Life with a Fractured Humerus: Why the US Healthcare System is Broken

After many months of waiting, and waiting, sometimes not so patiently, waiting;

On June 1st I received the much coveted plastic card that says I was deemed insurable and worthy of healthcare.

It took a long time to get here mind you. I have been trying to be deemed insured in some form or fashion without completely committing perjury of falsifying records since I first broke my arm in October of 2007. My crimes that have deemed me uninsurable have consisted of:

• Not having a super corporate job and daring to work at a four star restaurant that just did not have any healthcare options
• Having a husband that was self employed and we not having a certified accountant to prove his income
• Not being poor enough..should just NOT work at all I guess!
• Not being an addict or someone who was on public assistance

This year our W2’s were pathetic enough that NY State said “yes, you are eligible!”….. in February. In March, hopeful that the end was maybe near, I made the appointment with the New doctor. I was not going to go back to the old one who: 1) did not reset my arm properly when I clearly had reinjured it in week 2 of the initial injury 2) Was all for operating until they heard “no insurance” 3) Ignored me and Rye multiple times when we said it wasn’t healing 4) didn’t even SEE me until March of 2008 when his “bone setter” finally gave in and admitted that it wasn’t quite healing. He was rathe shocked that I could not lift my arm. 5) Sent me home to not come in for 120 days after giving me some bone simulating machine, that did not work, and then.. sending my account to collections since I hadn’t been in to see, and pay, him 6) refused to see me after sending my account to collections even though I was having radial nerve pain. Nope, I was done with him! Now mind you, my MIL broke her same arm and went to the new doctor who had previously been recommended to me, so I was all please to go to the new doctor. She had told him about my story and how I was waiting for the insurance card and it was lovely to hear him say ”I want to see her now anyway”

Well, The doctor might have wanted to see me, but his office chick would have none of it and bared me from the April 13th appointment unless I could fork over the self payment of $200.

I figured, heck.. I had waited this long.. after all the October 2007 break was now on 1 and a half years of living with a fractured humerus.. so why should I be out 200 bucks when all I have to do is wait for cards right? They will be here soon… So I waited.. I waited all May for my cards and then, cancelled and rescheduled my May 29th appointment made a new one for today.. and promptly got my cards on June 1st. Figures! Long awaited, my doctor's appointment was today, but then there had to be a hitch.

I had to have a referral from my primary care physician.

Now, being uninsured as long as I have, I don’t have a primary care physician. I did, but really, I was ready to change for someone more local anyway. So I didn’t mind that the magic insurance card had some Dr’s Name on it that I had no clue of. I called.. both Rye and I need full physicals, etc. ..I am willing and ready to go for a full check up, but in the meantime, can you give me a referral for my arm? No. They will not give me a referral until I see them and, here’s the kicker. They are not taking new patients until August. Nice. So I make my August 24th appointments and call up the Insurance gods.

What can I do, I ask them? My PCP that you gave me will not give me a referral and I have been waiting to go see the Arm doctor for months.

They say that they might be able to work it out with the arm doctor, but I know better. I was not going to go to the office and be held off in the waiting room again. I mean, I know I will just lose it and cry right then and there, so I call them first. And after getting lost on hold and going in circles and getting cut off.. I find Bev who now knows my story and Kelly.. who gets it and says that they can wave a referral at times and they could do it for me! Yeah.

And then, noooo.. the Insurance gods will no longer allow the doctors that power or control or doctor like decision making regarding people's health.

Mind you.. I am at work doing all this. So I think.. Ok I will go down the list on the website of all the doctors in my area and at least ONE Of them might be human enough to realize I am not asking for a refill of codeine, but that I HAVE HAD A BROKEN HUMEROS SINCE OCTOBER OF 2007 and it might be the HUMAN and decent thing to GIVE ME A REFERRAL. But, it’s 12:30 and all the doctors’ offices are all on.. lunch break. I lose it. I can’t bear the thought of canceling yet another appointment. I stand up crying, in my office, and declare that I am going to the ER and will say “My arm hurts, I can’t move it.. oh, it’s broke? Really.. good I just happen to have a doctor’s appointment at an ortho in 4 minutes; GIVE ME A REFERRAL!” I walk home.. I cry the whole way. I am going to lose my shit.

Really ENOUGH. FIX MY ARM!

Ok.. so I don’t go to the ER.. my MIL pulls some strings and I go with her and we see them anyway. Guess what? My arms broken. It’s a really bad break. It has not healed. I have two bones where you all have one. They float about.. they click togther...I make people woozy.It’s truly like a second elbow. I should have had surgery back in November of 2007. Imagine that. I need serious surgery now and it still might not heal up, but.. with the bone grafts that they will take from my hip and the steel plate holding my bones together, I should be ok. But I have to see the head of the practice first.. on July 30th..as he does big operations like mine more often.

Oh and I still need to hunt up that referral from some primary care physician.

So I go home and I start calling all the doctors who are no longer on their lunch breaks and I find out that the NY plan that I am on.. it’s the ONLY one that still requires a referral. Oh and a lot of doctors on the list, well they don’t take it anymore. But I try calling anyway. So optimistic still for reaching a human being. It actually eventually happens…four calls later. After being told maybe a doctor will take me.. maybe. And then another had to send me paperwork first and then they would give me an appointment but it takes two to three weeks..then I get a woman who says.. “Oh.. do you have a problem?” “Yes. My arm is broken.” “Do you have pain?” “Yes, it hurts.” “So you need to be seen because you have a problem and need to be seen right away by the doctor?” I get where she is going with this.. oh yeah.. I need to be seen right way! OK, I didn’t take the July 3rd appointment this week because we are going camping.. but I took the one for Monday morning! I have NO IDEA who this doctor is but I don’t care. I have an appointment in 7 days. I still don’t know if Monday will be good enough for the bone doctors and the insurance company.. it’s a week later, but I will call them tomorrow and see. I have little choice really. I might still get billed for this…though I am insured. All I can say to all those people who are against nationalized healthcare because it takes away the consumer choice of which doctor to go to.. all those people who say that its socialism and American’s don’t want it… all those people who say that Canada’s healthcare system sucks.. I say to you: Screw YOU!

You try living with a broken arm for 21 months and then no one will give you a referral and the insurance gods want you to pay even though you are covered but god forbid they actually help you!

I can tell you it sucks. The only good news about today is that the good doctor did say that they will make the one incision behind my tattoo.. so my ink won’t get messed up. In the meantime..

I’m still waiting. Broke arm and all.