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The New Physicians

Updated on August 7, 2011
Sammie on the phone while Molly listens in.
Sammie on the phone while Molly listens in.

I haven’t been on much lately, there has been a lot going on in our lives here in Lulawissie.

Stress can be a terrible thing and it can take a horrendous toll on your mind and body. We (Sammie and I) have been struggling a lot financially due to a work injury that I had incurred back in April. It seems that I need to have my wrist reconstructed and that I quite possibly cannot continue to work in my chosen profession. I have been out of work since then, without pay, and have received no remuneration for my injuries thus far from any source. Our savings have been drained and I have used up all of my sick time and vacation time waiting for the worker’s compensation people to make a decision.

But that is not the worst of it. Sammie has been stressing so much about our financial state, that she drove herself to a stroke. She woke up on the morning of July 18th with a raging headache, unable to speak and blind in one eye. I took her to the ER and she was admitted immediately. Over the course of the next four days, she endured test after test after test while the doctor’s struggled to solve the riddle of her never ending headache. Her blood pressure was fluctuating and was becoming dangerously low.

At around 4AM on the morning of July 22nd, Sammie’s BP slipped down to 88/49, and she was sliding into a coma. By the grace of God, Kaitlyn, a young and fast acting RN happened to catch the BP reading and did whatever it took to bring her back. Kaitlyn was successful and Sammie was once again showing good BP numbers.

It was scary to say the least. God bless you, Kaitlyn.

So as the day wore on, more and more doctors were visiting with Sammie to try to figure out what had happened. She still could not speak well, her vision was better in her right eye, but was still blurry. Her headache pounded on. The doctor’s and specialists had a weekend of treatments and speech therapy planned for her, but all of that was soon dashed upon the rocks of red tape.

Our insurance carrier, Blue Cross/Blue Shield of Georgia notified the hospital that they would not authorize any more payments on Sammie’s behalf as an inpatient. They felt that anything else that she needed could be handled on an outpatient basis. She was ordered by the hospital to leave. The doctors argued with the hospital administrators, but to no avail. She had to come home.

She still couldn’t talk and she still couldn’t see fully, not to mention the killer headache.

So come Monday morning, I began the ritual of scheduling her outpatient visits with the doctors that fought for her in the hospital. As I walked to the front desk of the Neurologist’s office to check her in later that day, I was informed that she could not see the doctor without paying the $40 co-pay that my insurance requires.

“No, no” I said. “The doctor needs to see her, he saw her in the hospital. She had a stroke.”

“I’m sorry sir. You can’t see the doctor without first paying your $40 co-pay.”

“Can’t you bill me? I have been out of work myself with an injury.” (I raised my wrapped up arm).

“I’m sorry sir. You’ll have to reschedule your appointment.”

“What the hell?” I thought to myself. I was really puzzled and dumfounded. I absolutely could not believe what I just heard. The almighty dollar was standing between my wife of 30 years and her recovery from a stroke.

I felt so bad for Sammie. I felt like a penny under the dirt. I never left her side the whole time she was in the hospital, sleeping in a chair next to her bed. I wanted her to get better, but because of an unfortunate turn of events and red tape issues I couldn’t help her. I scrambled to borrow whatever money I could from my brother to get her to the medical help she needed.

But she is doing better now. Her vision has returned, and even though she still has difficulty speaking, she is expected to have a full recovery.

But what incenses and infuriates me is my insurance company. I get dinged $90 a week out of my paycheck for what I thought was pretty good health coverage. What right does the insurance company have to play doctor? With all of the new changes coming about in healthcare, are the insurance companies becoming the “New Physicians” that dictate medical policy and procedure to the hospitals and doctors? Is this the way “Obamacare” is going to end up?

I discussed this issue with a couple of my co-workers, one of whom had just returned from bilateral hernia surgery. The same thing happened to him. He had non-laparoscopic (conventional) surgery, and our insurance would not cover him as an inpatient. He needed to go home that same day. His belly was cut open at the beltline and he was stapled shut from one side to the other. BC/BS would not cover him for an overnight stay. He was absolutely miserable.

Some say that it is the economy that is causing the insurance companies to short change us. But that shouldn’t matter. My co-workers and I pay an average of $4,600 annually in insurance premiums along with various co-payments. Shouldn’t we get the service and coverage that we expect? Are these “new physicians” always going to have the final say so in our healthcare from now on? And if so, it almost makes the insurance not worth having.

Every time I turn around anymore, there is something else that sucks.

I think that I’m going to quit turning around.

©2011 By Del Banks



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      Grizz 6 years ago

      Thank you!

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      Mags 6 years ago

      I'm sorry to hear about Sammie. I wish you both a speedy recovery.