Questions for those on Medicare (or who have experience with it)

[Glitterati]

48. You're STILL blaming the wrong party

It's not the patient nor the family who made those decisions - it's the doctor AND the hospital.

Let's just talk about my specific situation.

I have Graves Disease (hyperthyroidism). 22 years ago, I had an original diagnosis, got care, and was released from medical care. This instance was "supposedly" from a pregnancy and would not recur. At least that is what I was told by my Doctor.

22 years later, the day after Thanksgiving, my family insisted I go to the ER because I was so sick. My legs and feet were so swollen, you couldn't distinguish my shin from my foot, nor my lower leg from my thigh. Additionally, I couldn't walk up the 14 stairs to my kitchen, I could only CRAWL up them. Also, between Halloween and Thanksgiving, I had lost 60 pounds. Frankly, I looked (and still do) like a walking skeleton.

I finally relented and went to the ER. I was diagnosed with a deadly thyroid storm, congestive heart failure and fluid on my lungs.

I was admitted to the hospital, put on IVs, meds and complete bed rest.

When the endocrinologist came in and started talking surgery, I called my sister (a 2nd year medical student) to come home. She had worked at a clinic in downtown Atlanta while she was at Georgia Tech and I knew the doctors there were high quality, caring and cognizant of cost controls - they treat the underserved, the poor.

At any rate, we got the doctors at the hospital to release me, got an appointment at Good Sam and I went home after 3 days. Sick as a dog, with lots of prescriptions I can't afford, but on my way to better, cheaper care. In fact, the day after I got home, I passed out on a concrete floor and broke my nose because the meds dropped my blood pressure too fast. I refused to go back to the hospital. My single goal was to get to the cheaper doctors.

I did get to Good Sam, loved the doctor who stopped the surgery talk, explaining that in Europe patients stayed on the meds I was on for years without needing surgery!

So yesterday, I saw the endocrinologist at Good Sam. She is talking about, eventually, killing my thyroid completely with a radioactive iodine treatment I have to drink. Of course, this treatment presents risks to my daughter at home, because I will be radioactive for WEEKS. She will have to stay with family for a couple of weeks. But, it requires no hospitalization, no surgery. No more expensive medical bills. And, the medication they will replace my thyroid function with will cost 10 CENTS a day, instead of the one I am on now that costs $5.90 per day.

I'm getting the best possible care at a cost that is reasonable - not "usual and customary." My visit with the endocrinologist cost $25.00 yesterday. I got the bill from the hospital for THEIR endocrinologist who came to my room one time - $970.00 - whose only solution was surgery to remove my thyroid and eventually put me on the same $0.10/medication as above.

But, the ONLY reason that doctor released me from the hospital is because HE worked at Good Sam once and knows the doctors and standard of care there. He actually told me "you're a walking malpractice lawsuit if I let you out of here." Frankly, that's why I refused to go back to the hospital when I passed out - so I didn't scare this man half to death and he locked me in that hospital until I was transported by ambulance to Good Sam.

What you also have to understand is the good luck of having a med student in the family who knew where to go, and how to get me there.

Most patients are not so lucky.

Also, uninsured or insured, the outcome would have been exactly the same. Insurance would NOT have stopped me from looking for the best possible care I could obtain at the best possible cost.