Health Insurance = Ugh

The point of this silly blog is to document the journey right? Well part of this frustrating journey is our stupid health care system in the US. No system is or ever will be perfect. However, the system we have in the US is so obviously not intended to be for the benefit of the patient.

This frustration bubbled up again today because I was researching Natural Killer Cells (NK cells) because another friend dealing with infertility who I connected with via facebook suggested I get tested for it. Never heard of NK cells? Me either! In doing research I couldn’t help but thinking that there should be a checklist or something that a patient gets when she goes to a fertility clinic that explains different types of reproductive specialists, the different tests that can be done and the order of most common to least common. That way you can go down and check off what you’ve done and what you can still get done. Once the list is complete, then and ONLY then can you be diagnosed with unexplained infertility.

When we went to Seattle Reproductive Medicine, we asked the doctors multiple times if there were any other tests that could be done before getting an unexplained infertility diagnosis. And especially before paying thousands of dollars for artificial treatments. They confidentially reassured us there weren’t any other tests to run. Guess what?! There are other stupid tests to do!

So today I find out that finding out about NK cells is a simple (and inexpensive) blood test. EASY! Not so fast. We are self employed. We have changed health insurance almost every year for the last decade. Sometimes we haven’t had insurance and sometimes we’ve done health share plans. We currently have Ambetter and pay about $500/mo. I have not been able to log into the online patient portal for who knows why reason. I’ve tried multiple times, called the customer service line multiple times and each time been told the rep didn’t know and try again in 20 minutes. In order to get the stupid NK blood cell test I need it ordered by a doctor. In order to get a doctor I need to set a primary care physician on the STUPID portal. In order to get into the portal I need it to allow me in!

If this was the first frustration with health insurance it wouldn’t be that big of a deal. But the US health system is f*cked!!! up. I have never paid so much money for such a bad product and customer service. The people that think it’s working fine are either politicians, radically wealthy or never use the stupid system.

In thinking about the checklist it also occurred to me that it would be helpful to have a price list with each test recommended. Unfortunately that is not possible in the US because of negotiated rates for different insurance carriers vs private pay. Having a spreadsheet out there available for public consumption that shows the deceptive prices charged to different insurance carriers vs private payers would look bad for the system, the insurance carriers and the health providers. Now we can’t have THAT now can we???

Maybe I should make a list. Something that shows all of the available tests that someone could take to their provider to at least ask about. Assuming your provider is going to give you all the information is infuriatingly naïve. You are your own advocate. You are the only person who can be counted on. The best book I have read to date on reproductive health was Making Babies. It gave me information that no doctor had given me yet. It gave me terminology. It gave me the confidence to just ask questions. I didn’t feel like an idiot so much anymore. I wish someone had given it to me 6 years ago. Want to get the book for someone who is experiencing infertility currently? Check out the comments for a link to the exact book.

I’m going to think on this list thing. I’m obviously not an expert. I don’t know all the tests that should be done (which is part of the problem). I’m not medical which is exactly why I shouldn’t be in charge of knowing everything to figure out my own fertility. I shouldn’t have to know more then the doctor in order to force them to give me the tests that could give the solution. We need health insurance reform!

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February 25th 2022

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