I have been working in a call center for just over six months. My job is to accept phone calls from people who have insurance from a relatively prominent insurance company. Having already been a supporter of Universal Health care, I can certainly say my new job has been enlightening. For one thing I will never get an HMO. My hope for the reinvention of this blog is to try to shed some light on the plight of our nation. The only industrialized nation without socialized medicine. Yes, I said socialized.
Everyday I come home and unload my worst phone call of the day on my poor spouse. And so it begins...
Today, it was a poor young man who had thrown out his knee this Saturday. Today he had an appointment to see an Orthopedic specialist. Hobbling around on crutches. He was calling from his cell while sitting in the lobby of the specialists office. They were refusing to see him because there was no referral in place from his primary care doctor.
You see, when you have an HMO you can't just go see a doctor if you feel sick. You have to see the doctor that is named on your policy. If you see anyone besides your primary care doctor you have to have a referral. It takes up to three days to get a referral. It can be expedited and then you can get a referral in a speedy 24-48 hours.
So here is the caller. In the lobby. A mere twenty feet away from the doctor who can help him. But he doctor was refusing to see him. Apparently they had some sort of issue with the Prominent Insurance Company for which I work. You see. The primary care doctor had agreed to issue an expedited referral for him, but the referral guy had gotten into a fender bender over his lunch break and therefore would not be back at the office to call us. The specialist, the caller, and I, myself, called them to try to get someone else to issue the referral. No dice.
The call ended with the caller "disconnecting" while I was calling our internal team that intervenes in cases when immediate care is needed. Once I called them I learned that they do not take my type of call. They only take Medicare calls.
It's red tape. It's jumping through hoops. It's squeezing blood from a rock. But there is something fundamentally wrong with our health care system. From the providers to the insurance companies to the people not seeking care because of all the nonsense and thus getting sicker and sicker.
I'll consider it my job to keep telling these stories until someone hears them..
