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Tuesday, July 13, 2010

Whose Case Is It Anyway?

Well, now I know why the doctors I've been seeing about my spine haven't been giving me advice on how to manage my problems.  Seems that the neurologist now considers herself to be operating solely in an advisory capacity to the neurosurgeon, but she didn't mention that to me.  Also the surgeon moved his practice from Providence St. Vincent Hospital to Legacy Meridian Hospital (different health systems and provider networks, of course), and that's the first I've heard of that, also.  So it looks like I've fallen through the cracks.  Time will tell, we've got messages in to the surgeon's new office asking what my status really is.

Oh, and quite by accident, this won't affect my health insurance situation.  If I were staying on COBRA it would, since that coverage makes Providence a preferred provider network; anything done at Legacy costs me an extra 20% of the invoiced amount (which has been a problem because the neurologist is at Legacy Meridian).  But as of the beginning of this month my COBRA coverage has expired (thanks, Congress), and I'm going on the Oregon Medical Insurance Pool.  Coverage won't lapse, but I have to wait for the paperwork to be done and my coverage info sent to me before I can get it to the providers.  I believe the OMIP coverage will be the same for both providers (at least I hope it will; Providence is more convenient for a lot of things, and I like the hospital itself better).

It's interesting to compare this situation with the therapy Eva is getting for breast cancer prophylaxis.  There is a single person who is her case worker whose job it is to coordinate therapies and doctors, and to make sure that she knows what's going on, and that everyone is singing from the same page of the score.  And all the health professionals go to great lengths to keep it that way.  I think everybody should have a case worker, for all health concerns.  I did a rough back of the envelope calculation: Eva's caseworker says she's carrying 300 active cases; for everybody to get one (and assuming an entire family gets the same caseworker, which makes sense to me) means we'd need considerably fewer than a million caseworkers nationwide.  I bet we could train that many of the currently-unemployed to do the job in less than a year.

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