THE COMPLEXITY OF SIMPLICITY

Although I expected this to happen — KNEW it would happen — it’s still one-of-those-things that makes me crazy.

We changed medical plans this year, switching from BlueCross (great, but expensive) to Mass Advantage. This is a local group based out of UMass, which is our hospital. We use all their doctors anyway, so I figured it might not be too calamitous.

I knew we’d have to call everyone and change information — including the pharmacy, doctors, hospital, and probably more. It has taken me two full hours to change a doctors appointment and test for Garry — and I’m sure, since I have so many more doctors, it will be even worse for me.

I did finally change our coverage information and scheduled a new appointment and test date — for next March — for Garry. He has a mild case of glaucoma, so the delay should not be a major problem. The real issue is he needs a lift back from the hospital. It would have been this week, but Owen can’t drive because he has a court date for which he has been waiting a long time. I don’t drive long distances anymore and haven’t in several years, so this task falls to Owen — who is only off on Wednesday and Sunday. No appointments on Sunday — so it had to be on a Wednesday and because neither Garry nor I move fast or early, in the afternoon.

Medical care in this country is not merely inadequate, it is also ridiculously and unnecessarily complicated. Lacking a centralized system for record keeping, ones medical history doesn’t follow you if you move or change insurance providers. If you are working, usually your company takes care of it (or not), but if you are on Medicare or a Medicare Advantage plan, every time you move, you’re lucky if you can even get hold of your records.

Every state and insurance company has its own software and computer interface which typically is incompatible with every other version of software — all of which does the same job. Each version is just different enough to make it impossible to electronically transfer data from one system to the next.

I’m not sure why we digitized all this data since it can’t be transferred electronically. That was, as far as I understand it — the whole point of computerization.

Not only is our medical data broken up state by state — we have 50 states — but typically is divided by insurance group. Even for Medicare plans and often, by hospital or medical group. Our medical data is fragmented at each turning point. Even if you don’t move, doctors move. Retire. Die. Change their own groups.

I have a crate of medical records that weighs about five pounds. I used to keep it in the car, but it has moved to the basement for lack of room in the trunk. Small car. Small trunk. Big box. If I lose it, I will have NO medical history.

I’m sure I’ll get this all sorted out. I’m just wondering how long it will take and how many hours on hold I will wait and how many times I’ll be disconnected. How many times will I hear this dreary message?

You are important to us. Please continue to hold.

This may (or may not) be followed by music. Bad music. Loud music. Or (my favorite) dead silence. You only know you’ve been disconnected when, after a long wait, you hear the dial tone.

I can only wonder — as do we all — how they would treat us if we were NOT important!



Categories: Anecdote, Health, Humor, medical history, Medical humor, Medicare

Tags: , , , , ,

13 replies

  1. Must be quite frustrating for you. Don’t they respond to emails?

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  2. So true, Marilyn! Our medical system is screwed up in so many ways. Covid-19 has only made this more obvious. Yet, long wait times are used as an excuse NOT to go to a Medicare-for-All system! If only one entity were in charge of everyone’s medical records, transfers would be smoother – although the database would be huge! Who knows?? It might also be unmanageable, but the Europeans do it and mostly like it!

    I can’t change plans because if I do, I’ll be disqualified due to the fact I have a heart condition. That is, insurance companies won’t want to take a chance with me. Apparently they can refuse to cover you if you CHANGE your Medicare supplement. The company I chose first couldn’t ask me questions about my state of health (no more “pre-existing conditions” according to the ACA?) but if I were to change plans – say, go to a Medicare Advantage plan, they can ask questions about my health and refuse to cover me. So I am stuck with my original choice, whether I like it or not!

    We are so important to them that they don’t have the staff to man the phones!!

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    • I know Obama changed that clause for ACA, but for all I know, you-know-who brought it back for ACA. I don’t know.

      But I don’t think that applies to Medicare at all. What you can do is call Medicare and ask them. I’m pretty sure the laws are the same regardless of where you live. If you have not asked the question, you’ll never know the answer. I have a massive heart issue with monumental surgery plus I’ve had cancer twice and just changed advantage plans. No one asked me a single question about health. There is an assumption that old people have problems. We all have issues of some kind because — you know — we’re OLD.

      I think you may be wrong about this. Ask. Medicare is very good and very patient about answering questions. I don’t think it would be fine in Massachusetts but different in other states. This isn’t Medicaid where the structure IS different state to state. I think Medicare has national standards. I could be wrong — so ask. If you can’t get through to them, try calling AARP. They would know. That’s what they do.

      In all the years I’ve been with Medicare — even before Obama — no one EVER asked health questions. I started in 2004, so that was four years before Obama. Medicare takes anyone old enough to belong or disabled enough to be eligible. Since Medicare’s entire clientele is old, we all have something potentially lethal — including simply being OLD.

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  3. I love when the phone tells your approximate wait time or how many callers are ahead of you. Five ahead of me? Oh, can’t be that bad. Ten minutes later and only 4 are ahead of me. In my mind, I am picturing the grocery line where people and carts are a mile long, and only two registers are open. We are at their mercy, Marilyn. “And in case we get disconnected, what’s a good number for you?” Kill me now.

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    • I wish most places would ASK for a phone number! At least UMass lets you leave your number and they promise to call back — eventually. This can be any time from a few minutes to the next day (or never, my personal favorite). I don’t trust them to return a call, no matter what they tell me. Today they told me there were “unusually long wait times.” Oh sigh. When have there NOT been unusually long wait times?

      Everything is running slow, from mail — VERY slow — to vet and doctor appointments. I think our vet is down to just one guy. It used to be four or five vets. The groomers are even worse!

      And yes, we are absolutely at their mercy. I really hate the “You are very important to us. Please hold until the next available operator can answer” message. I often think they only have one person answering and she doesn’t know anything.

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