February 19, 2006
Really Broken Healthcare System
If you're a newbie to the Bay Area or planning to move west, not only will you go through real estate sticker shock (which you are pre-warned about), but you'll also have to deal with a broken healthcare system. While the 'system' is clearly broken nationwide, it seems to be even more grim in the state of California.
Healthcare insurance is higher overall and the maze of forms, choices and lack-ofs are abundant. My monthly premium back east was much less than it is here (both Blue Cross), and my benefits are nowhere close to as comprehensive.
You should always read between the lines.....if a plan says it covers you for an annual physical, it may not even be worth it. They pay up to a 'certain' amount of an annual physical which in my case (even though its apparently a very comprehensive PPO), it doesn't cover half of what the physical may cost and does not include tests should you need them.
Once I discovered what the sticker price was, I didn't even bother. One other thing to mention - the $$$ spent towards the annual would apparently not contribute to my deductible. Nor does the money you spend on prescriptions. (in other words, anything and everything to keep you, the customer/patient paying, rather than them -- the poor insurance company).
Now that you're through the painful paperwork process, let's explore what its like to actually 'find a doctor' and I'll also add dentist, since this was equally frustrating.
I called six pages of general docs in the San Francisco area; most of them came as referrals. None of the ones I called would take a new patient and the couple I could get to see me, were teaching hospitals (meaning I had a choice of a new doc or someone in residence). Even then, there was a long wait time and there didn't seem to be much of a price difference.
After losing two days and ending up back at zero, I was thankful that touch wood, booking an annual physical was not an emergency and in the end, decided to drop the whole thing.....it was simply too much work.
After emailing for more references and suggestions, the stories I received from others were daunting. Here are a few ' responses, all from women.
--I don't even have a general doctor because of the same issues you faced, so I haven't bothered getting one until I decide I really need one....
--I actually fly east for my check-ups because its easier and cheaper than dealing with the system out here.
--I have a gyn but not a general doctor. I'm not even happy with my gyn but it was so much hassal to find one and to now change, I simply haven't gotten around to it.
--Unfortunately I actually do not have a general physician. Pretty much had the same experience as you looking for one, so here I am still not having one. I have blue cross ppo so if you do actually find a doctor, please let me know....
--I would love to help you, but I don't have a general doc (refuse to get sick because the system is so broken). I just went to a new gyn, it took 8 months to get the appointment, she charged $500 for 10 minutes, gave me a prescription that didn't work. When I called the office, they recommended I schedule a consult with her (she charges by the minute). I quite literally cried. Might be worthwhile to fly east. Makes you realize how desperately we need healthcare reform.
--I myself am waiting to see a doctor recommended by a neighbor. It took a few months to get the appointment. Even though I live in Marin, I actually went to San Jose to have a hysterectomy because the gynecologist I had here in Marin was so awful. I heard that he has since retired. This was about 5 years ago. And I don't have a new one yet.
--Your experience is not uncommon. Our system is incredibly broken.
NO KIDDING! Ya think? The list goes on and on and on.
Because California is such a 'sue-happy state, every dentist I called REQUIRES you to have regular exrays and exams. After a dozen or so calls to various dental providers, I asked this question - what if an individual can't afford the whole package but wants to get regular check-ups or at least regular cleans? "We refuse service," she responded.
What a great way to promote preventative healthcare. BTW, for those without insurance (and if you're a small business or self employed, its very expensive and not easy), the package to 'get in the door' starts around $300 -- the exrays, the ten minute hello and check by the dentist and the cleaning. Most of the ones I called were significantly higher: the $350-$375 range.
I thought - hey, I could get a $275 return flight to Boston (and there are NY and Boston fares that low), get my teeth cleaned and still come out ahead. We live in supposedly one of the richest countries in the world and this is what we have to deal with.
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You said that we supposedly live in one of the richest countries in the world. WE DO. Concerning the situation in California you describe, don't you think the Liberal Democrats had something to do with it? I don't think the other guys are totally to blame, do you?
Posted by: Richard | Feb 20, 2006 8:40:50 AM
Yeah, lets blame the liberals. So what would health care be like had the conservatives had complete control over. Answer: it would be non existant for anyone that could not afford the true premiums, and health care companies would be charging even a higer premium. And please don't tell me the law suits are to blame. It's already been calculated to be 1% of the price increase. And if a doctor ever did screw up your procedure, you'd be the first in line in a bay area court house.
Posted by: Sal | Feb 20, 2006 12:51:38 PM
Hey Sal, I am not a Conservative, but I am hardly a Liberal. I did write " I don't think the other guys are totally to blame". I was alluding to the Republicans(I don't belong to either party). I guess you missed that. If you think the Liberals are not to blame, more power to you. Question, perhaps you can explain why the Clinton health care plan for the nation did not succeed?
Posted by: Richard | Feb 20, 2006 6:48:41 PM
The Clinton health care was ahead of its time, but introduced at the wrong time. There is such a thing as the bleeding edge. Mark my words: health care will need to be socialized! It may be a two tier system, but government will intervene. It will have no choice. Health care is near crisis mode!
Posted by: Sal | Feb 20, 2006 6:52:06 PM
The Clinton attempt warned the healthcare industry that their days are numbered. But in typical Clinton fashion----all hype and no follow thru, all that resulted was an industry digging in and jacking premiums so they will have more to bargain with when their gravy train grinds to a crawl. Thanks but no thanks Clinton. Bush lied and did zero. But who is the real villain here?
The media, who tones down this nightmare for many Americans
in exchange for bribes from the health care industry.
Do we really need to know more about Nexium or how wonderful Blue Cross is? The health care industry is evil and the media and politicians have betrayed America!
Posted by: Lou Meyers | Mar 24, 2007 5:36:48 AM