Sasha
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It’s Monday morning at Dr. Know-it-all’s cardiology practice, and everyone is celebrating. Well, almost everyone. Holly, the practice administrator with CPC credentials and enough confidence to run a hospital, has just presented her monthly financial report. “Collections are up 12%! We brought in $103,000 last month!” Dr. Know-it-all practically jumps out of his chair. “Excellent!…
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It’s Tuesday morning. Suzi receives another reminder from her primary care office. “You’re overdue for your annual physical.” She deletes it. Another reminder arrives a week later. “Your mammogram is overdue. Schedule your appointment.” She closes the notification. Then comes the colorectal cancer screening reminder. Wonderful. Apparently, turning 45 comes with a subscription service nobody…
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It’s Monday morning. Suzi has a job. Apparently she has another one nobody told her about: managing her healthcare. It starts innocently enough. She needs to schedule an appointment with a specialist. One appointment. How hard could that be? Suzi calls the specialist’s office. “We need a referral from your primary care physician.” Fine. She…
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Suzi wakes up with a nagging pain on the lower left side of her stomach. It’s not bad enough to double her over. It’s just there, every single day, refusing to go away on its own like these things are supposed to. She figures it’ll pass. It doesn’t. So she does the responsible thing and…
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Suzi opens the medical chart. She already knows she is in trouble. Not because the procedure is complicated. Not because the hospital forgot to send medical records. Not because the insurance company changed the rules again. Because Dr. Know-it-all touched it. Let’s meet today’s patient. Jack Smith went in for a cardiac catheterization at the…
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Jill develops knee pain. Nothing life-threatening. She isn’t headed to the ER, she isn’t calling 911. But every time she takes the stairs, her knee reminds her that something’s wrong. Her primary care physician recommends seeing an orthopedist. Jill picks up the phone, expecting to book something for next week. The scheduler checks the calendar.…
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Jack Smith needs an MRI. His doctor examines him, reviews his symptoms, and orders the test. Done. At least that’s what Jack thinks. A week later, a notice shows up saying the MRI has been denied. No explanation he can follow. No real reason. Just denied. So Jack calls his insurance company, which seems like…
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Jack Smith walks into the medical practice for a regular visit. Nothing dramatic. No red carpet. No thunderstorm. Just Jack, his insurance card, and the hope that grown adults in a medical office know how to read an EOB (explanation of benefits). How nice. The visit gets billed. The insurance company processes the claim. The…
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Let me say something that sounds ridiculous but is completely normal in the United States: your access to healthcare depends on your job. Not your health, not your needs, not your situation. Your job. Lose your job, and you are not just losing income. You are losing your insurance, your medical care, your medications, and…
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Patients believe insurance exists to cover the cost of care. That is a reasonable assumption. It is also a wrong one. The real power in American healthcare has nothing to do with who treats you. It has everything to do with who decides whether you get treated at all. Right now, that power belongs to…