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Getting the Health Care You Need (Even Without Insurance)

Most of us have had a major health crisis come up at some point in our lives or another.  Aging seems to add to the burden on our bodies to the point that things that used to just annoy us begin changing our lives.  A little insomnia, a back ache, an irregular heart beat, shortness of breath, etc. can become more pronounced, debilitating, or worse, disabling.  If you're like most aging Americans, you have seen health care change drastically during your lifetime.

There was a time when you could call for a doctor, see him/her & you'd arrange for payment directly with the doctor.  The payment might be in cash or goods, such as an extra chicken or some other product you could offer.  This, of course, was in bygone days.  During this time, you'd discuss options with the doctor & they would do their best to fix what they could to improve your life.  This option does look the best with rosy coloured glasses, because it offered the least amount of intrusion, the least confusion & the highest level of integrity.  If a doctor in an area did something terribly wrong, the neighbors would know about it & that doctor would not be practicing for long.

Next came the era of private health care.  Doctors began to go to school for more specialized practice.  They wanted to learn about one aspect of the human body & learn it well.  Cardiologists went to school to study the heart, oncologists to study cancer, etc.  They could branch out, while others took over general practice.  Nurses came into play.  Lab technicians were needed to run tests that the doctors & specialists all ordered.  Advances in medicine eventually became so profound that all of those extra layers were needed in order to check into all of the potential influences on our health, trying to get to the bottom line, a diagnosis & find the best treatment.  Because there were so many layers of professionals, however, you could certainly not arrange payment with each one separately while trying to combat your disease or problem.  Health Insurance companies stepped in to try to profit, but also to try to help simplify the process.  It was optional.  You could always go and try to untangle whom you needed to pay for which service, but most people that could afford health insurance opted for it in order to make their lives easier. Health care providers were required to treat patients even if the patients could not pay, because it's only ethical.  By doing this, they were out a large amount of money each year.

Fast forward to today.  Because of lobbying pressure, our health care is still largely privatized & is now mandatory.  You must have some sort of coverage.  The only problem is that there is still a large part of the population that cannot pay for that health care coverage.  So the government decided that there would also be a government health care option for those who'd run out of other options for paying for treatment from a doctor.  The government health care covers many things, but the amount of paperwork that you need to do in order to prove that you qualify is daunting & can be a terrible burden for those who are already struggling with terrible illness.  In addition, care may be delayed by paperwork.

Whether you fall into the last category, or a previous one, there are often certain things that are not covered with your particular insurance, or there may be deductible bills that you cannot pay on top of your premium payment each month.  Here are a few ideas to get the most for what you're paying & for getting discounts.

Before you ever set foot into a clinic (assuming you are not in an emergency situation), call around.  Ask for the billing department, then ask them what their discount is for a self-pay patient.  This discount is set by that particular clinic & can be as little as 5% and I've seen one that is 45%!  It is worth it to ask & to find the best percentage off if you have to pay for the services you'll receive out of pocket.

Next, start asking around to friends & family for referrals within that particular clinic.  Find out why they like certain doctors or nurses & which one might be a better pick for you.  Some people do not like to have all of the intricacies of their health explained to them, they just want to be tested, have the doctor tell them what to do & follow protocol.  Others want things explained in detail & want time to process what they're told.  If you think you have narrowed it down, make an appointment to address your health concern.

Before you go, take some time to write down any symptoms that you have that might be pertinent to that particular health issue.  There is nothing worse than having 15 minutes of undivided attention from a doctor to talk about your issue & forget one piece to the puzzle that may have been important.  That will likely mean that you have to go in for another visit & end up paying more.  If you don't know if a symptom could be related, mention it anyway, just to be sure.  Also write down any medications or supplements that you're on, how often & what dose.  Many people assume that the doctors will have all this information at their fingertips, and in a perfect world they would, but they may not or may only have partial information.  If you've had any reactions from previously prescribed medications, this should also be written down so that their records can be updated.  If you were on a blood thinner & it made you so dizzy that you stopped taking it, you need to make sure this physician knows that so that they know not to prescribe it & won't assume you're taking it when they prescribe other things.  YOU are your own advocate in this.  No one else, whether they are a doctor or a nurse, will know whether you've been taking something regularly or not.  If you truly want to get to the bottom of your medical concern, they need all the information.

Ask questions, especially the question why.  If you have low iron & have been on an iron supplement, ask WHY?  Where is it going?  If my iron is low, how will it affect my health?  If you're having digestive issues, ask WHY?  Do not just ask it once, ask it until you really understand & at various times throughout the search to find the answer. When you think you've found the answer, keep written record of the treatment & whether it seems to be working. If not, then go back again and ask WHY?! Some information you may be able to glean from the internet, but remember that the doctor is getting paid because they've studied medicine for a significant amount of time.  They know far more about the human body than most of us that have not studied it.  Accept help & information from someone who has studied it.  They do not know all of the things, but in this area, they know much.  If you do not understand a term that they use, ask about it.  If you were unfamiliar with electricity & went to work with an electrician for a day, you would not feel bad asking about what the different terms meant or how things interacted electrically.  In the same way, you'll have to work alongside your doctor to get to the bottom of the problem, yet you may not have the vocabulary to ask what you need to know, so...ASK!  You're hiring him/her, you've selected them for their expertise, so utilize the service to the fullest.

Be friendly.  Remember, “you draw more flies with honey than with vinegar”.  Do not go in with a bad attitude, even if you're feeling poorly.  It is not the caretaker's fault that you feel unwell & they are the ones trying to figure out how to help.  Make friends with the nurses, the technicians, the secretaries, the billing department.  Do not be afraid of any of them.  When your health is compromised, it can be a difficult task to be friendly, but I assure you, you will receive much better care if you do. Try to remember names & what part they play in the puzzling world of health care.  If you are asking questions to a lab tech that only a doctor can answer, do not be upset with the lab tech.  They are just there to draw your blood, not to give a diagnosis.  If you're friendly, however, you may learn much more about your health than if you are grumpy because people naturally want to talk to others who are friendly versus grumpy.  If you have a question about the charges for a certain test & would like to know in advance, do not ask a doctor or nurse...they don't know.  Call the billing department & ask your question.  You want the doctor and nurse to be thinking about how to help you, not about how much a blood draw costs.

If you are concerned about paying for a battery of tests that you may have to pay for because you haven't reached your deductible or because you are currently uninsured for a short time, ask the doctor which ones are the most urgent to get done right away.  Be honest & say that you are concerned about costs & wondered if they could recommend any of the tests as a higher priority than another.

Finally, follow up.  If you're being treated for something & it does not seem to be alleviating your symptoms, go back to your doctor so that you can ask the question WHY again!  If you start going to many different doctors, you'll have to go through your entire history again & start from scratch.  Unless you are very unhappy with your doctor, it's best to stick with one primary physician.  You can get second opinions about specific issues, but your primary doctor should have the fullest health history on you.  Also, if you're supposed to be taking treatment for things, take them as prescribed.  If you are having an issue, let the doctor know so that they can alter or eliminate that treatment & come up with another option.  Let the records department know if you find you have a severe reaction to something so that they can put it in your file.

Above all, remember that for the best of care you must advocate for yourself.  Do not be ashamed of your health issue, or your inability to pay or your lack of sufficient insurance for the thing that has been thrust upon you.  Ask questions & find answers so that it does not hang over your head as an added anxiety.  If you need financial assistance, ask the billing department how to go about that.  Ask for phone numbers & help with filling out forms.  Many people go untreated because they're afraid of how much something costs, but that is wholly unnecessary in this day and age.  It can be covered in some way, if you're willing to do the investigative work to take care of it.  Put it on small payments if it is allowed.  Whatever you do, do not ignore the issue until bills begin pouring in in the mail.  If you suspect that it could be a problem to pay, go directly to the billing department on your first visit.  They'll help you work through those issues so that you can rest knowing that it's been discussed & it will be covered.

It is certainly not like it was in the “old days” where you could talk to a doctor & pay with what you agreed on.  But remember, it's also not like it was in the “old days” when people died of many diseases that are simple inconveniences today.  Be thankful for the progress, even if it comes with complications. Then, take a deep breath & make the call to get treatment.


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