I didn’t see a message board titled “When a Family Member Can’t Go to the Doctor” so thought I’d try posting here. If anyone has any ideas about what to do I’m all ears. My wife and I both have critical health concerns, but we are at our wit’s ends about what to do. We do not have health insurance and can’t get any, and there’s the rub.
For a little background, I’m 50 years old, and have been getting strange pains in my head, gradually increasing, for over a year. Initially felt only lying down or when I bent over, now I feel it most all the time. Also, at night I first couldn’t lay on one side of my head because it was sore inside, then also on my back, and now on the other side. I sleep propped partly up on the headboard so there’s no weight pressing on the sides of my head. One day I got amnesia, but got better the next day, although that day and several previous days are lost to my memory. The latest thing is for a couple months now I have noticed part of the top of my head is shaped different than it used to be.
Having been turned down by two insurance carriers, I have gone to the clinics in our area which have a sliding fee scale. Both they, and the emergency room doctor from the amnesia episode, said I needed to see a neurologist. I called all of them in the phone book (6). Not one will schedule an initial visit because I don’t have private insurance, even if I could afford the $400 for 10 minutes of their time to look at my medical file and decide which tests they want me to take - MRI, etc. (No sliding-fee scale here! You can tell where their priorities are.) I have talked to several medical people in casual encounters (nurse practitioner, chiropractor, even dentist) who all say the same thing; I need to see a neurologist, but they agree there is no way I can. No one has any idea what to do, except to go away and be quiet so they can pretend their industry is all about caring and helping people.
My wife has occasional stomach pains which the clinic says are probably gall stones. Without insurance, they say to live with it until it gets excruciating, then go to the ER. Okay, I guess. She also has asthma which she tries to manage with free samples from the clinic, but they say she should really go to a specialist. She has bad times when we debate whether to go to the ER, even though there’d then be a few thousand dollar hospital bill to deal with. A friend loaned us her oxygen tank once, which really helped during the next asthma attack, but we can’t rent one without getting a prescription from a doctor. Of course no such doctor will see her either. I have thought of a way to get some oxygen for those times even though Lincare (there's that phony "care" word again) told me it would be illegal.(So tell me I should just let her feel like she’s suffocating.)
We live in CA, but CMSP is no help. It works like this: For a two person household like us, the household gross income may not exceed $900-something/month, or your medical deductible is the difference. Period. So with our household monthly gross income of $3,000, we are responsible to pay over $2,000 in any given month before CMSP kicks in. Makes sense for an emergency visit to the ER, but not for a couple $400 doctor visits and a $1200 MRI one month, more expensive tests, etc., next month, whatever treatments (Dare I say surgery, possibly chemo, etc.?) may be necessary in the following months. Not to mention that the specialists won’t accept CMSP anyway. Even if we had mucho cash, one doctor’s receptionist was nice enough to explain to me that they still just wouldn’t take me as a patient without private (as opposed to CMSP/MediCal) insurance.
MediCal would be no help even if they did accept it. It only comes into play when one is disabled and can’t work. By then I may be beyond the need of most doctor’s precious billable expertise anyway.
State high-risk insurance is a sham for most medical orphans like us.. It is a token gesture by government designed to make politicians feel good about themselves. Although we are ineligible for standard insurance, our letters of denial-of-insurance only entitle us to deposit our first month’s premium of $900 which will then allow our names to be put on a waiting list. Eventually, after enough people die off, our names will rise to the top. Only then, if we are still alive, will we finally be allowed to grace that dear dedicated doctor’s doorway.
Does anyone have any ideas of what to do next? It seems we are out of options and for me it feels like time is running out (if it’s not too late already).
