Health - Part I

I've had some time over the past several days to meditate on what it would be like to be genuinely poor, sick and missing even one of the resources I have available in order to obtain medical treatment. I have not experienced an epiphany during my mediations, just a re-realization of how difficult the health care system can be to navigate.

My first appointment was scheduled for 1:45 PM on a weekday afternoon. I have at least two follow-up appointments, also on weekday afternoons during working hours. In total I will be missing around 8 hours of work over a two week period, just to see my doctor.

I am not a salaried employee. I work for an hourly wage and taking time out of my required 40 hours is an inconvenience. However, I have options. I can take half a sick day or work longer on other days to make up the time. I can also elect to work fewer hours as my wage is high enough to offset the missing time in my paycheck. I will still be able to meet my bills.

My doctor works out of a clinic in a lower income neighborhood located outside the Pittsburgh city limits. She came highly recommended and makes seeing a physician a pleasant experience. She spends the first twenty minutes of every exam just talking. She is also half an hour away, no matter which form of transportation I elect to take, whether it is a bus, my car or a cab.

If I take the bus, I have to spend time studying the schedules, hope it shows up on time, hope that I don't arrive too early, hope that I don't wait too long, hope that I calculated correctly to miss the minimum amount of work. If I drive, I have to add in the cost of paying to park. If I take a cab, I have to calculate the cost of the trip. With any of these options I lose – either time or money. But it is my choice to make.

In addition to the prescriptions and the previously anticipated shoulder x-ray, my doctor order a chest x-ray, a blood draw and a TB test. More time spent, trying to get to a lab to get the blood work done, trying to find a location with decent hours to get the x-rays completed. Calculating how late I can arrive at work, how early can I leave, when can I make up those hours?

Filling prescriptions. First I am told that my doctor would have to call and authorize my allergy/asthma drug as “medically necessary”. Twenty-four hours later, via a phone call by the pharmacist, I am told that the doctor will have to file paperwork stating I have a formal diagnosis of allergies/asthma before the company will pay for the medication. Which will take at least two weeks, probably longer. If I want to start it right away I am going to need to ask my doctor for samples. Which means going across town again. For a medication that was unrestricted the last time I had the prescription filled.

What if I worked at a lower pay rate? What if my boss was not as sympathetic or flexible? What if the only option I had was the bus? What if I did not have a choice of doctor? Or labs? Or hospitals? Or pharmacy? What if I did not have enough money to pay for all those office visits? What would I do then?