Friday, February 16, 2007

Phun with Physicians!

It's been almost three years since my last eye exam, and my old guy eyes aren't getting any younger, so I decided it was time to get my scrip updated so I can get a new pair of eyeglasses. Simple process, right? No, not exactly. Let me start right out by saying I have some issues with health care in America. My mom had a prolonged illness and passed away several years back, so when I say I have more than a passing acquaintance with hospitals and health care providers, I really mean it. Still, I don't currently have any real health problems, so my interactions with doctors aren't too frequent. Having thus set the stage, let's raise the curtain of this production.

I belong to an HMO, so I have to get a referral from my primary care physician to see the Ophthalmologist. So I dutifully call the G.P.'s office to ask for a referral. This on Monday. Silly me, of course I get voice mail! Having left a message with my name, phone number and request, I figure that it generally takes a while to get an appointment, so I call the eye doctor's office to set that up. Turns out it was my lucky day - they had an opening first thing Thursday morning. If I couldn't make that, they had openings in April. Sheesh. OK, so I take the one on Thursday. Tuesday comes, and no call from my primary doc's office. I try calling, and do get through, but it's not Bonnie, the usual receptionist - I can tell right away because she didn't put me on hold. She tells me that I'll have to wait until tomorrow to talk to Bonnie. I tell the nice lady that I have an appointment on Thursday, so I really need to get the referral by the next day. She tells me that I'll have to wait for Bonnie, and assures me that it isn't that much of a deal any more - the referrals are now electronic and I don't absolutely have to have it before my appointment, it can be within a few days.

Continue reading post...

Having had more than enough fun with the rapidly mutating stories that you can get from health care professionals, I of course called the eye doctor's office for confirmation. Color me surprised - they had a slightly different take. I could show up without having the referral in hand, but I would have to sign a waiver, and they would need the referral within 48 hours of the visit. OK, so it seems safe enough, the referral is in the works.

Wednesday we had snow. No referral for me. OK, so on to plan B.

I show up early as requested at the eye doc's Thursday morning - been so long that I've gotta fill out the forms all over again, don't ya know? So the usual eye chart, eye drops, bright lights, yadda yadda. Then we get to the part about the long time since my last visit. Tisk tisk. Well, the doc has concerns about my eyes - I have an enlarged optic nerve or some such that can be a sign of glaucoma, although they have tested me for glaucoma in the past and I don't have any other symptoms, thank the Flying Spaghetti Monster. I remember all that glaucoma stuff they put me through 4 years ago - not fun, and involving several additional visits, including an extra one when the doc rescheduled on me the day when the medical photographer took pics of my retinas. (Please pay the additional co-pay on your way out, thanks!)

Interesting thing about the enlarged optic nerve, though. The next time I went in for an exam, they had a new electronic gizmo. It allows the doc to examine your retinas without using the drops to dilate your pupils. However, the HMO won't pay for it, so you have to pay an additional $35 out of pocket. But you do get to have the digital pics of your retinas saved to your file, so they can always look at the pics to see if there is any change. Well, I gave it a shot. They were very proud of their new, toy, and made a big show of the glorious images on the computer screen showing my "perfectly normal retinas!" Uh, last visit I had an enlarged optic nerve, which entailed extra visits. Did I get better? Later, I googled the name of the gizmo and found the manufacturer's web site, expounding the virtues of the machine - as a profit center for your practice. Huh.

The physician trade has been in an interesting squeeze of late. Insurers are requiring ever more paperwork, and putting downward pressure on what docs will be paid for what they do. Meanwhile, the additional paperwork has caused the doctors' staffs to devote an increasing amount of time to doing said paperwork, thereby increasing overhead. So doctors have been looking at alternate ways to increase revenue, and those have given me an unsettled feeling more than once. I didn't go to the G.P. to buy vitamins, or the eye doc to buy wrinkle cream, so I'm somewhat put off when they pitch me for it. And my G.P. has never met a prescription he didn't like - we call him doctor pusher because of his fondness of sending you away with at least three scrips and a handfull of sample after every visit. Hell, the pharmacy once refused to fill one of his scrips because it was too many pills! I keep wondering if he's on some crazy incentive plan.

Meanwhile, back to the eye doc and my enlarged whatchamacallit. She wants me to come back in a year for an exam with their specialist to make sure that I'm still not at risk for glaucoma and to take more pics of my eyes. OK, but didn't you get enough already with the $35 gizmo. Oh no, that doesn't take the right kind of pictures - but they do have a new machine, made in Germany, that does take the right kind of pics. I wonder what I'll find on the manufacturers web site if I google it?

I put on my shades, squint my way into work, and get on the phone to Bonnie. She tells me that she'll get me the referral, but that it's hard copy, not electronic. Huh, where did I ever get the idea that it was electronic? So she'll put it in an envelope in a drop box outside the office and I can pick it up on my way home from work. I swing by after work and pick it up, and what do you know? There's other stuff in there. First, a note telling me about the new 5 day notice policy on referrals. Oopsy. Second, forms for some blood tests and a note telling me that since it's been two years since my last visit, I'll need to get the tests done and schedule a follow up visit with the doc, or they will have to archive my files and they won't be able to give me any more referrals. Huh.

So here's the bottom line out of this long meandering tale - is this stuff all for my benefit, or theirs? I'd like to think that the doctors only concern is the well being of their patients, but I am very uncomfortable with some of the stuff that they do. I mean, come on! Wrinkle cream? Thinly veiled blackmail so I'll schedule a visit? (Please pay the additional co-pay on your way out, thanks!) This is all just more symptoms of our screwed up health care system. It's really time for change. Long past time.

Wednesday, February 14, 2007

No More of the Hapless Victim Routine!

OK, this post has been building in me since last week. It's an elaboration of a comment I made on Big Brass Blog in response to a post by Chet Scoville. The pseudo-controversy over the Edwards campaign hiring two people who were bloggers has finally come to a conclusion, with Amanda of Pandagon and Melissa of Shakespeare's Sister resigning. This saddens me for the lost opportunity for two good people, but it also has me completely fed up as well. So here goes.

Mr. Edwards, you have lost my vote. You have plenty of time to regain it, but I am dubious that you will be able to. The reason could have been the way that you tiptoed your way through the recent controversy, but that wasn't it. It could have been that you chose to apologize, and had Amanda and Melissa apologize, but that wasn't it. Here's the thing - if you aren't capable of defending yourself or those who work for you from low class bullies, you have certainly given me no confidence that you are capable of leading our nation. Hell, you weren't even able to stand up for yourself, Amanda and Melissa in a battle of words; you certainly don't appear up to the task of making Amanda and Melissa feel secure in their persons or families against the threats of death and violence that they have been receiving. And that's why you will lose!

Say what you will about President Bush (he's stupid, obstinate, arrogant, dishonest and incompetent, but I digress), at least he has shown that he will stand up for the people who work for him. This is true even long after the jury has come in about them. Witness Donald Rumsfeld's tenure. This makes Bush appear to be a stand up guy. He and Dick Cheney have no problem getting out in front of the media and fighting back against any accusation or negative comment made about them - even if it's true! Watching the Wolf Blitzer interview where Cheney denies having said things in the past which he most certainly did, and telling Blitzer that discussing Mary Cheney's pregnancy is out of line, which it most certainly is not, you can see how they play the game. Poor Wolf was left stammering. They can stand up to media critics successfully, even when they are patently wrong!

Time and again, Democrats have been the hapless victims of right wing thugs and a biased media. You know what? Hapless victims don't win. You certainly are deserving of, and do receive sympathy. You just don't receive sympathy votes. Nobody ever gets sympathy votes. You get votes because you convince people that you have the cojones to lead! In 2000, when the right wing thugs sabotaged McCain's primary campaign in South Carolina by accusing him of having a biracial child out of wedlock, he could have kept going if he fought back like hell, but he didn't. And in so doing, he lost. In 2004 when the right wing thugs did the same to Kerry, the infamous "Swift-Boat Vets," he could have fought back like hell, but he didn't. And in so doing, he lost. This is where things like false accusations of scandal or dishonorable conduct succeed - not in that the accusations are false, but that you don't fight back!

Here's a great idea: from now on, any and every Democratic candidate, officeholder, and spokesperson, upon encountering an example of the right-wing hit machine doing its thing, don't waste your time explaining and defending yourself. Instead, immediately point out that this is an extremely partisan player once again performing a hit job, and that the media giving this person air time is yet another example of "Right-Wing, Fox News Type Bias" or "Right-Wing, Fox News Bias." All caps. Repeated as loudly and as often as possible, and in every instance of any wingnut doing another hit job. Make absolutely certain to include the Fox News reference between the words "Right-Wing" and "Bias." We want Fox News to become synonymous with bias. This is exactly how the right wing hit machine works, and it has proven very effective.

So when Nancy Pelosi is accused of ordering a large luxury jet for herself to travel in, the correct response is not to defend herself from the charge. The correct response is to say this, and only this: "It is outrageous that the media is giving air time to such an outrageous and obviously false story. This is yet another example of Right-Wing, Fox News Type Bias." And that's it. No further comments, no explanations, just that. This leaves the media with just this tape to run. Nothing else. They can't cut out the parts they don't like, and leave in the ones that support their spin. They either run with this, or they go with no tape at all, just talking heads in front of a photo giving their own spin.

Of course, Fox will go ballistic about being referred to this way. They will respond with the talking heads in front of a photo, spinning furiously. However, since they are already a highly biased right-wing news organ, it's not like they weren't already going to do as much damage as they could. Just look at the "Barack Obama went to a madrassa" debacle. I can't imagine anyone daring to attempt that with Bush or Cheney - certainly not since Dan Rather destroyed his career with the false evidence of Bush failing to fulfill his Air National Guard obligation. And yet, I haven't heard of any repercussions of the false Obama story.

So, seriously, to all you Democrats out there - stop rolling over for the right wing hit men. Regardless of the bloggers working on the Edwards campaign, Donohue was never going to vote for or endorse Edwards, ever. Neither was Malkin. Responding to their machinations in any way other than pointing out that they are highly partisan cronies without a shred of credibility does you little if any good. So take back some control of the discourse!

At least you will look like you have some backbone! And that will get votes!

Update: Jeffrey Feldman has a post which is far better than mine, and is well worth the read.

Friday, February 02, 2007

The Cat is Under the Table

She haunts my dreams, this cat. She obsesses my waking hours. She consumes my thoughts. Who is this cat? Why is she under the table? Does she simply vant to be alone, or is she up to something much, much more sinister. I need to know. "The cat is under the table" the voice drones. "Die Katze is unter den tisch." "Die Katze is unter den tisch." "Die Katze is unter..." But I digress.

We're going to Germany in a couple of months. I've bought some learn-German-in-90-days software. So far I've learned how to say great things like "The dog is in the airplane", "The girl is running" and "The boy is on the horse." Money well spent, nicht?

I keep wondering when I'll get to the really useful things. Things I'll actually use. Important things. Things like "The strudel tastes like ass. Please refund my money", "Thank you, but I do not wish to view your schei├če video.", "I would like to procure a blow-job please." and "I'm sorry Officer, my German is very bad. What I really meant to say was: 'the cat is under the table'."

What do you think would happen if I walked up to a Berliner, with a big grin on my face, hand extended and said "Die Katze is unter den tisch?" Would they back away slowly, smiling and nodding, frightened, trying not to excite me? Would they pat my head and smile patronizingly, thinking "it's nice we leave people like this in our country." Or would they nod solemnly, recognizing me as one of their own, a member of the cabal, and let me in on the secret? The secret about what that damn cat is really up to. But I digress.

Aqua Teen Hunger Farce

I don't know if everyone has been following the great Aqua Teen Hunger Force debacle in Boston. For those of you who don't know, ATHF is a bizarrely surreal cartoon on Adult Swim, the evening adult part of the Cartoon Network's programming. The short version is that there was a guerrilla marketing campaign launched a couple weeks ago to promote the upcoming ATHF movie, and in Boston, they discovered the black battery powered ad thingies which looked like mini Lite-Brites. I saw a post linked off of BoingBoing, and was really amused by another video post I found there. Enjoy!

To date, this post on the Huffington Post the most level-headed post I've read about the incident: Another Reminder, They've Won. Meanwhile, while I sometimes watch ATHF, guilty pleasures being what they are, I'm much more entertained by Morel Orel and The Venture Brothers. Thank God for ReplayTV - those shows are on late!