reverse threading

the path back is the path forward


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the moon and fries. [two artists tuesday]

in the category of vices-to-get-us-through-the-winter, you will find the occasional french fry binge. these are not the side dish. instead, they are front and center at happy hour…shoestring happiness. there is something about carbs and sea salt combined that will – yes, i know it’s temporary – raise our spirits to the point of giddy. much like the sheer joy my best friend susan and i would experience on giant bike hikes back on long island when we’d pull into the mcdonald’s parking lot and head inside to order large fries and a chocolate shake, d and i wait for the oven timer to go off and do the french-fry-happy-dance when it does. it’s the same. i am back at 14. sea-salty fries and a beverage-of-choice – in this case a red – give us moments to ride up the carb-escalator-of-glee and we have no remorse.

i needed fries on friday. comfort food for a complex day.

somehow i have hurt my foot and, after researching hand-in-hand with google numerous times, icing, resting and advil-ing over the past not-quite-two-weeks, decided it was time to see a real-live doctor.

i made an appointment at a medical clinic i’ve been going to for the last fifteen years or so. my former doctor, a woman, is no longer practicing there but there is a male physician i’ve seen and i figured that since he had an interest in sports medicine he would be a fine person to evaluate my foot, start the process of proper care. the receptionist told me they were “coding” me as a “new patient”, even though i wasn’t. so i asked what implications that had – on my insurance, on this specific visit, on me as a patient. i am a big question-asker. she informed me that there were no implications whatsoever.

cue up debacle.

i’ll skip to the part where i was in the examining room explaining to the nurse about my foot and two other concerns i had wanted to address.

she asked me if i had fasted.

“fasted?” i repeated back. “no…why would i have fasted?”

“for the bloodwork,” she replied.

“bloodwork??? what bloodwork???” i inquired.

“the bloodwork for your physical,” she stated flatly, staring at me.

i stared back, likely with a blank look on my face. “i’m not having a physical. i’m just here for my foot,” i calmly explained, a nagging sensation beginning in the pit of my stomach.

“you’re a new patient. you have to have a physical,” was her retort, followed by “you’re running out of your appointment. what do you wanna do?”

continuing to have eye contact i asked, “why wasn’t i told there would be a physical? why, when i specifically asked questions about the implications of the terminology ‘new patient’ wasn’t i told a physical would be necessary and that i should fast for bloodwork?”

she then threw the front end folks under the bus saying, “they’re receptionists. they don’t know anything.”

evenly, but with a growing nagging sensation now at the nape of my neck, i asked, “if THEY don’t know anything, how would i?”

“look, this isn’t urgent care. what do you wanna do?”

a few moments and a few queries later and it was obvious that this appointment – for which i hadn’t been instructed to fast and for which i hadn’t prepared the laundry list of questions and concerns one should bring to a once-a-year physical – would be the only one health insurance would cover for this year.

i hadn’t been properly informed. i didn’t find that acceptable. this health care system’s “safe care promise” states “see what to expect at your visit” and “clear previsit instructions” will be provided. hmm. not.

i left.

after d picked me up at the curb outside the center we sat in the parking lot for a few minutes, processing.

“your health and safety is our highest priority” reads the front page of their website. it would seem that patient-centered care would be their ‘thing’. yet, these were moments when (and i grant you that the entire medical community has been and is in overwhelm – as are all of us living through this pandemic) a nurse in this circumstance could have responded in a hundred different ways.

responding to me, as a patient trusting the information i have been given (or not given, for that matter), she could have apologized for the lack of clarity represented to me. she could have not thrown her colleagues, regardless of the pecking order, under the bus. she could have suggested that they waive the physical for this particular appointment since i had actually seen this doctor before and since they had at least fifteen years of records on me at that location, offering a chance to return for a physical at a later date. she could have given the doctor the choice. she could have ensured that the patient’s pressing need – the reason for being there – pain and an obvious concern that made me limp slowly down the hall apologizing for not being able to keep up – was addressed.

she could have.

but she didn’t.

“you are at the heart of everything we do. we treat each person as a person, not as a patient, an illness or an appointment. anything is possible when we apply our imaginations and knowledge toward our purpose of helping people live well. at advocate aurora health, we’re embracing bold, innovative ways to connect our consumers, team members and communities to their health. where we’re going is for the daring. advocate aurora’s goal is to have zero events of serious patient harm by 2025. this is advocate aurora’s “true north goal”. we also call this our “moonshot goal” since its just like putting a man on the moon.” (directly from the website)

and so, french fries were clearly on the happy hour docket longgg before happy hour.

they didn’t help my foot but they sure helped my spirit.

my foot? it’s on the moon, waiting.

*****

read DAVID’S (much sweeter) thoughts this TWO ARTISTS TUESDAY


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two broken wrists. and the saga continues. [k.s. friday]

and the saga continues

bananas.  they were $.49 lb.  we picked up a bunch and walked to the register.  a moment later, with no question or drama, we paid our $1.17 and left.

the next step in my two-broken-wrists saga is occupational therapy.  not because we do everything with our hands.  not because we write with them and open doors with them.  not because we use them for our personal hygiene or because we cook with them.  not because we drive with them or dress with them or shake hands with them.  but because using my hands IS what i do.  the therapist asked me how long i have played the piano.  53 years.  it’s what i DO.  so getting my wrists back to pre-snowboard-fall is imperative to me.  there are no other options.

before we went to this first appointment i, responsibly, called our healthcare insurance company – the one we pay $29,000 a year to – the one with the slogan ” for the care you need at a price you can afford” – to check in about the coverage of OT.  i was told, after much menu-choosing, that i am limited to 20 visits and that the cost will be $50 per visit.  with the OT’s recommendation that my getting-these-wrists-back-trajectory would involve appointments twice a week, that would add $400 to the already-$2400/month in healthcare costs.  bracing.  impossible.

the OT office checked in with me to remind me of my appointment, coincidentally, just after i hung up with the insurance company.  i told them what i had just learned and they insisted i was wrong.  “no,” i was told, “we have never heard of molina charging ANYthing for a copay.”  I asked them to please double-check for me and they assured me they would and that they would apprise me at my appointment.

when i arrived, the receptionist checking me in told me that they had their 23-year-insurance-veteran in the office check and that there would be no copay.  i asked them to provide a written document to that effect so that if and when i was billed i would have recourse.  they assured me that they would triple-check and to stop back after my appointment.

at the end of my appointment with the therapist, the receptionist told me that “no, you don’t have to pay $50 per visit.  it’s actually worse.  instead, you have to pay 100% of all fees until your thousands-of-dollars-deductible is met.”  what?!!!!  now this is the third story i am hearing about the same service with the same provider and the same insurance company.  who am i to believe?

i stood there and literally cried in front of the receptionist in the middle of the waiting area.  you mean to tell me that our $29,000 a year doesn’t really cover much of anything???  this is blatantly wrong, grossly outrageous.

bernie sanders, if you have listened to him speak, has given a example of the perverted and pathetic healthcare in this country.  he speaks about a family who makes $60,000 a year and that this family must pay $12,000 for healthcare.  “that’s 20% of their gross income,” he bellows.  what i wish he would add is this next example:  consider a couple who makes say $65,000 a year (this is the magic healthcare cliff for two people and only $5000 more than the previous example).  that couple will pay anywhere between $24,000 and $29,000 for a policy that will still have high deductibles and yet (clearly) not actually have good coverage.  i want to jump on the bernie-bellowing-band-wagon and yell, “that’s 45% of that couple’s income!!!  what is wrong with that???? EVERYTHING!”  how is it that we can live in this country, the richest country in the world, and have the worst healthcare for our populace?  how is it right to set the populace up for financial disaster when they have to deal with the eventual health scare, injury, illness??  (on a side note, i won’t even beGIN to start talking about Covid-19, for i have nothing good to say about the administration’s handling, lack of information or truth, and unpreparedness for this pandemic that will truly test the resiliency of our country.)

when i could take a breath at the receptionist’s desk i asked, “what do these appointments cost?”  how much is my professionalism worth to me, i am thinking.  i earn my living playing the piano, i am thinking.  i have fifteen albums of piano music, i am thinking.  i am a pianist, i am thinking.  i just need care for my wrists so that i can do what i do, i am thinking.  at what cost, i am thinking.

but healthcare is not like bananas.  i was told, “we can’t answer that.  we don’t know.”  i beg your pardon???  “billing handles that.  and it’s different depending upon insurance plans and whether or not you have appropriate insurance.”  i beg your pardon???? “what if i just wanted to pay cash right now?” i ask.  “you can’t,” she says.  “we don’t know what it costs.”

i wonder if it would be more if i paid cash – after all, i’m not an overstuffed insurance company that has the capacity to deny portions of the billing or disallow costs or base payment on the coding used to describe my treatment, while at the same time accepting ridiculously high premiums from clients with the knowledge that the insurance offered is incomprehensibly lacking.

no.  i’m just a person who needs her hands.

we left, went to the store and bought more bananas.

read DAVID’S thoughts this K.S. FRIDAY

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