Monday, April 20, 2015

affordable Care ?

A friend of mine is waiting to get a physical exam.  She enrolled in an ACA HMO policy this year, I think it was February.  She is having to wait until July.  She is worried about her heart.  She has been paying $360 per month and hasn't seen anyone yet, despite two attempts.  Last time she was down to the clinic in hope of getting seen, she saw lots of pamphlets about free tests for poor people.

Meanwhile, I have a reasonably good company policy, and I've been talked to about going through another battery of likely unnecessary tests to continue getting my statins refilled.  Last time, 8 years ago, I went all the way, from radiological treadmill to ultrasound to cardiac catheterization.  In the end the finding was squeaky clean.  I've never had any serious symptom (I complained once about multiple beats) and heart disease hasn't been the family problem (both of my parents died from cancer).  I am somewhat overweight but I avoid stress and have low blood pressure.  This year my doctor saw me in her office to tell me about getting more tests the very day I called about getting my statin refill.  I am grateful she let it pass this many years (I think she's been telling me to go back to the cardiologist several years in a row now).  I am not worried about my heart, though I think statins are helpful (they do improve my cholesterol numbers fwiw).  I have heard a lot of claims that statins are not even helpful, high cholesterol is a phony problem, and stents (what might have otherwise been the outcome of my cardiac catheterization) are less then helpful as a precautionary measure.  While I still think statins are helpful, I suspect they don't help very much.  I'm more worried about the downside to the escalating examination/treatment treadmill than losing the benefits of treatment which is not symptomatically demanded.  Last time, during the cardiac cathertization they used a newly approved metal closure--for which I gave permission as I was on the operating gurney.  If I had had a chance to check it out, I would have insisted on the old fashioned method.  That cardiac catheterization cured me of any desire to have any more testing or treatment that doesn't seem to me to be absolutely necessary.  On top of it all, my policy wants me to sign up for an additional "wellness coach," and I'm not responding to that.

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