Publisher’s Perspective

The nation’s medical system is broken


A few weeks ago, I came down with a rash that has been dragging me down for over three weeks.

While it continues to bother me, the thing that really burns my butt is the system and process a person has to endure in order to receive medical treatment. Not just here in Gonzales, but throughout the great state of Texas and the entire country.

The problem? Major medical insurers and their bottomless, insatiable appetite for forms, minutiae, exclusions and outrageous profits.

About three weeks ago, I noticed my arms were developing a rash on both sides. By nightfall, I was covered in them. Head to waist, arms, stomach, back. I was miserable.

Friends told me to run up to the pharmacy and get some Benadryl and hydrocortisone to alleviate the itching—which I did. For a few days, that appeared to do the trick as everything was almost 100 percent cleared up. It came roaring back three days later, and ever since my life has been miserable and downright disgusting. I feel like a leper. I’m irritated at all the hoops you jump through to qualify your medical benefits. No one is happy with it—except the investors and medical insurers who profit from it. What a mess.

My latest journey through the morass and maze of medical malfeasance in America was a lesson in futility, disbelief and even anger. It started when I decided to get a shot or prescription of steroids a week after the first outbreak. It took over three hours and numerous phone calls to get in to see an “in-network” provider. For a whole day I had to scratch and itch and apply lotion just to be able to get to see someone who participated in our company insurance plan. Finally, the suffering was too much. Early the next morning I drove to the Emergency Room in Luling (Unfortunately Gonzales does not take our company’s newest Blue Cross HMO plan) thinking I would get a shot and be on my way. But nooooo!

It took a couple of hours to fill out the paperwork, wait for the insurance company to approve the visit, then actually get the shot and leave. It was absurd in the amount of detail and hoops a person has to jump through just to get to the point of, well yes, actually getting treated.

It was maddening, but it was only a harbinger of more dilatory things to come. A few days after the shot had cleared up the rash, we boarded a plane and went to Las Vegas to see Willie Nelson and Jimmy Buffet. While there, the rash came back. I called around and finally found a Walgreen’s pharmacy that had a doctor “on-call” 24/7. I agreed to meet the doctor on the Strip, and he eventually prescribed me a limited dosage of steroids. I was grateful for his disposition and willingness to meet with me, but then it started all over again.

More paperwork. More waiting. And for me: a lot more itching and scratching and being completely uncomfortable. I didn’t go to Vegas to spend three hours just waiting around to fill out paperwork that I had already filled out more than twice. I was assured, however, this dosage of steroids would resolve the problem. For that I was grateful. I came back a couple of days later optimistic I had finally rid myself of the skin scourge.

Then it came back again! I had to find a different doctor to see me. I started calling around trying to find someone who was “in-network.” Again, hours and hours of paperwork and wasted time just sitting scratching like a leper with fleas. I got my prescription and took my meds. I hoped and prayed that it would finally be fixed.

The rash returned.

Apparently, the medical insurance system and I are totally broken. Now I am waiting to find out if Blue Cross will actually pay for a dermatologist later in the week to see what can be done about this recurring rash. I have already seen three different doctors at three different locations. My situation still has not been resolved. As I write this, I have large welts and rashes all over my arms, back, neck and legs. I am blowing through Benadryl like it’s going out of style and I am not one day closer to being healed or diagnosed.

This is completely unacceptable. To be treated like a no-name number with no compassion on the insurance side is a stain on American business and fairness. When you need medical treatment, a person is not feeling well or has a disease—they are at the bottom of their game and need help. They are scared and nervous about what lies ahead. So what do you face when you are not feeling well?

What should be a time of compassion and understanding is not part of the equation. In order to make sure the doctor gets paid, he or she has to train staff people to monitor the insurance and billing regulations before you ever get to receive treatment. No insurance, no medicine. And the doctors and nurses are just as mad about the system as the patients are. So you sit and suffer the slings and arrows of outrageous fortune, fill out paperwork to satisfy the insurance company regulations, but continue to wallow in your own squalor.

No one should have to endure this in order to satisfy the vast bureaucracy of the medical insurer—that is who I blame the whole problem on. The nurses, the E.R. staff, the doctors and even local insurance agents dislike the system. Everyone admits the system is broken and has been for over 25 years. Yet it continues unabated.

The insurance companies (and I mean the national companies; not the local insurance agencies) have gone rouge on us. They are one of the most powerful lobbies in all the land—both at the national and state level. Their lobbyists are commonly seen just outside the doors of the legislative halls and meeting rooms where law and policy are made. Many lobbyists are given access to the law-making proceedings by an elected beneficiary who has received a financial renumeration from the insurance company’s largess. We do not have access to the places these monied interests go.

It is out-of-control. It is abhorrent to democratic principles this is still going on and allowed to continue.

It is time to fix the problem. And hopefully, cure whatever is ailing me.