11 ms·

Lots of cheap takes in here. I think it’s a solid bet. Healthcare makes no sense. Example: I fractured my elbow 2 weeks ago snowboarding (sticky down-flat-down

Lots of cheap takes in here. I think it’s a solid bet. Healthcare makes no sense. Example: I fractured my elbow 2 weeks ago snowboarding (sticky down-flat-down). In order to see an orthopedic, I need to see a primary care physician for a referral. But I don’t have a doctor in the area and haven’t had a checkup in a long time. So in order to get an xray of my elbow I need to get a new primary care physician to write me a referral for an orthopedic specialist. It would take like 6 hours of my time to go through this process. So what am I doing? I’m hoping and praying that it doesn’t require surgery and letting it heal on its own. I still can’t fully extend or retract my arm. You might think this is dumb on my part, but I don’t want to miss work. Millions of people think the way I think. Telemedicine changes everything.

barbazoo 4y ago
That sounds tough, sorry you have to go through that. I do want to share that up here in BC, we have both, publicly funded health care AND telemedicine offered by private companies but charging MSP (Medical Services Plan). So it's not an either or. We don't need Amazon to bring health care to people.
- ygjb 4y ago
  That's not a very complete story. The proliferation of telemedicine services by private sector services in BC, and Telus in particular has actively reduced the availability of healthcare professionals in rural communities. While telemedicine is a suitable replacement for some medical services, the cannibalization of public health services for privately owned, less capable service delivery models is actively harming folks who need in person care. This isn't theoretical, there have been numerous cases across BC, Alberta, Manitoba and Saskatchewan where medical offices in rural communities have simply closed to in-person visits and the doctors have shifted to deliver telehealth services exclusively. This increases access for prescription refills, or low-to-moderate risk, non-acute diagnosis that can be done, but lowers access to in-person care, or the established doctor/patient relationship for prescriptions for high risk medications. I am not opposed to private participation in publicly funded health care programs, but the increased push across Canada from business and some political parties for increased private care options appears to be directly undermining the public health care system. We should have a true single payer system, with mandated pricing for medical procedures, and drive private sector competition to allow them to compete with publicly delivered options in a way that increases, not decreases access. I'm not sure how to do that because I am an application security specialist, not a medical policy specialist, but it's obvious to many Canadians that the current approach is not working, and is probably not a model to promote.
en4bz 4y ago
Haven't most plans moved to PPO since Obamacare. They usually allow you to just skip primary care nowadays.
mska 4y ago
I hope you recover fast. I was wondering, shouldn't you go to an emergency care for an accident like this one?
- deathanatos 4y ago
  Urgent care would be more appropriate, I think, but yes, it doesn't seem like a PCP is necessarily required. (But now might be a decent time to think about it anyways?)
  - yardie 4y ago
    Most of the urgent care I've used don't have the equipment to handle this. I've been twice in the last 6 months to 2 seperate urgent cares. In both cases I had to go to the ER anyway for X-rays. The doctor in one urgent care gave me a referal since she has surgical rights (I think?). I was sent straight to the X-ray tech rather than waiting it out in triage.
DMell 4y ago
>sticky down-flat-down This is exactly how I broke my collarbone.
- nickysielicki 4y ago
  Park crew doesn’t do their job in terms of removing rust with a wire brush, and we pay the price. If I wasn’t concerned about getting my pass pulled, I’d buy one of those small cans of WD-40 to spray on the rail on my first lap.
wil421 4y ago
I’ve never had insurance that doesn’t let me directly make an appointment with specialists. Never once have I been asked for a referral. Last year I thought I fractured my heel or something. I called an orthopedist, did X-rays with him, and he went through them on the spot. No break but he told me about a bunch of stretches to prevent my heel pain from coming back. Same deal with an ENT for an ear problem after a lake swim and another issue. I updated my regular doctor on my next visit.
- photon12 4y ago
  Have you never known anyone in your life for whom this was a requirement? This is a pretty common occurrence for the less well-off folks I've known as the risk profile for lower-income insurance markets puts the cost analysis toward requiring referrals to "prevent excessive utilization." The inevitable outcome when you have such segregated risk pools.
  - wil421 4y ago
    I have family members who qualify for subsidized Obama healthcare on my state’s marketplace based on income. Their kid has another special state provided insurance. It’s an interesting question I will ask them. What does Medicade and Medicare do? I’d imaging there are more hoops to jump through with government plans.
- nickysielicki 4y ago
  Well maybe this is more to my point: I don’t know how my insurance plan maps to what I’m required to do in terms of seeking care. But I do know that if I guess wrong I’m looking at paying my entire deductible, so what I end up doing is avoiding the medical system as much as possible. My point is just that if it’s an app on my phone, it’s a lot different. I’m probably going to sign up for this.
  - wil421 4y ago
    My healthcare plan has a website and you can put in a zip to see who is around you. They should list in network doctors, if there are only out of network doctors you can call the insurance and get an authorization. United Healthcare dropped a large provider in my state for a few months and I had to do the authorization thing to see my regular doc. No out of network changes.
elteto 4y ago
You do not need referrals to go to an ER, and they will perform initial care, including x-rays and surgery if needed. If you don’t need immediate surgery they will patch you up and send you away, and that’s when you have to go see a specialist with a referral (if your plan requires it). Did you go to the ER? Also, don’t mess with joints, go see a Dr.
- nickysielicki 4y ago
  No, I didn’t go to the ER. That sounds expensive, and I am a cheap bastard.
  - unethical_ban 4y ago
    Joints are critical. I can't judge without knowing a situation, but I wouldn't want to live my life with a fucked up elbow because I didn't go to the doctor. When I was briefly without insurance between jobs, I went on a desert hike and was scared about getting injured, so I get it.
  - v64 4y ago
    I suggest reading this reddit post about hospital billing [1]. You certainly have options other than paying a shitload or leaving your arm untreated. Money can be negotiated, but you only get one body. Edit: I see elsewhere in the thread you have health insurance. If you're paying for it, utilize it. You're in a better position to deal with this than uninsured people. [1] https://www.reddit.com/r/TrueOffMyChest/comments/x9b7vm/im_probably_going_to_kill_myself_over_my_hospital/ https://www.reddit.com/r/TrueOffMyChest/comments/x9b7vm/im_p...
  - mustacheemperor 4y ago
    Your untreated joint injury has a strong chance of winding up much more expensive later, especially if you develop chronic symptoms that make it difficult to work.
- stronglikedan 4y ago
  If you have insurance, an urgent care center is typically much cheaper and faster than an ER visit, for non-life-threatening injuries.
globalreset 4y ago
I just want to walk into a place, ask for a price, pay with cash and get a xray (or anything else I want or need). The clusterfuck US healthcare is just show how deeply dysfunctional the political system is. Health insurances should be banned. Everything should be paid in cash, prices posted at the door, and government should maybe co-pay to help low income and/or unfortunate (cancer and such), possibly funding most effective preventing healthcare to make sure everyone gets, all paid from normal taxes.
- nxm 4y ago
  See how the NHS is currently doing.
  - flangola7 4y ago
    Being increasingly gutted by Tories.
  - jimbokun 4y ago
    How's it doing? I imagine it's still a lot better than the high cost and poor outcomes we have here in the US.
  - e2le 4y ago
    Not a good example. At the moment it's being criminally mismanaged by the conservative government. The NHS has seen better days.
    - closeparen 4y ago
      Of course it's a good example. The whole point of nationalizing things is to make them subject to politics, and an important consideration in nationalizing important services is that they will only run as well as your country's politics.
      - fakedang 4y ago
        While the NHS is subject to the whims of Tory politicians, it can still be kept trudging along through a period of incapable government thanks to the legion of civil servants running in the background. I don't think the US has any equivalent answer for the UK Civil service.
lispisok 4y ago
Primary care doctors can order xray's and many primary care offices have their own machine. You dont need an ortho referral to check for a fracture or apply a basic cast
thelittlec 4y ago
I'm sorry that happened to you but you could go to the ER if you could afford it? I fractured my elbow on a bike and went to the ER who scheduled me an ortho the next day. Ended up with surgery two days after the accident and paying my high deductible health plan for the year. This was my first major health problem. It solidified to me how much of a clusterf the healthcare system was and how fortunate I was to be able to take off work for a week afterwards and be able to pay my high deductible.
shmatt 4y ago
>In order to see an orthopedic, I need to see a primary care physician for a referral I've never had insurance that requires a PCP. But if I did, i'd be sure to have a PCP. It's not that complicated. Even if you wanted to go the One Medical route, that means you pay Amazon $200, and choose a PCP. So essentially nothing in your circumstances have changed. I don't believe One Medical, or any other virtual doctor service will give you referrals that will be accepted by your insurance. Your insurance will still require a PCP. Your PCP might or might not be accepting virtual appointments. In One Medical they do not. The virtual appointments are done by nurses who don't work in the One Medical offices
- 98codes 4y ago
  > Your PCP might or might not be accepting virtual appointments. In One Medical they do not. Not true, and thanks for the reminder -- I just booked a remote followup with my PCP (the very same Dr, not a NP or anyone else) to discuss some test results.
- JohnFen 4y ago
  > But if I did, i'd be sure to have a PCP. It's not that complicated. In all fairness, this isn't possible everywhere. There's such a shortage of doctors in my part of the US (a medium-large metro area) that there are literally none accepting new patients. I know four people who have been actively looking for a PCP for more than two years now.
vasco 4y ago
You'll miss way more work when you have constant pains. Go to the doctor if you can afford it, what the heck are you doing?
sanjayio 4y ago
You can't go to the ER for this? Take care of yourself. 6 hours is a very small price for your health.
- 98codes 4y ago
  And an ER trip is a very big price for something that shouldn't need that level of treatment.
  - isatty 4y ago
    Most insurances cover ERs well - also, a fractured elbow definitely seems to me like something that warrants a trip to the ER.
bloudermilk 4y ago
Have you called a local urgent care facility? I don’t think I’ve ever paid more than $150 for a visit out of pocket (no insurance) even when I got X-rays for broken ribs. You can charge it to a credit card if you need to and figure out reimbursement from your insurance later.
dangwhy 4y ago
> I fractured my elbow > In order to see an orthopedic Why does even a simple thing like fracture need a specialist in USA.
- nickysielicki 4y ago
  Elbow fractures aren’t simple, it’s not just about identifying the presence of a fracture and putting it in a cast. They send you home in a sling for elbow fractures in adults, either with surgery or without it. PCPs aren’t qualified to make the determination about how it’s going to heal and whether surgery is needed.
kerpotgh 4y ago
[dead]
hd95489 4y ago
Just go to urgent care or walk in and get a referral not that hard
- hairofadog 4y ago
  When I broke my collarbone a few years back, urgent care turned me away. Maybe others have had better luck there, but in my experience they're not good for much more than maybe stitches and dispensing over-the-counter pain medication.
garyfirestorm 4y ago
wouldn't you walk into an urgentcare for exactly this? I had an ache, havent had a PCP for a while, walked into an urgentcare, they xrayed me and everything...

barbazoo 4y ago

That sounds tough, sorry you have to go through that. I do want to share that up here in BC, we have both, publicly funded health care AND telemedicine offered by private companies but charging MSP (Medical Services Plan). So it's not an either or. We don't need Amazon to bring health care to people.

ygjb 4y ago
That's not a very complete story. The proliferation of telemedicine services by private sector services in BC, and Telus in particular has actively reduced the availability of healthcare professionals in rural communities. While telemedicine is a suitable replacement for some medical services, the cannibalization of public health services for privately owned, less capable service delivery models is actively harming folks who need in person care. This isn't theoretical, there have been numerous cases across BC, Alberta, Manitoba and Saskatchewan where medical offices in rural communities have simply closed to in-person visits and the doctors have shifted to deliver telehealth services exclusively. This increases access for prescription refills, or low-to-moderate risk, non-acute diagnosis that can be done, but lowers access to in-person care, or the established doctor/patient relationship for prescriptions for high risk medications. I am not opposed to private participation in publicly funded health care programs, but the increased push across Canada from business and some political parties for increased private care options appears to be directly undermining the public health care system. We should have a true single payer system, with mandated pricing for medical procedures, and drive private sector competition to allow them to compete with publicly delivered options in a way that increases, not decreases access. I'm not sure how to do that because I am an application security specialist, not a medical policy specialist, but it's obvious to many Canadians that the current approach is not working, and is probably not a model to promote.

en4bz 4y ago

Haven't most plans moved to PPO since Obamacare. They usually allow you to just skip primary care nowadays.

mska 4y ago

I hope you recover fast. I was wondering, shouldn't you go to an emergency care for an accident like this one?

deathanatos 4y ago
Urgent care would be more appropriate, I think, but yes, it doesn't seem like a PCP is necessarily required. (But now might be a decent time to think about it anyways?)
- yardie 4y ago
  Most of the urgent care I've used don't have the equipment to handle this. I've been twice in the last 6 months to 2 seperate urgent cares. In both cases I had to go to the ER anyway for X-rays. The doctor in one urgent care gave me a referal since she has surgical rights (I think?). I was sent straight to the X-ray tech rather than waiting it out in triage.

DMell 4y ago

>sticky down-flat-down This is exactly how I broke my collarbone.

nickysielicki 4y ago
Park crew doesn’t do their job in terms of removing rust with a wire brush, and we pay the price. If I wasn’t concerned about getting my pass pulled, I’d buy one of those small cans of WD-40 to spray on the rail on my first lap.

wil421 4y ago

I’ve never had insurance that doesn’t let me directly make an appointment with specialists. Never once have I been asked for a referral. Last year I thought I fractured my heel or something. I called an orthopedist, did X-rays with him, and he went through them on the spot. No break but he told me about a bunch of stretches to prevent my heel pain from coming back. Same deal with an ENT for an ear problem after a lake swim and another issue. I updated my regular doctor on my next visit.

photon12 4y ago
Have you never known anyone in your life for whom this was a requirement? This is a pretty common occurrence for the less well-off folks I've known as the risk profile for lower-income insurance markets puts the cost analysis toward requiring referrals to "prevent excessive utilization." The inevitable outcome when you have such segregated risk pools.
- wil421 4y ago
  I have family members who qualify for subsidized Obama healthcare on my state’s marketplace based on income. Their kid has another special state provided insurance. It’s an interesting question I will ask them. What does Medicade and Medicare do? I’d imaging there are more hoops to jump through with government plans.
nickysielicki 4y ago
Well maybe this is more to my point: I don’t know how my insurance plan maps to what I’m required to do in terms of seeking care. But I do know that if I guess wrong I’m looking at paying my entire deductible, so what I end up doing is avoiding the medical system as much as possible. My point is just that if it’s an app on my phone, it’s a lot different. I’m probably going to sign up for this.
- wil421 4y ago
  My healthcare plan has a website and you can put in a zip to see who is around you. They should list in network doctors, if there are only out of network doctors you can call the insurance and get an authorization. United Healthcare dropped a large provider in my state for a few months and I had to do the authorization thing to see my regular doc. No out of network changes.

elteto 4y ago

You do not need referrals to go to an ER, and they will perform initial care, including x-rays and surgery if needed. If you don’t need immediate surgery they will patch you up and send you away, and that’s when you have to go see a specialist with a referral (if your plan requires it). Did you go to the ER? Also, don’t mess with joints, go see a Dr.

nickysielicki 4y ago
No, I didn’t go to the ER. That sounds expensive, and I am a cheap bastard.
- unethical_ban 4y ago
  Joints are critical. I can't judge without knowing a situation, but I wouldn't want to live my life with a fucked up elbow because I didn't go to the doctor. When I was briefly without insurance between jobs, I went on a desert hike and was scared about getting injured, so I get it.
- v64 4y ago
  I suggest reading this reddit post about hospital billing [1]. You certainly have options other than paying a shitload or leaving your arm untreated. Money can be negotiated, but you only get one body. Edit: I see elsewhere in the thread you have health insurance. If you're paying for it, utilize it. You're in a better position to deal with this than uninsured people. [1] https://www.reddit.com/r/TrueOffMyChest/comments/x9b7vm/im_probably_going_to_kill_myself_over_my_hospital/ https://www.reddit.com/r/TrueOffMyChest/comments/x9b7vm/im_p...
- mustacheemperor 4y ago
  Your untreated joint injury has a strong chance of winding up much more expensive later, especially if you develop chronic symptoms that make it difficult to work.
stronglikedan 4y ago
If you have insurance, an urgent care center is typically much cheaper and faster than an ER visit, for non-life-threatening injuries.

globalreset 4y ago

I just want to walk into a place, ask for a price, pay with cash and get a xray (or anything else I want or need). The clusterfuck US healthcare is just show how deeply dysfunctional the political system is. Health insurances should be banned. Everything should be paid in cash, prices posted at the door, and government should maybe co-pay to help low income and/or unfortunate (cancer and such), possibly funding most effective preventing healthcare to make sure everyone gets, all paid from normal taxes.

nxm 4y ago
See how the NHS is currently doing.
- flangola7 4y ago
  Being increasingly gutted by Tories.
- jimbokun 4y ago
  How's it doing? I imagine it's still a lot better than the high cost and poor outcomes we have here in the US.
- e2le 4y ago
  Not a good example. At the moment it's being criminally mismanaged by the conservative government. The NHS has seen better days.
  - closeparen 4y ago
    Of course it's a good example. The whole point of nationalizing things is to make them subject to politics, and an important consideration in nationalizing important services is that they will only run as well as your country's politics.
    - fakedang 4y ago
      While the NHS is subject to the whims of Tory politicians, it can still be kept trudging along through a period of incapable government thanks to the legion of civil servants running in the background. I don't think the US has any equivalent answer for the UK Civil service.

lispisok 4y ago

Primary care doctors can order xray's and many primary care offices have their own machine. You dont need an ortho referral to check for a fracture or apply a basic cast

thelittlec 4y ago

I'm sorry that happened to you but you could go to the ER if you could afford it? I fractured my elbow on a bike and went to the ER who scheduled me an ortho the next day. Ended up with surgery two days after the accident and paying my high deductible health plan for the year. This was my first major health problem. It solidified to me how much of a clusterf the healthcare system was and how fortunate I was to be able to take off work for a week afterwards and be able to pay my high deductible.

shmatt 4y ago

>In order to see an orthopedic, I need to see a primary care physician for a referral I've never had insurance that requires a PCP. But if I did, i'd be sure to have a PCP. It's not that complicated. Even if you wanted to go the One Medical route, that means you pay Amazon $200, and choose a PCP. So essentially nothing in your circumstances have changed. I don't believe One Medical, or any other virtual doctor service will give you referrals that will be accepted by your insurance. Your insurance will still require a PCP. Your PCP might or might not be accepting virtual appointments. In One Medical they do not. The virtual appointments are done by nurses who don't work in the One Medical offices

98codes 4y ago
> Your PCP might or might not be accepting virtual appointments. In One Medical they do not. Not true, and thanks for the reminder -- I just booked a remote followup with my PCP (the very same Dr, not a NP or anyone else) to discuss some test results.
JohnFen 4y ago
> But if I did, i'd be sure to have a PCP. It's not that complicated. In all fairness, this isn't possible everywhere. There's such a shortage of doctors in my part of the US (a medium-large metro area) that there are literally none accepting new patients. I know four people who have been actively looking for a PCP for more than two years now.

vasco 4y ago

You'll miss way more work when you have constant pains. Go to the doctor if you can afford it, what the heck are you doing?

sanjayio 4y ago

You can't go to the ER for this? Take care of yourself. 6 hours is a very small price for your health.

98codes 4y ago
And an ER trip is a very big price for something that shouldn't need that level of treatment.
- isatty 4y ago
  Most insurances cover ERs well - also, a fractured elbow definitely seems to me like something that warrants a trip to the ER.

bloudermilk 4y ago

Have you called a local urgent care facility? I don’t think I’ve ever paid more than $150 for a visit out of pocket (no insurance) even when I got X-rays for broken ribs. You can charge it to a credit card if you need to and figure out reimbursement from your insurance later.

dangwhy 4y ago

> I fractured my elbow > In order to see an orthopedic Why does even a simple thing like fracture need a specialist in USA.

nickysielicki 4y ago
Elbow fractures aren’t simple, it’s not just about identifying the presence of a fracture and putting it in a cast. They send you home in a sling for elbow fractures in adults, either with surgery or without it. PCPs aren’t qualified to make the determination about how it’s going to heal and whether surgery is needed.

kerpotgh 4y ago

[dead]

hd95489 4y ago

Just go to urgent care or walk in and get a referral not that hard

hairofadog 4y ago
When I broke my collarbone a few years back, urgent care turned me away. Maybe others have had better luck there, but in my experience they're not good for much more than maybe stitches and dispensing over-the-counter pain medication.

garyfirestorm 4y ago

wouldn't you walk into an urgentcare for exactly this? I had an ache, havent had a PCP for a while, walked into an urgentcare, they xrayed me and everything...