problem.
At what point does a hospital start listening to you? If you call up and say words like “malpractice” and “lawsuit” do they pay attention and treat you with basic human dignity? Or do they retaliate and sue you out of existence?
At the very least, I’d like to leave a written reprimand on this doctor’s file. The solution isn’t just to ghost me. If they aren’t going to call in the prescription, they need to tell me. It’s irresponsible for them to think that I’ll go away if they simply ignore me.
Unless they’re just assuming I’m going to die.
Our system is corrupt and it needs to change
The worst part is what’s going to happen a month from now when I start getting all the bills from these various conversations I’ve been having. I’m willing to bet that you’ll soon be charged for leaving phone messages at a hospital, even when they go unanswered.
Why is there any controversy about the need for health care reform in the United States? It’s so blatantly obvious that this is a completely corrupt and ineffective system.
I’m not a doctor! It shouldn’t be up to me to figure out what medications to take. This is crazy!
You darn well know that people in this country live their lives in unnecessary agony so that a few jerks can become obscenely wealthy.
Sooner or later everybody gets sick. If you haven’t yet experienced this level of frustration and discomfort, you will.
I guarantee your life is going to end in agony because our country values profit over human life. Let’s just say it. It’s true.
So totally agree with you about the horrible Health Insurance problems in the USA. I too have asthma & was prescribed Trelegy...for asthma by 2 different doctors. I then moved from New York State to NJ - when applying for a Medicare Supplemental Plan in NJ was screamed at by a medical underwriter that I had COPD or Emphysema. I said that I have never been diagnosed with those. She screamed at me again. I reported this 3 times to United Healthcare through AARP. The absolutely worst and most horrible Insurance Company - yet endorsed by AARP. Ultimately I don't have a Medicare Supplemental Plan because I have "chronic conditions " - as if I chose to have a chronic condition at age 4 when I was diagnosed with Asthma. I can remember my mother crying even then because she could not arrange for proper treatment for me at that time. I could go on with the details but I totally agree with you - this country doesn't care whether we live or die - especially when we are seniors & no longer have jobs. Insurance companies are then petrified that we will need surgery and don't want to insure us - because it might cost them money. Another note to make - Insurance coverage varies from State to State - something I did not know until I moved from NYS to NJ - a very bad thing to do. And then my Primary Care Doctor said that she could not help me with the denial of United Healthcare - endorsed by AARP - to approve Insurance coverage for me. So now I might have to move back to NYS. At this point I am looking forward in some ways to dying - Only if you are very wealthy in this country do you receive good Healthcare.
Man, I got really frustrated just reading what you went through. I've been in that situation, too, and it reduces me to tears every time. They make everything so much harder than it has to be. I'm glad you wrote about it.