The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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In lieu of something actually interesting (We're nearing "Three months on a bootleg Chinese GLP" and "10 months in a trucking office"; the latter has potential.), I present an update on [my bum elbow].
A month later, and four doctor's visits (one urgent care, orthopedist No. 1, CT scan, and orthopedist No. 2) later my HSA is soon to be some hundreds of dollars poorer (On that note, why does every practice seem to have its own app, and how do I even find what I owe after the insurance discount to pay it? Is someone going to mail/email me a bill at some point? I'm used to just paying urgent cares cash up front like a pleb.), my elbow thoroughly scanned and X-rayed, and the answer is about what I thought it was, something along the lines of "not great, not terrible".
"Wow, that's an ugly elbow. Can you move that thing?", the nurse for ortho No. 1 remarked upon seeing the X-ray with a tone of bemusement that I found charming. The urgent care doc had supplied a decadron shot and prescribed some variety of steroid shots for the road as expected, but referred me to his buddy at the local ortho clinic to try and get to the bottom of my elbow seemingly going on strike at random. Both ortho appointments were remarkably short and the questions remarkably repetitive, be they from the screening nurse or the doctors themselves. One wonders if anyone takes notes given how many times I had to answer "Why are you here?". "function normally limited but not intrusively bothersome, flare ups ranging from annoying to seriously intrusive and crippling, flare ups have become more frequent and severe with age". Ortho No.1 was more gung-ho about arthroscopic surgery. Ortho No. 2, apparently the "elbow guy" (Why didn't I get the elbow guy the first time?), was more conservative, advocating a "wait and watch" approach.
The verdict: Yup, the joint has lots of arthritis, the cartilage is gone, and there are some bone fragments floating around that might be catching and causing range of motion issues. Some nerve damage/muscle atrophy is visible on the left hand. That said: if it doesn't get much worse doing nothing might be the correct answer here. The bad news is that we're unlikely to achieve serious improvement with surgery (No lifting weights for you!). The good news is that it probably won't get much worse or at least won't get worse quickly and if the situation does degrade we can probably get you back to "not great, not terrible" with a scalpel.
Here's hoping this has just been an anomalously bad spring, things will stabilize, and I'll have forgotten about this by the time its solidly summer. I do know that traveling up north for Easter, driving through a big storm, and then smack into a major cold front was most likely the faux pas that provoked the latest flare up.
In advance, you just don't. I mean, you eventually will, when the bill comes, but before that, it looks like our civilization is not advanced enough to find an answer to this question. That's one of the infuriating things in in US medical system - everything is set up to make it nearly impossible to state the cost upfront, or at least everybody involved in the system has been telling me so for years. Of course, this has a great benefit (for the providers involved) of precluding any price comparisons.
Yes, sometimes several bills, because why make it easy for you, what you are going to do, not use medical services? And yes, those several bills may be from several billing systems, each set up differently, and not talking to each other. Some don't even have online payment options. A lot of medical billing is surprisingly low-tech still.
Weird thing they actually do - at least the system I'm with now, you can see the visit notes afterwards, and they actually record pretty much everything. Whether or not anybody reads it afterwards is an entirely different question.
Sorry about your elbow.
I suppose I should just say it. I know you implied it, but someone should just say it directly. This thing that everybody involved in the system has been telling us for years... that the system is not advanced enough to find an answer to this question... is a lie. The people involved have the numbers that are required. They can just give those numbers to patients. When this is pointed out, they will lie and misdirect and do everything they can to throw up fake and imagined roadblocks to this very simple reality, to the point of playing dumb/lying about whether they are even capable of identifying the names of the numbers in question. It is the great shame of the medical industry that they have harmed so many patients by their addiction to price opacity. I've pointed before at pieces like this where they talk of patients making choices to not get care because of price opacity or situations where because talking about prices is verboten, the doctor might prescribe an expensive drug that the patient won't buy, but could have prescribed a cheaper, almost as good, drug that the patient could actually afford and would buy. I don't know how one would even estimate the number of times that people simply suffer through problems rather than seek medical help because of price opacity. They feel like if they even consider seeking medical help, they will never have any further chance to consider the cost involved. The perception is that if they do it, they're basically spinning the roulette wheel and then will learn after the fact, after services have been rendered, whether they will owe $10 or $10k. It's unsurprising that many reasonable decisionmaking-under-uncertainty-and-budget-constraint algorithms just opt out of that game of roulette.
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While this is annoying it's actually better than the alternatively, usually when you get separate bills it mean you are getting one from the physician, the health system, and the lab or something else similar to that.
Why not consolidate?
Well some places do and then you have a monopoly with resulting problems.
Separate bills means separate entities which slightly keeps what little of free market economics you can get in healthcare.
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