 |
|
|
|
|
 |
 |
|
||
 |
 |
|
||
|
||||
 |
|
|||
|
||||
|
||||
InsuranceApril 18, 2008 How was the cataract thing different from the retina thing? Let me count the ways. If you want to count along with me, have a look at "My Terrorist Eye." It doesn't give you the blow-by-blow (I'll spare you the journal which was more or less its first draft, all 60-plus handwritten pages of it), but you'll get the idea. The retina thing came out of nowhere. Both of 'em. I didn't know retinas could detach before mine did. I'm not sure I could have told you on July 31, 2004, exactly what a retina was. By January 2005 I knew I had a cataract and that sooner or later it was going to have to be removed. It was a while longer (maybe as many as three years?) before I got around to learning what a cataract was. Till then I thought that removing a cataract was like removing a cyst, or maybe extracting a splinter. What they actually do is take the cataract-affected lens out of your eye and give you a new one. It's not just a removal, it's a transplant, and the new lens doesn't come from someone else's eye; it's manufactured. Each retina surgery took about an hour; the second was somewhat more involved and took a little longer because the surgeon sewed a "buckle" around my eye to make sure the retina wouldn't detach again. The cataract was outta there in about 10 minutes. When the retina detached the first time, I'd never had any kind of surgery in my life. No, that's not true: when I was about a month old, I had surgery to remove a big birthmark. I only know this because my mother told me about it many years later. That was the last time I spent the night in a hospital. I have no recollection of that either. Before the first retina reattachment surgery, I had no idea what my blood pressure was, or whether I had any allergies to anesthesia. The surgeon's associate told me what my blood pressure was but I promptly forgot it because I didn't know what the numbers meant or what was supposed to be normal. The important thing was that the associate didn't recommend medical intervention. The allergy business didn't worry me much because I'm not allergic to anything that I know of, though the smell of most fish turns my stomach. Retina detachment is an emergency. Emergencies has this way of putting worries in perspective. Cataract surgery wasn't an emergency, but with two retina reattachments under my belt, I was an old hand. I still don't know many people whose retinas have detached, but nearly everyone I know has either had or knows someone who's had cataract surgery. The unanimous verdict is that it's no big deal. Both retina surgeries involved a bus trip to Boston, staying two nights at my sister's, going to a post-op at the eye center, and then coming home. Cataract surgery was in Sandwich; that's this side of the Bourne and Sagamore bridges. I drove there; Cris drove back. We were off-island for a total of about six hours. After cataract surgery, apart from the patch on my eye and the numbness across the right side of my forehead down to about my cheekbone, I felt totally normal. After retina-reattachment surgery, things didn't even approach normal for weeks. I had to keep the patch on my eye for several days, and tape a plastic shield over my eye when I went to bed, and sleep with a dictionary behind my back so I wouldn't roll onto my back or my right side. All I could see with my right eye was the gas bubble that had been implanted to help keep the retina in place. The first bubble lasted two weeks; the second more than six. Watching the bubble shrink and break up is the only good thing that can be said about recuperation from retina-reattachment surgery. After retina reattachment surgery you have to look down as much as possible, so the gas bubble can exert maximum pressure on the reattachment. Yuck. Ptui. Given a choice between another retina detachment and eating fish for the rest of my life, I'd take the fish. I'd even give up beer. Given a choice between another retina detachment and voting Republican . . . ? That's hard. Don't ask. On July 31, 2004, I could see things sharply out of my right eye, with glasses or contact lenses of course. Until April 17, 2008 -- which is to say "last night" -- the best I could see through that eye, even with lenses, was a soft-focus blur. In 2004 I didn't have insurance. In 2008 I do. Hoo boy, what a difference. If you're going to have a medical emergency while uninsured, eye surgery is a pretty good choice, at least compared to, say, getting hit by a truck or diagnosed with cancer. Many eye surgeries are done outpatient: no hospital stays, which means much less costly. Follow-up treatment is minimal, and the prescription medications (eyedrops) are relatively inexpensive. Still, though I got the "Medicare rate" for retina-reattachment surgery, it still wasn't exactly cheap, and I had to have two of them. It was a year before I had my credit card paid off, and a year after that I was still fighting with the anesthesia contractor's billing department. (I finally won.) The difference started becoming obvious in January when I went to see my optometrist about cataract surgery. Appointment cost me $20. Without insurance it would have been over $100 easy. In mid-February I went for evaluation at the Sandwich eye center: three hours of appointments and tests with at least five different techs and specialists. I can't quite figure out from the invoice what the actual cost was, but it looks like $856. My bill was for $20. I had to have a pre-surgery checkup -- I hadn't had any kind of checkup since I was 26, and that one wasn't exactly thorough. That cost $10. The two eyedrops I had to use before surgery would have cost me $184.15 without insurance; with, they cost $60. The co-pay for outpatient surgery is $100. I'll be billed for that; with each of the retina surgeries, I had to hand over my credit card before they'd operate. The big long-running fight I had with the anesthesia people started when the eye center inadvertently didn't charge me for anesthesia the first time around. I didn't even realize anesthesia was a separate line item till it showed up on the bill for the second surgery. Whereupon the anesthesia people claimed I wasn't eligible for the prepay rate because I hadn't prepaid. Goddamn right I hadn't prepaid, because it wasn't on the bill. The prepay rate was about $300; the postpay was over $900. You bet I'm going to fight about it. I was theoretically prepared to fork over $300, but $900? No way. I wrote impeccably documented letters and sent them out in triplicate. They got to the point where they were threatening me with a collection agency -- and then the letters stopped. They backed off. I still wonder how it would have gone if I didn't have an expert's command of written English. Without insurance, you have an intimate relationship with what you're being charged. You know the figures down to the last penny, and you have to come up with the money. Insurance, it seems, is like anesthesia. You don't really know what it costs, and if it works, you don't feel a thing.
|
|
|||
|
||||
|
||||
|
||||
 |
|
|||
 |
|
|||
Home - Writing - Editing - About Susanna - Bloggery - Articles - Poems - Contact Copyright ©
Susanna J. Sturgis. All rights reserved. |
||||