This year, my family has had to deal with what we have been fortunate enough to avoid so far – health issues. None of us is chronically ill; we are generally healthy people and usually do not have to see doctors regularly. This year, though? I hope that 2016 is an anomaly.
It all started with my cracked tooth – first “root canaled” and then removed – and now I have a hole in my head waiting for an implant later this year. Though I am fortunate to have insurance, the remaining balance due is enough to make a grown woman cry. And it has.
Then Max’s shoulder problem seems to have gotten worse over the past few months. Traditional medicine would probably require surgery, so he has looked for and finally found relief from alternative medicine – a massage therapist who does a specific kind of therapy that has made his shoulder almost normal again. None of that is covered by insurance.
What has been the most bothersome, though, is that our daughter has unfortunately inherited – from me, of course – a tendency to get migraine headaches. Hers began, as did mine, at age seven. Unlike me, though, she has ocular migraines, with more severe symptoms, such as her arm’s going numb. None of the neurologists she has seen has been able to give her a good strategy for keeping the headaches at bay, and the last one didn’t even meet with her before prescribing a medication that had adverse effects on her general health.
We asked around, and it seems that the best place to go for migraines is the Mayo Clinic. The Clinic’s neurology program is well-known, and my BFF Vida had been there earlier this year. Emily’s primary care physician also thought Mayo would be a good idea, given her history, so we called for an appointment. It took Vida about a year to get in, but Emily got an appointment within two months. That was a relief, but our journey was not over. You guessed it. Emily’s insurance was not going to cover the visit because the Mayo Clinic is “out of network.”
By this time, I was understanding most personally the frustration many people go through when their insurance, the insurance they have paid for and should be able to use, will not pay for treatment that their physicians deem necessary. This of course, was not the first time this year that I have been irritated with insurance companies (see my 2/27/16 column).
Fortunately, after some inquiry and negotiation, the insurance company agreed to treat the visit as “in network” and will pay most of the cost.
The Mayo Clinic, in Rochester, Minnesota, inspires awe. It comprises several architecturally pleasing buildings that are full of beautiful, serene art and modern medical equipment. Waiting rooms are large and comfortable, and staff is pleasant and knowledgeable. There’s even an elevator operator! In this contemporary setting, Emily’s doctor walked in carrying a tattered medical bag that had been with him, I’m sure, since his graduation from Northwestern University medical school. Somehow, that gave me great comfort – as did his evaluation of Emily’s headaches.
We got really good news. But we saw people who received heartbreaking news, whose health concerns are serious and life-threatening, and some who have already heard bad news and are trying to cope with it.
Yes, this year, we have discovered that our good health is something to treasure, and we are lucky enough to have insurance that will – for the most part – help pay for our medical care. But what about the people we saw there – and here at home – who have health problems everyday? Are they able to rely on an insurance company, or are they incurring debt that will be as devastating as their diagnoses? And what about the people who simply are not receiving care because they neither have insurance or any way to pay for it?
I am still haunted by mental images of some of the faces we saw in Rochester, and for them I continue to pray for grace, help, and healing. For us, though, I can say prayers of gratitude.
Deborah Mitchell is a a local attorney and a Municipal Court Judge.