Expat Magazine

American Patients - A Day in the Life

By Expatmum @tonihargis
I'm constantly amazed that so many Americans are vehemently opposed to any changes in their healthcare system, when the one in place is often completely rubbish.
I won't even go into the bigger social aspect of about 47 million Americans not even having health insurance. My beef is with the minutiae you have to deal with if you're lucky enough to have coverage and can get to a doctor.
First, you have to make sure that your health insurance actually allows you to see a specific doctor. While Americans aren't required to go to the nearest doctor or hospital, their health policy often has a "network" outside of which you cannot go without having to pay most of the costs yourself. (And let me tell you, those costs are astronomical.) The problem is often that the literature and lists of "in network" physicians, are out of date. Doctors drop health plans all the time, and coverage changes with surprising speed. Best thing to do is check with your insurance company AND call the doctors office to make sure they still take the plan.
If you're on more than one medication, say from two different doctors, there's no one to say "Hey - that combination of drugs is potentially lethal." Walgreens, a large chain in the US, has just started offering this service (as long as you get all your prescriptions filled with them) which will alert them to any potential problems.
Prescription labels often have a refill number on them, allowing you to re-order the medication. However, just because there's a refill order on the label, doesn't mean you can get it. My teens both use skin creams, prescribed by their dermatologist. Before we went to England in the summer they both told me they were out of certain creams, so I phoned my lovely pharmacist, and he duly phoned the dermatologist to authorize the refill. No go. Apparently it was just over a year since my kids had been seen by the doctor, so the receptionist couldn't authorize the refill. I explained that we were about to leave for a month, but she was unimpressed. (Jobs worth anyone?) I gritted my teeth, made the appointment, paid through the nose for a nurse (not even the doctor) to say everything was still the same and we could have the creams.
Last week I needed to fill another cream prescription for the Queenager. The pharmacist duly faxed the request to the dermatologist, and we waited. Two days later (the day before she left for college) still no cream. I called the pharmacist who said they'd faxed and heard nothing. I phoned the dermatology office where I was told flatly, that no fax had been received. "But we have a fax acknowledgment from you". Still flatly denied. Grr, and grr again. (This is where you learn not to argue but to just put the request in again.)
Hopefully we'll get the cream before she leaves.

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