About turtledove


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Registered May 19, 2010

turtledove's most recent comments:

  • On Wed, 30 Sep 2015, 9:08pm PDT in Sweden going to a six hour day, turtledove said:

    tovarichpeter says

    the 6-hour workday

    Okay..... but only if they can earn a paid week off for every month worked and have guaranteed retirement benefits set to their highest salary ever earned paid to them beginning at age 50. Fair is fair.

  • On Wed, 30 Sep 2015, 6:09pm PDT in Study: Obamacare is working in California, turtledove said:

    Ironman says

    The big question, did she write that check out of the $2,500 savings her family got on her Obamacare policy?

    This situation is actually pretty sad. This woman got Essure a few years back. These are contraceptive coils that the doctor can insert into the fallopian tubes. These devices were very heavily marketed to military and Medicaid participants, FYI, and has recently been in front of the FDA due to all the problems... Anyway, the inserting doctor fucked up the insertion. She has a coil embedded into the uterine wall. Basically, he shot it and misfired. The woman is in pain and having all kinds of problems. She wants them out, of course. She's been told by her Covered California generalist that the only way to get them out is with a hysterectomy. This is not necessarily true if you go to a reproductive specialist. So, she found us. As an in vitro fertilization clinic, we do surgeries all the time with the primary goal of saving the reproductive organs. We've removed these devices many times (often complex cases) without having to do hysterectomies. Yet, when she went to her truly in-network provider, he wanted to take everything out. Just so you know, this is a very common tale.

    She was pretty upset when she found out that her supposed in-network specialist (according to the Blue Shield provider directory) isn't really in-network for her particular plan. Talk about misleading. So, we're doing the surgery for what I would get back according to the network agreement - had we actually been in-network. We can't work for free. So, I gave her the option to pay the in-network reimbursement amount of about $1,700. It's the best I can do. So, she pays her premiums... and now she pays for the surgery herself. It makes no sense. Why the special carve-out for "covered CA" plans? Either we're a Blue Shield provider or we aren't. It isn't health insurance when you are denied needed care when you need it most. Goes to show you can mandate insurance, but that doesn't guarantee care.

    So, here are her choices. She can have her in-network generalist doctor do it and be put into menopause at age 30. Or, she can pay $1,700 and have us do it and keep all her organs. Her insurance has cast its vote.... and it isn't in her best interest. She opted to pay for it herself rather than be forced to have a hysterectomy -- because hysterectomy-- only -- is what the insurance company is willing to pay for. Whatever Obamacare savings she may have had will be blown on this... that's for sure.

  • On Wed, 30 Sep 2015, 2:56pm PDT in Study: Obamacare is working in California, turtledove said:

    Covered California is especially awesome! Just had to tell a patient that in order to have her surgery (highly specialized -- she can't go just anywhere) that she will have to pay out of pocket because even though we're in network with Blue Shield... we are NOT considered in-network if it's a "covered CA" plan, which hers is... So there you go. She already pays for her premiums. And a few minutes ago, she wrote me a check for the very healthcare she was supposedly guaranteed by that ever-elusive promise of healthcare.

    BayAreaObserver says

    Obamacare could shift many hundreds of millions in claims to workers' comp insurers, especially in California.

    They should take a lesson from Aetna. They assume the need for any procedure that's done might be due to an accident. They've been holding onto a payment for two months making sure that our patient didn't possibly suffer a slip-and-fall that might have resulted in her contraceptive coil device migrating from her fallopian tubes into her uterine wall. I know -- I hate it when that happens.

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