How We Got Here

Not feeling too good myself . . .

Western Loudoun Community Facebook Group says political posts are prohibited. Loudoun is a rich county, but as you get further west it gets more rural, with fewer splendid houses on three acre lots. Most messages are queries about where to find a handyman or some other household service. When I posted one critical of MAGA, it was taken down. Others that went in the other direction stay up. That tells you about the sort of group it is, though it does include a few malcontents other than me.

I spent a morning surfing the web, looking for a new doctor. I know I’m old. In the past, I could usually talk to my primary doctor, after leaving a message. Now none of them will pick up the phone or even surrender an email address. Exceptions are some who have merged into bigger practices with “portals” where you may be able to leave a message. I have found that even those are degrading in response time. I’m not a hypochondriac, but when I have a question — not often — damnit I want an answer. You can pay extra — at least hundreds of dollars a month — for so-called “concierge” service, but I’ve heard those are no great shakes either. I refuse to buy it on principle.

At any rate, I posted a little rant about my troubles finding a doctor who a) is taking new patients, and b) accepts those with Medicare. Around here, even in a prosperous county, it isn’t easy. My wife tells me imagine what it must be like in rural Louisiana, where she is from. (She ended up finding somebody for me, and I don’t think I’m at death’s door.)

DO NOT use this as an occasion to tell me your medical issues, and I won’t tell you mine, deal? Nothing is more tedious. You’ve got your troubles, and I’ve got mine, but I don’t want to talk about them.

At any rate, here is a thread that says a lot about the herd of independent minds governing our fair nation. Why do people settle for this nonsense? I don’t understand people, as I’ve said before. How do they get so confused. I’ve X’ed out names. XXX with a lower case letter is a response from someone else.

This was my original post:

People babble about "socialized medicine." I can't get an appointment with a new doctor until September or a doctor who accepts Medicare. Or I can go to an ER, sit for three hours, then be told to go find a doctor.

Responses, with my interjections (mostly on this site, not on FB, since there is no point in arguing with some people).

XXX:

I've heard that a lot of access depends on the type of Medicare supplement people have. No one would guess that going in.

(Me): For most any Medicare is an automatic no-go. I know this because when I say I’m on Medicare, they always say “Sorry” and never ask what kind of Medicare. It’s really Medicare Part B that’s the issue. Everyone is automatically enrolled in Part A, which is for hospitals. B is for doctors. If you have Medicare Advantage, I don’t, I think they assign you to doctors, or to a network.

XXX2: The rich get richer and everyone else gets screwed

Thanks, Zohran.

XXX2a: and all because of Obamacare. I hate to say. "I told you so", but "I told you so". I used to work for Medicare years ago. It hasn't gotten better.

N.B. I have Medicare and Blue Cross, nothing to do with ObamaCare.

XXX2b: technically the ACA strengthened Medicare. https://www.healthline.com/.../affordable-care-act-and...

Thank you, but your feelings don’t care about facts.

XXX2c: far too many people hate facts truth reality. And as we see on this page a lot of them stand against facts and are very happy to see others suffer

Downthread, somebody called this person out, said they should stay on their meds.

XXX3:

The billable amount they’re allowed to charge from service to insurance company differs depending on insurance company. Different cost brackets for every single billable service varies quite a bit with the insurance companies, before the services even have a patient to it. Same reason some offices don’t accept Medicaid/Medicare (especially independent Doctors office) due to how much it costs them down the line.

Also same reason how a simple change of diagnosis code can make a service/rx go from not covered to covered in Medicare especially. Medicare A B C D is important as well and secondary insurance.

(me) Pity the poor doctors, Medicare reimbursement only makes them slightly rich, not filthy rich. Swine.

XXX4:

I used to work with a GI doctor who was fantastic but said the fact that he continued to take Medicare/Medicaid gave people the impression that he was not very good. I can't remember how he had deduced that but it was an interesting point.

Interesting. There’s an econ literature on “signalling.”

XXX4a: I have heard this too. Especially surrounding psychiatrists.

Anonymous member XXX5:

I believe Dr Idrees takes Medicare. I had a foster child last year that had Medicaid coverage through the state and used their office a couple times. I would definitely recommend them.

This person refers me to a walk-in clinic. We used it once, and it was fine. I’m sure the doctor there is great, but it seems to me for one’s “regular doctor” you don’t want somebody running a walk-in clinic. This says something about the poster’s diminished notion of medical care.

XXX6:

I don’t know if they take it, but have you tried the doctors at Georgetown Hospital? You don’t always have to go all the way to Georgetown to see them, many have satellite offices as well. And there’s some of the best doctors in the world.

Too obvious to be very helpful, but thank you for your input.

XXX7:

Since the county switched us retirees from Medicare to the new one linked with Cigna, no one that is competent takes it. I am paying so much out-of-pocket and currently have no PCP (the last two I tried gave me misdiagnosis, and the specialists I chose to go to couldn't believe it--two different issues, that weren't issues).

As a friend of mine told me with a refreshing lack of empathy, ‘we’re all dodging bullets,’ and see above.

XXX8:

Dealing with this right now. Been in the ER 5x since May and they keep saying you need a specialist. First appt I can get is Sept. Ridiculous

Yup.

XXX8a: waiting on a rheumotologist in October. Made the appointment in april

Anonymous member XXX9:

My husband has an 8 month wait to see his urologist of choice and he has to go to Reston because the Lansdowne/Leesburg offices have no appointments until after the new year. (Note: Reston is a good hour or more drive from Loudoun, and this is the first I’ve seen about people posting as “Anonymous member.”)

XXX10:

Health insurance is the big racket in modern times. It's criminal.

I looked at the numbers once. Actually it’s not mainly the inscos. It’s the fucking doctors, specialists, big Pharma, and hospitals with the fancy equipment. That’s where most of the hot air is, why we in the U.S. pay twice as much or more for the same results people in wiser countries get.

XXX11:

Concierge medicine!

See above.

XXX12:

Was the guaranteed deal with government healthcare.

It’s free, but you can’t get it.

All part of planned depopulation.

Spooky!

XXX13:

The Inova system has been good with Medicare (novacare) offices in Purcellville, Leesburg, waxpool road Ashburn, and others.

Most of those places, the ones I checked, either don’t take new patients or don’t take Medicare.

XXX14:

My husband needed to see a very specialized neurologist about seven years ago. Wait time at least 6 months and this was when he was a government employee. We are now on Medicare with BCCS and go to Inova for most of our medical issues. Our GP is with Inova in Ashburn and we are very happy with her.

The healthcare system is quite fragile here and seems to be worsening fast.

As noted, if it’s worsening here it must be quite unmanageable in most other places.

XXX15:

I've been helping people with Medicare & supplements for 15 years. A lot of doctors accept medicare but a lot also don't accept new patients. It's best to establish doctors before you transition to medicare. These long waiting times for appts are a national issue. I'm here to help answer any questions.

I’m too cheap to pay for information. I learned the truth of this caution when I moved to Va. I was happy to notice a doctor’s office five minutes away. I found out they don’t take ‘Medicare,’ and I foolishly enrolled in Medicare B before trying to get an appointment there.

XXX16:

“Socialized medicine” in the US looks like military healthcare at military treatment facilities. It works when the possibility of providers “losing money” is removed from the equation.

The current situation with Medicare is not an accurate depiction of what would happen if everyone were on the same system.

Cyptic but plausible.

XXX16a: yeah you have to look at UK, Canada, etc. to see how bad it would get. No thanks

See below.

XXX17:

Appts in Europe under socialized medicine are even harder to get! Well the ones I know from friends there are Switzerland, Scotland and England.

Nope nope nope. Via Google’s trusty AI:

XXX18:

Appointments in countries with socialized medicine are even more difficult to get, and depending on your health condition can refuse to even treat you.

Misinformation helps to explain why our system sucks.

XXX19:

This is counter to my recent experience. I called tru (Purcellville) recently to inquire about primary care appointments for a new patient and they had openings within a week b

XXX20:

I also recommend the INOVA clinic in Purcellville. I have been a Medicare patient there for 6 years. My doctor’s teen children see the nurse-practitioner and love her. My husband also sees her and likes her.

Nice if you can get accepted as a patient.

XXX21:

Tru urgent Care/primary Care in Purcellville

That walk-in place. See above.

XXX22:

Dr Idrees in Purcellvile. They are open 7 days a week and have walk ins but also easy to get an appt. Great nurse practitioners as well.

XXX23:

If everyone had the same coverage, there would be no “weeding out” of undesirable coverages. Maybe…

Yes

XXX24:

This is a problem with all healthcare, not just "socialized medicine". I tried to schedule a med check with my doctor a month in advance and I had to wait 2.5 months for an opening.

I had to wait 3+ months to get in at a physical therapist office.

Except I wasn’t complaining about “socialized medicine.”

XXX25:

Dr Idrees in Pville...they take walkins...

XXX26:

I have good private insurance that basically everyone takes. I couldn't get STAT appointments when I was hospitalized and being released. The specialists wanted to see me within 10 days of release. One took 2 weeks. The other will be one month out. Both are with being "fit in," otherwise, it would have been October at the earliest.

I am sorry that you're struggling to find care, but there's massive attrition in healthcare with providers leaving, exacerbating pre-COVID shortages. We don't train enough MDs and allied professionals in part because Congress won't authorize additional residency and training spots. So call our members of Congress and ask them to support more support for subsidized med school and residency with more incentives for allied health professionals. It's not going to solve your short term issue, but would hopefully help the longer term problems that are only getting worse.

Probably at the behest of the medical profession, which like any craven monopolist, agitates to restrict supply and push up prices.

XXX27:

There are pitfalls and imperfections to deal with in any healthcare system, but America's current healthcare industry is incredibly tenuous and extortionate, and we pay far too much to have such difficulty in getting treated.

Pretty much all of us except the very rich will have to decide one day when we're old, whether we want to saddle our families with exorbitant medical debt, or die prematurely, and in a lot of pain.

Health insurance is a scam that only exists to create massive profit for insurance salesmen, and it's been perpetuated by decades, to the point that we think it's business as usual. But it doesn't have to be like this.

Amen