The Catch-22 of Needing Healthcare Services: My Case Study

I haven’t posted a blog article in months, and this is because I fractured my ankle while moving into a new apartment. Fortunately, I have good health insurance. However, even having such comprehensive health insurance did not save me from becoming ensnared in the our technology-dependent healthcare system. Not to mention the difficulty in transporting myself (or finding someone else to drive me) to the too-distant office of my designated Primary Care Physician.

In my new residence—while icing and elevating my foot (in accordance with the R.I.C.E injury first aid protocol)—I discovered that my cell phone reception was utterly sporadic. Meanwhile, my Internet service was not yet connected, and I was also unable to access my email due to a software update glitch. Indeed, I was cast back to the time before the Internet became an assumed fact of everyday life.

However, no clinical provider prior to 30 years ago expected every patient to be connected to the Internet—so there were more “back-up” measures on the part of clinicians to enable provider-patient communication.

Interestingly, according to an IEEE-published article in 2006 (that presented study findings pertaining to healthcare call centers), 46 percent of people using healthcare call centers in the preceding year attempted to bypass them. My hunch is that this percentage has not lessened over time!

Back to my personal story. Given the cell phone reception “desert” in my new neighborhood, just phoning my doctor’s office became a maddening ordeal (involving wading through lengthy menu options, only to be followed by an eventual dropped call). Yes, I was Sisyphus pushing up a robotic rock. Then, things got even worse.

I couldn’t drive to my doctor’s office on a painful and purple foot. Therefore, I wrapped it in sports tape and finished unpacking my moving boxes. When—on a Monday two weeks after my accident—I described my injury on the phone to a my medical clinic’s receptionist, she told me that the earliest appointment available was on Friday morning of that week.

“I’ll take it,” I said in desperation.

That Friday morning, I mentally prepared myself for the hour-long drive during rush hour to reach my medical clinic. However, I  received a phone call from the medical clinic five minutes before I was going to hobble down my front steps and into my standard-shift car. This is how I learned that the nurse had called in sick and all of her appointments had been cancelled—including mine.

After much cajoling, I was able to re-schedule my  appointment for the following day (but was reminded that only brief, urgent appointments were permitted on a Saturday).

The good news was that I got to see my own Primary Care Physician, as she happened to be the sole scheduled physician that Saturday. The bad news was that the clinic’s x-ray technician did not work on weekends. Therefore, I was requested to return to the clinic on Monday for the x-ray. Due to the pain in my foot, I decided not to try driving back to the clinic until the pain lessened (and my land-line phone, TV, and Internet were all functioning properly, which involved waiting interminably for technicians to come to my apartment).

It took another week for me to drive to the nearest public transit station (to take a train back to the clinic) in order to finally get my x-ray. On arriving home that evening, I listened to a voicemail message from my doctor that my x-ray had revealed a fracture in my ankle. Her voicemail then instructed me to stay off my foot, and to go to an emergency room ASAP to have my foot splinted. Oh, and I could read her report online at the clinic’s patient website portal. The problem was that my Internet connection was still intermittent at best!

Most importantly, had it not been for a close friend who was retired from her job (and, therefore, had the time to drive me to weekday appointments), I would not have been able to get to my medical clinic, the emergency room, and other subsequent medical appointments.

At the emergency room, the staff could not utilize the disc of my x-ray that I had brought with me. Their software was incompatible with that of my clinic. Therefore, they needed to perform a repeat x-ray. Afterwards, they splinted my foot, and I was told that I needed to make an appointment with an orthopedic surgeon (which required a faxed referral from my Primary Care Physician).

There was absolutely no step in the process of obtaining treatment that was not utterly time-consuming and frustrating. Did I mention that I had injured myself while moving?! However, the inability to use the Internet to acquire my own medical reports, and my inability to know for sure that I would have access to transportation to get to my medical appointments, were the most frustrating to me.

What I Didn’t Blog About While Recovering — Trump’s Further Attempts to Dismantle the ACA

Since my last post in July, the Republicans’ Graham-Cassidy bill surfaced and (fortunately) crashed. Next, President Trump used his executive order authority to curtail access to Affordable Care Act (ACA) enrollment options on the federal website, so that fewer Americans would try either to enroll or renew their coverage. Likewise, ACA health navigators—whose roles were to aid individuals in choosing appropriate health plans from among those plans available—were defunded and eliminated. This was in support of Trump’s previously-stated aim to “let ObamaCare implode”.

President Trump also refused to pay the ACA-mandated payments to insurers to cover the out-of-pocket expenses of lower-income enrollees. An article on October 12, 2017 in the New York Times described one ramification of Trump’s decision to withhold insurer subsidies as the high likelihood that insurance companies would offset this financial loss by raising monthly insurance premiums. In this way, the implosion of the ACA actually could be hastened by Trump’s executive orders.

Meanwhile, Tom Price—head of the Department of Health and Human Services (DHSS) and an ardent ACA foe—resigned in disgrace at the end of  September for using costly private jets (at taxpayer expense) to attend meetings. While his resignation was terrific news, it is probable that Trump (in accordance with the anti-ACA perspective of Vice President Mike Pence) will choose someone equally anti-ACA as Price’s replacement.

Effect of the Republican Tax Plan on the Future of the ACA

Dollars in the form of tax revenues are needed by any government (whether state or federal) in order to pay its bills. Therefore, reducing federal tax dollars will likely limit our government’s capacity to cover customary federal expenditures (e.g., highway and bridge repairs, and service members’ uniforms)—as well as to pay for healthcare system costs.

Passed today by the Republican-controlled House (in a 216-212 vote), President Trump’s tax overhaul plan is now headed for a vote in the Republican-dominated Senate. This plan aims to cut $6 Trillion in taxes over the next decade. Consequently, it could cost the nation $2.2 Trillion in lost federal revenue (according to a study by the Committee for a Responsible Federal Budget).

Although touted by President Trump as a beneficial tax plan for all Americans, his plan is skewed toward enabling a far greater tax break for billionaires and corporations than for middle-class Americans and smaller businesses. Furthermore, if the House-passed tax plan gets a “thumbs up” in the Senate and becomes law, extensive federal budget cuts will  become a necessity to avoid a hefty increase in the national debt (which is currently $20,443,455,421,241).

Another probable impact of enactment of Trump’s tax overhaul is a further shift of our democratic form of government towards an oligarchic one—thereby advancing the interests of billionaires over everyone else in our country for at least a generation.

Republican Senators need to show some backbone, and just vote “no” on this horrible tax plan.