Friday, January 22, 2010

Driving My Cadillac

My little medical saga has continued since I last posted. My New Best Friend is a physiatrist at the Neurospine Center, who reviewed my x-rays and MRI and gave me a very thorough exam. The good news is that he believes he can alleviate the pain and restore some shoulder function without resorting to surgery. The less-than-good news is that the severity of my weakness may indicate that some of the nerve damage is permanent (or else the neurospine lawyers require him to say this). I am likely looking at a long course of treatment and rehabilitation with some uncertainty about the ultimate outcome. Next week he will inject cortisone directly into the site of the pinched nerve (I will be lying immobilized beneath an x-ray machine while he does this), which will hopefully reduce the inflammation over the course of several days. I also went back to see Dan, my physical therapist, who set me up with my very own Home Traction Machine.

I can only begin to guess the total cost of the various tests, procedures, treatments and toys I have received over these past two weeks. Our total out-of-pocket expense to date: zero. It has been a difficult year for Susan at the University – rescinded raise, mandatory furlough, reduced faculty and more students. But what the state of Wisconsin still provides for us is remarkable health coverage, what the shrinking number of Democrats in congress term a “Cadillac plan.” Frankly I do not think the metaphor is strong enough. It is BMW seven series coverage; an Aston Martin DB9 plan.

Each new medical receptionist I meet (and I have met quite a few lately) hands me a sheaf of papers to fill out (“Was anyone in your immediate family ever bitten by a rabid skunk?”) and takes my insurance card to copy. They handle it as if it were the Holy Grail (“Oh! No co-payment for you!”) When I made the appointment for my cortisone injection – a complex and expensive procedure – the woman looked at my coverage and grinned – “Great! No pre-approval needed!” I am glad I can make their jobs easier. Any physician treating me can order any test or procedure that he or she sees as in my best interest without first seeking permission. Of course, that physician can also order any test or procedure that is in the financial interests of the practice as well, which takes us close to the core of the health care reform debate.

Dan told me that the manufacturer of my traction machine will bill my health insurance for $725, and the health insurance company will offer them about $400. In the end, the manufacturer will have to eat the difference. If I had Chevy Malibu health insurance, that difference would have become my co-pay. I asked him where I should return it when I was done with it. “Return it? It’s yours.” When I have recovered sufficiently I will need to ponder its recreational possibilities.

Following the election in Massachusetts, I have no idea what will be sorted out in congress about health care reform. Certainly the Republicans want to drop the proposed tax on “Cadillac health coverage,” and they will likely win on that one. I am very grateful to have such coverage, and would gladly pay extra taxes to help provide health coverage for those who will never experience such privilege. A pinched nerve is no picnic and a pinched wallet would make it that much more miserable, but we could have handled the extra costs without descending into abject poverty. Many others are not that fortunate. In a moral society, everyone should be able to receive competent medical treatment without being driven to the poorhouse.

But for now I am going to go lie down in my traction machine. I am thinking I should have held out for one with surround sound.

4 comments:

Jane said...

A traction machine! I am so jealous.

bbwraight said...

John, I agree that I would be happy to pay a tax on a Cadillac plan so others could have minimal insurance. I believe you are the exception rather than the rule these days, with a plan that elicits oohs and aahs from the receptionists. I am losing my COBRA benefits in a month and am not sure where I will get affordable insurance. Its a level of vulnerability I haven't felt in a long time. My hope is that Obama casts caution to the wind and rams healthcare reform through at all costs, Republicans be damned! Not that it will beperfect, but at least it will be a start. Happy traction machine, whatever that is!

barbara said...

I also am in a position where if anything medical happens to me, we will lose all of our savings. Every insurance plan I apply for comes back and won't cover virtually anything to do with my colon, bones, back, neck, bladder, etc. Any little thing I have ever been treated for basically. I only work part time, and there is little prospect for a good job at this time. It is really depressing. As this health care thing plays out in the news I get more and more depressed. I simply don't understand why anyone is against health care for all! Is it selfishness?

rick in cos said...

John,I'm so sorry for your troubles. Ultimately, insurance or cost isn't the issue; our health and quality of life transcends issues of wealth/cash. I've known people of great wealth who suffer away and can't enjoy it due to poor health, and others who have little who get the most out of life they can, as they "feel well". My goal is to have about enough $$ so that when we do get around to retiring, we'll have enough to both keep our health up, and then live well, and time it to run out about the time we do.....
We'll keep you in our prayers for successful intervention/therapy.