On the bus, I pull out the most recent lab reports. I have been using homeopathic remedies for exactly three months, so how’s it working?
There is no significant change in the blood work; the urinalysis results are not in yet. So how come I feel better?
Maybe we are not measuring the right things. Next week I will ask to have the immunology tests repeated.
So I go about my shopping, buy bread, beef, cheese, ice cream, zucchini, nectarines and zinnias, and take the bus back home. At home, there is no sign of the aide. I put the zinnias in water, the ice cream in the freezer, and call the agency. The scheduler reports that she has just gotten off the phone with the aide.
The aide’s story is that she was sitting on the stones around the koi pond at 9:45; my story is that I was sitting out front at 9:45. Three minutes later, the bus arrived. The aide says she never saw me or the bus. I went hunting for her and did not find her. Nine minutes later the bus and I left.
This is where it gets good: the aide says that she waited for me from 9:45 to 11:15. What kind of moron, who is on the clock getting paid, waits for a client for an hour and half without reporting it to her supervisor? Aides are given clear instructions that if they arrive at a client’s home and the client is not there, they are to call the office immediately.
And then the aide called and talked to the scheduler for half an hour. It took me three minutes to report the problem and five to discuss it. Why did the scheduler let the aide waste half an hour of her time?
The scheduler says she will find another aide to work with me the next day, and will call me back later in the afternoon.
So then I go to the office of Dr. Sheehan, board certified allergist and immunologist. I have been referred to him by Dr. Kelly, an endocrinologist at Joslin Diabetes Center. While being processed in, I am handed paperwork that says they do not accept Medicaid. I have Medicare primary and Medicaid secondary.
The co-pay must be paid at the time of delivery of services. It is August 28, three business days before my Social Security check comes in, and I have just come from grocery shopping. I have about eight dollars in my pocket. So I go talk to the receptionist, who decides this is a question for Linda, so she goes and gets Linda and I talk to her. I ask her how much money we’re talking about.
She says that the co-pay is 20% of the doctor’s bill.
And how much would that be, I ask?
Linda replies that she doesn’t know. The charge would depend on what the doctor does.
Years ago, I used to go through this crap. I’d go to a doctor’s office, extend my Medicare and Medicaid cards, and be required to sign a statement that I would pay for anything not covered by my insurance. So, I would ask, what kind of expenses are we talking about? Where I come from, you find out what something costs before you agree to pay for it. In the medical industry, they expect you to sign without knowing.
I got a whole bunch of people mad at me because I asked questions they couldn’t answer. They would say well, it will be whatever it will be—now sign! They didn’t like it even when I would quietly explain that I had no money, and I didn’t want to stiff them for the bill, so I was asking in advance. The doctor’s office staff would get all huffy and put a note on my computer file that I was uncooperative.
When I go into JC Penney’s and want to buy a set of sheets, I look at the price tag before I take the product to the cashier. I have limited funds and need to know if the purchase is within my budget. I am sure that some people are wealthy enough that they can buy sheets without looking at the price, but most of us look at the price before we decide to buy. Not in a medical office. You are expected to pledge to pay without knowing the cost.
Medical bills are the most prevalent cause of personal bankruptcy, even among people with insurance:
So Linda keeps telling me that it will be 20%, and I keep asking, “Of what?” and she finally says, “Oh, you mean you want me to figure it out?” Duh. Yes, please, I say. So she goes and does the calculations and tells me that for a new patient appointment Dr. Sheehan charges between $60 and $150, so the co-pay is between $14 and $30. That’s a big help, I think, thinking of the $8 in my pocket.
So you don’t treat poor people, I say.
Oh, yes, we do, she says. We accept managed Medicaid!
I have regular Medicaid. I don’t know what managed Medicaid is, and I don’t know how it’s different from regular Medicaid, and I don’t know why Dr. Sheehan accepts one but not the other. What I do know is that Dr. Sheehan only treats some poor people. I am not one of them, so I leave and go home.
The All-Metro scheduler has not called back, nor does she on the remainder of Thursday.
I wait 24 hours and then call her back. She apologizes for not having returned my call the previous day, then tells me that she has a call out to another aide. The scheduler says she will follow up with the other aide and call me back Friday afternoon.
So for all you people who think that Medicaid means you get a free ride, the answer is no. You don’t get any “ride”—aides or doctors—at all.