She literally called me at the time of the appointment to tell me she can’t see me. She was so apologetic, but was like “I absolutely can treat you, but I’m not allowed by your insurance”. Fuck this country.
Update: I went to urgent care. Before leaving home, I called to be sure they would accept my insurance (Aetna). They said yes… After arriving for my appointment, they told me they do not accept my insurance. I will simply leave without paying.
Final Update: I can understand that that differences in physical biology demand different attention. That’s not what I’m complaining about. It’s the way it’s set up. I was told that at my appointment. Why not just refer me to a specialist? The website could’ve even just referred me to urgent care (yes, my insurance requires a primary care physician’s referral for urgent care, according to the urgent care facility). But, no, their goal is to obfuscate and irritate until the patient gives you and pays out-of-pocket.
I was able to receive care at a cost I could not afford. I won’t discuss what I had to do to “find” the money to pay for care and prescriptions. That being said, the condition I was diagnosed with was more serious than a simple infection, and I’m glad that I saw a doctor. I need further treatment and just hope I can get insurance to cover any of it.
If you’re an American reading this, please consider ways to get involved in organizing in support of Medicare For All in your community. Here is one resource I have found. We don’t need to live like this. We deserve better. Stay safe and healthy, friends.
So a few things. This is a CVS minute-clinic visit, not a visit to a general provider. The minute clinics have contracts with insurance companies that look a bit different in terms of what and who they are permitted by the insurance companies to treat. There are some really odd variations in these contracts by insurance companies for reasons that are not always grounded in science.
This, as you’ve noted, is an unfortunate reality of a for-profit health care system that is dictated by private companies, insurance companies, and mind-bogglingly complex contracts that sit between providers and patients. The most annoying part IMO is that insurance companies provide zero transparency into these contracts and the justification behind decisions. It’s all “business decisions” at the end of the day, not decisions that are medically sound and in the best interest of the patient.
And for those wondering why OP maybe just didn’t go to a “regular doctor” - the U.S. has a horrible shortage of general practitioners (primary care) physicians. This shortage is worse in some areas than others. And even if you’re lucky to live in an area that has general practitioners, the waiting list to get into their practices might be long. This leaves many people relying on a “doc in the box” aka CVS Minute Clinic or some similar outfit. These doc in the box clinics often only have a nurse or nurse practitioner on site, with a supervising physician off side. They are for-profit entities and they work with the insurance companies to design their contracts to maximize profit.
If you ever find yourself in OP’s physician, one easy way to get around this is to indicate that the visit is for something more general, like abdominal pain or unexplained fever. While the staff still might refer you off to another provider, it might be a good way to at least “get in” with someone.
Another option is to visit a local urgent care clinic if one is available and covered by insurance. These are often staffed by actual physicians so they can treat a wider range of conditions. Many often even have testing facilities right on site for a number of issues.
Finally, another option is to call your insurance company and see if they have an over-the-phone nurse consultant available. They can usually help direct you to the right location for treatment based on your symptoms and insurance coverage.
But yes, OP, I agree with you that we need something better. Medicaid and Medicare have slowly been expanding and my hope is that they will eventually expand enough to cover all Americans. it has been proven that they can still operate without completely decimating the insurance industry (see Medicare and Medicaid managed care). While I don’t agree with for-profit health insurance, the reality is that they are a lobbying force that has to be worked with if we are going to get everyone universal coverage.
Source: Health policy professional by trade, extensive experience within the health care industry
How is the us a real place wtf?
And it’s not like we learn this stuff in school. It’s not written out anywhere. We have to rely on word of mouth, people with experience, or people like the commenter above you who are familiar with the ins and outs.
The bottom line is that it is complicated on purpose and designed to wear you out so you don’t get coverage for your most basic human needs - like peeing without your urethra being on fire.
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No sorry that is wrong. The need for profit and growth in profit absolutely pushes health insurance organizations to limit their costs, and denying service is routine, planned and not some mysterious accident.
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undefined> The real kicker is you’re wrong. It’s not designed that way. That’s just a happy accident of capitalism run amok. Almost no one involved in the system is an intentionally bad actor. Almost everyone wants to do the right, good thing.
That statement.,
You should really look into the history of modern US healthcare. Johnson nearly passed a public health system. They consciously decided to go with this instead. This is absolutely by design. The people in charge simply fire anyone not making a profit until they find someone willing to do anything to create a profit, legal or not. (See Wells Fargo for this too, it’s an old playbook at this point.) They play naive but they are totally aware of what is done to create those profits.
Also we recently found this with the Opiate stuff too and that entire family exchanging messages clearly indicating they knew the illegal activities and lies being told for profit. They just played dumb publicly.
Back in my day we always pee’d with our urethra on fire after we walked to school and back uphill both ways - and we liked it!
Back in my day we peed on each other around the fire and instead of school a man would come around the house and hit us over the head with an encyclopaedia for 6 hours in the hope we’d learn by osmosis, and we were happy to have that.
Just ask yourself, could a rich person make money off of this? And it all falls into place. Over the last several decades the people of the United States have been increasingly treated like a mined resource.
First world country which treats its citizens as third world, that’s what we live in. Follow the money, because if something isn’t making money for someone, then we don’t get it.
A lot, and I do mean it, of third-world countries have better access to medical care and universal healthcare than the US.
You are presuming that it is a UTI and and coding it wrong for insurance purposes. Do a visit for something more generalized that is covered like abdominal pain and doctor will know how to code it properly for insurance.
That’s more than mildly infuriating…
Sounds like discrimination based on sex. A clear violation of the Civil Rights act of 1964.
Car insurance companies are literally allowed to discriminate by sex and will openly tell you that they do so, why would health insurance be different?
Civil Rights Act of 1964 prohibits different treatment of insured persons on the basis of their sex in connection with pension funds. This was a supreme court ruling, so kind of linked but not quite.
https://www.jstor.org/stable/253100
Interestingly, in UK and EU it became illegal to discriminate by sex for car insurance from about 2012, without very careful use of data - which doesn’t happen. It is allowed to be linked on things like jobs though.
newsflash: US never cared about civil rights and despite it being “law” it gets regularly ignored on an institutional scale
I will look into that. Thank you for brining it to my attention ❤️
It might be, but some health related coverage is legitimately divided along sex lines. I don’t know what the answer is, but it might not be so simple.
Stupid either way though.
Different genitals. But all genders have bladders so why the hell wouldn’t the insurance just cover it for everyone
I’m living in Turkey. All health care is free.
but if you live in turkey you get hate for being gay
You get that in the US too, so what’s the difference?
true that
Unless you are unemployed. Then you have to pay the unemployed tax (GSS) whether you use the healthcare services or not.
That sounds so fucking stupid
You’re unemployed so pay us money you can’t recoup until we make you homeless
That sounds expensive. So when you don’t have an income source they charge you a tax for it?
It makes sense if you think about it (assuming my thoughts are correct, I’m in the US). If you’re employed, you are contributing through your taxes. Just because you’re unemployed, it doesn’t mean your contributions pause. Now, should they? That’s a good question, but the current implementation makes sense. I imagine it does incentivize people to look for employment.
there is so much money in the world, and food/water, and housing that literally everyone - theoretically - could be fed and healthy without needing to pick on the unemployed first.
No. No, it does not. A poor tax makes no sense.
We can discuss where the money comes from, but the idea isn’t pie-in-the-sky wild. I don’t disagree with you.
In germany, the stat is paying for your health insurance when you’re unemployed.
I think you’re just supposed to die now…
I don’t believe I can afford to, though. 😓
Aww man you poor sods. In any other civilised country that wouldn’t be so much of a worry. 😭
The fuck did you just call us?
This country is f****** crazy. I remember like 8 years ago I was trying to get into rehab to kick opiates which I eventually did in 2015. When I got into a free bed for a detox, they wouldn’t let me in because it said my insurance wasn’t accepted. The irony was I didn’t have insurance anymore, they still had me listed as being insured with some s***** Blue Cross program at my old job.
I actually had to get proof that I wasn’t insured so the state would cover my bed.
Any other OECD Nation pretty much and you get treated like anyone else. And the sick part is both political parties are okay with this, and militantly fight any serious ever for a public health care system with one single risk pool where everybody is automatically opted in.
Are the people in the comments bots or real people? It’s too good to be true that so many people have switched to Lemmy!!
I checked and am definitely a robot.
Everyone on Lemmy is a bot except you.
We are bots😃
do get it treated OP, however one does that in that joke of a country you’re unfortunate enough to live in. Do know that unlike female UTIs which are relatively common and often uncomplicated if treated, male UTIs are not common and CAN herald some other underlying pathologies (such as urinary stones, blockages, anatomical problems etc) which should be properly investigated. So do go see a doctor if you’re able to.
I’m actually surprised that the CVS provider still offered to treat him, for this exact reason. I’m a trans guy who went through a bout of recurring UTIs during the height of the pandemic. For all medical purposes I could have been treated the same as any cis woman, but actually accessing the virtual-only care that’s readily available to cis women was a trial for me because the systems are set up to filter out men.
Are you sure this isn’t just a CVS thing? It says the same thing for me and I know my insurance covers UTIs for everyone. Maybe try an urgent care?
This is correct… there is 2 things to remember here
- CVS only has nurse practitioners, nurses, or pharmacists that are doing the screening, and must refer for certain cases
- There are 2 types of UTIs….
- complicated and uncomplicated
- Men ALWAYS have a complicated uti due to the anatomy of where the uti is located
- women can have either, these NPs are only allowed to treat UNCOMPLICATED UTIS and must refer all complicated cases to a physician.
FYI it has nothing to do with insurance
The entirely of modern America could be summarized with “Mildly Infiruating”, tbh.
It is utterly baffling to me how the US has not figured out nationalized healthcare. Literally every other developped nation in the western hemisphere has at this point.
A politician could come out and say “my number one priority is to ensure that every American has access to healthcare, paid for by the state”, and would instantly be villified by like half the country, and that’s insane.
The most developed country in the world ladies and gentlemen.
I hope they don’t catch you op.
Most powerful. The most developed is arguably in Europe, probably one of the Nordic countries.
This is so ridiculous! Our system is beyond broken. If you’re sick you almost have to scrape by before Medicaid limit or pay out the ass and have excellent job with very good insurance. It’s so fucked up. This is truly nutty.
I can’t help but wonder what happens to girls 15 and under when they get UTIs. Insurance company says sucks to be a girl?
There are different regulations regarding treatment dispensed directly by a pharmacist than those dispensed by a physician. Under 16 would generally have to be seen by an a doctor, often a pediatrician.
Probably.
We knowingly vote for this shitty health care system every two years, so why would they ever change?
At the federal and state levels, we knowingly vote against King Heron so he doesn’t eat all the frogs. (That is, we vote against Republicans who are actively working to neuter democracy).
Getting social safety net stuff, justice reform or even election reform will require grassroots pressure bigger than yhe George Floyd / BLM protests.
And without those things, instead were going to get genocide politics and civil war.
I think we convince ourselves we’re voting the way we do for good reasons, but since Reagan, our votes have resulted in conservative outcomes no matter who we elect. Obama even had a supermajority for six months of his presidency, and we still had to hear the usual excuses people make in order to deflect from criticism of Democrats.
I agree with you though, meaningful change is impossible now. It would take an existential threat greater than COVID for it to happen, and in a country where 40,000,000 people can’t afford to miss a day of work, it’s just impossible.
Obama even had a supermajority for six months of his presidency, and we still had to hear the usual excuses people make in order to deflect from criticism of Democrats.
Another way of saying this is that with only 72 days of congress that Obama actually had a supermajority, he passed the largest expansion of healthcare coverage for Americans since medicare/medicaid.
I guess that’s a conservative outcome to you though.
he passed the largest expansion of healthcare coverage
Only if you can absorb being price gouged, otherwise you’re left in an ER to die. He had the power to enact universal health care and sided with lobbyists, and deserves full credit for it.
It should also be noted that Obamacare was modeled off of the system Mitt Romney implemented when he was a state governor. It’s literally a conservative system.
I’m going to assume you weren’t politically aware when Obamacare was being passed. It barely made it through as it was. There was absolutely zero chance universal health care could ever have been passed at that time. To claim Obama had the power to enact it is insane.
Also, since Obamacare contained huge expansions for medicaid eligibility, and Obamacare is, as you claim, “literally a conservative system”, wouldn’t medicaid for all be the most conservative system of them all?
Finally, no, no one is left in ERs to die, insured or not. Heck you don’t even need to be a citizen. That hasn’t been true since 1986. That said, you would get a hefty bill if they actually know who you are and I do fully support a system where that is not the case and one can get treatment without worrying about the cost.
Technically, if the only thing he could pass was a conservative system because the conservatives would block anything further left of it, then yeah, that explains how the ACA is a conservative system.
Obama was very much a neoliberal who mostly continued George W. Bush policies. (Bush was a far-right conservative, even if he was overshadowed by Trump). Curiously, Biden is continuing Trump policies, even to the point of letting people in crisis die.
The Democratic party has had stopgaps to keep it neoliberal (that is establishment, corporate-sponsored) since Carter, who was too left wing for its tastes. In both cases of Carter and Occasio-Cortez, party policy was changed to assure that no-one like them could be elected again. (Though the policy change of the DCCC after Occasio-Cortez was allegedly reversed due to public pressure.)
As Oxford noted, the US is not a true democracy, but an oligarchy with small democratic features. And now the GOP wants to make sure it’s a one-party system, so they don’t even have to bother campaigning.
![[Final Update] My insurance won't cover UTIs for males. Yes, I'm in the US.](https://lemmy.world/pictrs/image/3f7f2fe9-6596-4427-a750-ca0a16636fcc.png){kind=link}