I THOUGHT I HAD SEEN EVERYTHING

I thought I had seen everything.  I hadn’t!  Tonight, I saw a commercial for pubic hair.  That’s right, the cartoon character sang a song in which she proclaims how proud she was of her pubic hair.  In the next scene, the razor she used to sculpt her pubic hair was featured.  How long before we see actresses singing about their vaginas on commercials.  Perhaps the doc who’s on prime time touting her deodorant for private parts will commission a song about vagina pride.  Personally, I can’t wait till Hallmark has a National Pubic Hair Pride Day.  Perhaps we could have a Pubic Parade and shout, “Show us your pubes!”

The other thing I never thought I would see is mail order antidepressants and erectile meds.  The commercial is very reassuring stating that the meds are prescribed by licensed providers. You can be happy, hard and last longer! Depression can be a serious disorder and is best treated by counseling with appropriate follow-up with a MD.  Did it ever dawn on you that erectile dysfunction may be nature’s way of keeping you from screwing yourself to death?  ED is often related to vascular disease.  Lastly, erectile dysfunction is often the result of other disorders.  Sure, the medications are relatively safe but performing an exam over the phone is impossible.  While the rectum tolerates a finger, a cell phone or computer just won’t fit.  The commercials for ED are more than suggestive.  When I was young, they would have been considered pornographic. They certainly are better then the Playboy that used to hide under my mattress!

 The medical world moved to phone medicine during the pandemic.  It appears that phone medicine is being normalized and is here to stay.   I don’t like it.  Being able to see a patient in person, witness their demeanor, facial expressions, and interaction with others all help in making appropriate diagnosis and monitoring treatment success. 

Here’s today’s joke:

In Australia, a man set his pubic hair on fire;  I guess you could call that an “Australian bush fire.”

EXPENSE OF MEDS

According to a recent search of the internet, a scum bag is a “a contemptible or objectionable person .informal, derogatory.”  That would make the insurance agent I just talked to a “scum bag.”  Now that I think about it, I’ve dealt with a lot of scum bags over the last 40 years.

Many of you will think I’ve gone too far. I haven’t! I’ve watched my patients suffer at the hands of health insurers.  There are patients whose testing, labs, and hospitalizations have been refused by insurers who make money as if they were printing it ($100 million or more yearly for one well known insurer in one state).  I’ve watched patients go bankrupt trying to pay for the healthcare they needed that their insurers refused to pay.

In reality, insurers never deny care. They simply refuse to pay for care.  If your insurer refuses to pay for your care, contest their decision strenuously. 

Renee takes an inhaler that is essential if she wants to breathe.  Initially, the cost to her was $42 per month (about 10% of their retail cost of approximately $403).  This month her portion increased to about $102 per month (now 25% of their retail cost).  Their formula to determine when you have to pay more is based on their retail cost of the medication.  When you reach their set threshold of the retail cost of medication in a calendar year, you are moved into the next higher pay basket.  However, to get past the “Coverage Gap” into the “Catastrophic Coverage”, the basket change is based on out-of-pocket costs, not their retail prices.  It sounds like they are mixing apples and oranges.  Maybe they are just speaking two different languages to further confuse us.

In addition to trying to understand the double speak, the scum bag on the phone did not speak English intelligibly. She gave an explanation which boils down to two main points.  Reason number one: this insurer can set the cost of care whenever they want to because they can.  Reason number two: the insurer seems more concerned with stockholder profits than the health of its members.

Please understand that Renee was a medical office manager for 30 years.  If she had trouble understanding the agent’s explanation, do you think the average patient can understand the rules?  Of course not!  There is no transparency in pricing structures. The rule book that is available to the public and almost impossible to understand gives the insurer a huge advantage.  About 20 years ago, a Federal Judge was reduced to tears as he tried to get his medication released by his insurer.  He had asthma and needed his medication but refused to pay for it as the insurer dropped his medication from their formulary which had been a covered benefit for 20 years. He wanted “justice to prevail.”  All of his legal expertise was for naught when it came to dealing with the insurance industry.  He eventually won but at a great personal cost.

When I practiced medicine, I was afraid of the insurance companies.  I would not have written this article for fear of retribution. I’m still nervous! I’m also spending a significant amount of my retirement funds on medication and healthcare. I know I am not alone.  Many of us saved for retirement to be able to cover our medical expenses.  Little did we know what was coming.

Here is today’s joke:

The fitness trainer asked me “What kind of squats are you accustomed to doing?

I said, “Diddly !!”

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