I decided that I’d start blogging my experiences in trying to handle a medical issue and talk about what it’s like to navigate through the medical system without health insurance.
While we’ve been experiencing the same sorts of issues in the economic downturn as many families (two layoffs, loss of insurance, belt tightening) we’ve also managed to maintain a fairly stable standard of living so far. I think this has been possible in large part because we have no debt – no student loans and no credit card debt. Paid those off. We own our two fuel-efficient, economy cars (one 11 years old, one 5 years old) outright. When the first layoff happened, we got rid of cable television entirely and got rid of our landline at the same time. Private school tuition went next. We are all fairly healthy and the kid is at an age where she doesn’t see a doctor all the time, anymore. We don’t travel very much and nobody has any particularly expensive habits. I haven’t bought yarn for knitting or spinning fiber in over a year and I thrift a lot of my clothing.
Surprisingly, all that has been okay. We don’t miss television and the only thing missing by losing the landline is now there are no more telemarketers dialing the house at dinnertime. I don’t indulge in the fancy, fair trade, single origin coffee beans from Intelligentsia anymore but ya know, I don’t miss that either. Trader Joe’s has a pretty good fair trade blend for about 1/4 of the price. I don’t feel deprived in the morning, but I do feel better about spending responsibly with every cup. Scaling back made it possible for our day to day life to remain relatively stable. Yes, we’re a paycheck or two from the edge, but we are not over the edge. What I took away from this was a sense of cutting our life down to what mattered and making better choices with what resources we had.
We have been very lucky in this experience. It starts to get difficult when we are presented with something out of the ordinary. Like a large tax bill or a medical bill. A sick animal needing care. This is the way that the economic downturn has affected my family the most. Our experience is just that – OUR experience. Totally subjective. There are other families who are affected more, or less, but I can’t speak for them. I’m just talking about what it’s like for us. So please read this as one point, one perspective, on a spectrum of individual experiences.
So as I said in a previous post, I’ve been dealing with an as yet unidentified health issue that has been ongoing and really annoying. I’ve got a history of fibroids and ovarian cysts, of endometriosis and other not so fun things. When we lost our health insurance and I was unable to keep seeing my regular doctor for care, Planned Parenthood was pretty good for the basics. For a while that worked out. Planned Parenthood, while cheaper than my doctor, still ran me about $100 a visit. They do offer free and low cost healthcare on a sliding scale. I paid because I did not need free care, just affordable care. It felt good to be able to pay. But then I started having chronic issues and the good folks at Planned Parenthood stated that they could not help me anymore, so it was back to the regular doctor I went.
When I called to book my appointment, I was asked if I had insurance. I said no, I would be paying cash. Well the receptionist told me that that had to be approved by my doctor, who had the final say in whether or not she wished to treat me on a cash basis. They would require a credit card to hold the appointment. It would be $250 just to get in the door. In terms of our budget, that’s the equivalent of our car insurance.
When I got to the doctor’s office, the receptionist took my driver’s license and my debit card. I would get those back, I was told, when they ran my card at the end of the appointment, if it was accepted. I didn’t ask what would happen if it were declined but I imagine I would not have walked out of there and driven home legally.
I saw my doctor. So happy to see her again and such a relief because she’s a really, really good doctor. I’ve missed her.
As the exam progressed, it became apparent that we were running into some issues. She began to throw out things she’d like to do and I had to remind her several times that, “I’m uninsured and paying as I go. Do we have to do that now or is there something we can do first to maybe rule it out?”
I feel fortunate to be able to have this dialogue with my doctor. We’ve been together a long time and through many surgeries and issues. I can talk to her. She listens. I don’t know what I would do if there were a language barrier or we didn’t have a mutually respectful relationship. If she weren’t the kind of doctor who listens.
That too is a privilege that comes with health insurance. It is hard to find those kinds of doctors at Urgent Care or an overwhelmed public health clinic. Hard to get that high quality of care. I may not have insurance now, but in this case, I’m fully aware that I am still reaping the benefit of insurance I once had. Hey, I’ll take it.
We decided to start with labs. Cultures and bloodwork. I don’t know what those are going to cost. Since I don’t have to pay those as I go, I am planning on paying them off in bits and pieces as the bills arrive. It’s not fair to the lab, but, it’s the only place I have any wriggle room and there are worse things than collection agencies if it takes too long to pay.
We are ruling things out, my doctor says. She was obviously distressed and wanted to schedule an ultrasound right away. There was a palpable uterine mass, most probably a recurrence of fibroids – a known issue – but without an ultrasound we don’t know for sure. Not knowing for sure is worrisome and it scares me. She was trying to find a way to practice thorough, excellent medicine, but a lack of insurance makes that hard to do. You can’t just order all the tests you want. At the end of our visit, she looked worried and frustrated. The exam was exhausting and painful and at the end of the visit, I was worried and frustrated too. I go back next month, after all the labs come back, after medicine has had some time to work and hopefully calm things down.
I’m saving up for the ultrasound.
I’m waiting for the lab bill.
After they drew my blood, they handed me a bill and I paid. It was $390 for an hour, an exam, a few vials of blood, some swabs. The debit card went through, thank goodness, and I drove home legally, driver’s license in hand, after paying the parking garage $12 for the privilege of parking in their lot.
I spent $402 all told today, which, in my budget, is groceries for the month.
I haven’t got an extra $402 in my budget but I am not going to do without groceries, so now we get to figure out where that is going to come from. We won’t go out to dinner, we won’t eat meat but once a week, and beans and rice are always tasty, right? Maybe we’ll pay half of something and pay something else late. We will have to juggle and then juggle again when the lab bills start to come in.
We will juggle a little more to free up enough money next month to defray another exam, more labs, an ultrasound…
We’ll get by.
We’ll get by and we will figure out what the heck all this is about, and then we’ll figure out how to treat it. Step by step.
It’s a very stressful process and the whole family is ultimately affected. The current freelance contract ends on Labor Day. The paychecks will end. The money we would normally try to save against that reality is going to pay doctors.
This won’t be resolved by Labor Day.
What do we do after Labor Day?
We pray and we hope and we will keep our shit together. That’s what I tell myself.
I’m unbelievably grateful that it gets to be a process at all. That we can juggle enough to see the doctor, pay for the tests, pay for the exams. Because that spectrum I mentioned? Yeah there’s a point on that spectrum and after that point, you’re just fucked and you don’t go see a doctor at all. I’m not there. But I see it. I see it very clearly.
It’s not too far from where I’m sitting.
More later, after the next doctor visit.
I wish you good health.
...a homeschooling, unjobbing mama and modern day Mrs. Lovett. Knitter. Cat lady. Artist. Tattooed and irreverent, with a twist. My purpose on this earth is to bring a little inspiration and delight to all of y'all. Life is amazing! Grace is everywhere. Let me show you...
