At the doctor’s office. The primary care physician Healthnet assigned me. Cesar Vialpando MD, of the Mi Familia Medical Group. Off Alameda south of 62d. The way here was all Chinese frozen squid warehouses, giant chemical silos.
Waiting room is packed to the gills. Artificial pine paneling. The guy’s desk at reception is just a mass of random papers. They don’t have a computer. It’s Mexico in here. I’m stunned no one has a goat or chicken. Except in Mexico I could have just gone to the Farmacia and bought the cheap pills I need. I have strep throat. All I need Cesar Vialpando MD to do is write a script for penicillin. All I need Healthnet to do is cover this simple trip to to the guy they assigned me. I will leave here with neither of these things.
I’ll have to get into an argument with him. He’ll want to do a culture. 48 hours, lab fees. Look, I’ll say. If it’s a virus, what can you do. Nothing. If it’s bacterial, what can you do. Antibiotics. Why not just give me the fucking antibiotics. Easiest 40 bucks you ever made. I start a new job on Monday. I can’t not show up. I just don’t want to be contagious. That’s all.
I shouldn’t have even come. But I stupidly read about strep on the internet. First I learned: like everything else, it just goes away on its own. There’s a small chance you get scarlet fever, heart infection, etc. But you won’t. If strep really gave you scarlet fever we’d have mountains of scarlet fever corpses. It just goes away. BUT, if you don’t take antibiotics you’re contagious for three weeks.
I don’t want to spread it. For this I will suffer. When you do the right thing, you fuck yourself. You drive an hour in a third world rainstorm and sit hours and hours and hours past your appointment. Pay for needless tests so a guy can rubber stamp what you already knew. Then go and pay through the ass for the pills. Inflated prices for a hundred year old medication. Like every pill it costs one tenth as much in every other country in the world. They make it from fucking bread mold.
And the insurance. When was the last time you went to a doctor and insurance paid? The 32d of Nevuary. Even if they didn’t fuck you up front, with the doctor’s office just telling you they won’t take it. If they say they take it you still get a bill later for the full exorbitant amount. Stern warnings from the billing office advise you that this is YOUR personal responsibility. Maybe insurance pays some day, if you fight and fight and fight. Your wait time… is… forty… nine… minutes. Sir, you have to call a different number, this is PPO patients only… sir, we have no record of this information, we have not received it in writing from the health care provider… calls and letters and deadlines designed to make you give up. Just take the hit to your credit. The claims people get paid extra when they make sure your policy doesn’t do what you bought it for. Insurance exists to fuck you.
But I had to try. I signed up through Obamacare. The plan looked good. I have no doctor so I let them pick. Any doctor whose office you pass by on the way to work, whose facility doesn’t look like a slaughterhouse– they don’t work with your network. They don’t accept new patients. There is one doctor in the entire state who accepts new patients. I’m sitting in his wet pine paneled waiting room with every single new patient for miles.
The doctor who takes new patients doesn’t have a computer. I don’t give a fuck. I just need the pills. Just give me the fucking pills. God, I fucking hope this goes well. I just need ONE THING to work. ONE THING to be easy. Let them take the insurance which tells me this guy is my primary care physician. Let the insurance do what they promise. Don’t let the copay be too high. That’s all I need. Things to work somewhat as advertised.
Why am I even pretending they might.
He’s twenty patients behind and its 5 o’ clock on a Saturday. Please just let him listen. Look man, I just need penicillin. Write it down and I’m out of here. Boom. Next up, Hector Munoz. Gout’s acting up.
Here’s the problem with Obamacare. We need one extreme or the other. Say you have the socialized National Health. Go to the place down the street. Any one, they’re all the same. “I got strep.” Nurse looks at you. Five minute culture. Free penicillin right in the same building. Yes, this creates its own set of hassles. Raises taxes, fucks major industries, etc. Long wait times (actually fuck that– I’m waiting with my private insurance behind half of fucking Oaxaca right now). But it’s everywhere. It’s free. A flawed but good system.
OR– you have complete deregulation. Government hands off. Look up what you have on the internet. Go to CVS. Competing companies drive the penicillin price down. Buck a bag like cough drops. The shit is made from bread mold, for Christ’s sake. Take it for a week. Done. Price is not inflated by having to subsidize a hobo’s ER visit. His five hundred dollar tongue depressors. Import pills from Canada, Mexico, India. No law requires you to hand doctors a stack of cash just for telling you what you already know.
What fucks us is the compromise. Government mandate to buy from private corporations. Uncle Sam forces you to pay rent seeking leeches. The cost of everything mushrooms into the stratosphere. Insurance companies were made to fuck you. They exist to collect premiums and not pay claims. And the president thinks he’s fucking helping you by making you buy it.
More people just keep flooding in. Fortunately one of them is a fat Mexican high school girl. Pink track suit; her ass tells me it’s “Juicy.” I can kill time now. Imagine I’m yanking her black pigtails and pulling her porky little half bald cunt back into me doggystyle. My meatpipe goes cervix deep and she squeals “que rico!” I hope this woman next to me can’t read English.
Anyway. Fuck this shit, seriously. I could have driven to Tijuana and back by now.
The doctor saw me at 7. It was not Cesar Vialpando MD but his wife. Harried but nice. She checked my blood pressure. Sorry you were waiting so long, she said. We got 5,000 patients from Healthnet off Obamacare. We checked a box saying we took new people. We were literally the only one. Do you smoke, do you drink. What seems to be the problem.
I got strep, I said. Or I think I do. I just want a script for penicillin so I don’t spread it. I know you’re supposed to do a culture–
By the time Healthnet authorized the labs you’d be cured or dead. Here you go.
And there it was. Golden ticket. Do you know if my insurance will co–
Probably. But insurance price will be ten or fifteen bucks. Same as your copay. Ask for the cash price. Should be four bucks.
They charged me three bucks for the office visit, out of pity. I walked into the night humming a victory song.
All it took was three hours there. One hour driving. One hour on the phone at the first doctor’s office I tried days earlier. Had to have Healthnet fax proof of policy since they never sent a card. Six 1 800 numbers. Five variations of I’m sorry. That is not a valid option… goodbye (click). The fax finally spits it out. The doctor says oh, we no take HMO. You have to see your primary care.
One hour on the Healthnet web site trying to change my primary care doctor. One night waiting for the change to “take” since the web site said you did this successfully. Check in the morning and it’s back to Cesar Vialpando MD. The only one taking new patients. Fine. Call his office, a guy answers and tells you he has nothing to do with Cesar Vialpando MD and you should call back tomorrow. Saturday. Appointment at 4, they see you at 7.
Still. It’s a miracle. The doctor didn’t bullshit me. I’ll keep her as my primary care physician.
All it took was eight hours of tedium and rage. Hundreds of dollars in premiums. To cure a bacterial infection with a century-old chemical made from moldy Wonder bread.
Thank God the system works.