Cool, I have health insurance. Now what?

In My Humble Opinion
21

Thanks all for the replies. I still haven’t called anyone (or a dentist–I need one of those too), but I’ll get around to it.

A long time ago when I scheduled an appointment with a doctor, I scheduled a “physical”, but when I explained what I needed in order to be allowed to live in graduate housing, the doctor said, “oh, you just want a check-up then.” I guess there’s a difference?

And yes, the main reason I’m doing all this is that I want to have somewhere I can go if I get sick. It rarely happens, and I haven’t seen a doctor about it for 6 years or so, and that was just a minor “hmm, no, you’re not dying. If you’re still feeling like ass in a few days let us know” sort of thing.

22

[QUOTE=norinew]
Would you care to elaborate on why you think an annual physical is a bad idea?
[/QUOTE]

People tend to look at something like that in a vaccuum. . .

We ask, “Why do we need an annual physical?”

And answer, “because he might notice something that wouldn’t otherwise be detected which will SAVE YOUR LIFE.”

We give no weight at all to the questions:

How much are those physicals costing us?

How often is something serious actually detected?

How often is something prescribed coming out of those physicals due to the marketing of the pharmaceutical industries?

Even if a doctor finds something wrong (high cholesterol, e.g.) is there really anything he can tell you that you didn’t already know about your diet & exercise, and does a prescription he’d offer really do what it is supposed to do (e.g. does lipitor just reduce your cholesterol or does it actually reduce your odds of having a heart attack or arteriosclerosis?)

We act like there’s no cost too high to pay for the remote possibility of a doctor finding something bad. But, people just don’t vocalize my side. There’s no money to be made from it – there’s no edge to arguing it. You’ll be opposed by an industry. To be sure, a lot of people believe it. A lot of people act my way (especially men). They just say things like, “I forgot to go” or “I don’t have time”. Really, if it was important, they’d do it.

All we’re at is an arbitrary level that we’re comfortable with. There’s nothing special about the annual care we receive.

1 year?

I say 6 MONTHS!!!

And, I say breast exams for men, complete CT scans for everyone! EEGs and EKGs!!

If they could convince us of that. . .they would, and people would say, “you haven’t had your bi-annual month CT scan, what’s wrong with you?”

They’ve just found that sweet spot where they get to continue to make money, and we’re comfortable with how much they’re siphoning from us.

23

[QUOTE=Trunk]
How much are those physicals costing us?
[/quote]

Mine cost me a $15 copay. $15 a year is a reasonable price for being checked out to make sure there’s nothing developing.

How many times does somethign serious have to be detected under your equation?

This is a serious question but has more to do with the ethics of the pharmas than the utility of getting a physical.

I was recently diagnosed with high blood pressure and my doctor exploded a number of pieces of misinformation I had regarding diet and blood pressure. The med he put me on (which I believe is generic) has lowered my blood pressure. Generally speaking, the fewer precursors of an illness or condition one has, the greater the chance becomes that one won’t develop that illness, I would think.

There has been anecdotal evidence presented in this very thread that something “special” can come out of a routine annual physical.

Ah, the monolithic THEY. Do you have any supporting evidence for the position that “they” (whoever this particular “they” may be) suggest annual physicals out of greed rather than concern for the health of patients?

24

[QUOTE=Trunk]
People tend to look at something like that in a vaccuum. . .

We ask, “Why do we need an annual physical?”

And answer, “because he might notice something that wouldn’t otherwise be detected which will SAVE YOUR LIFE.”

We give no weight at all to the questions:

How much are those physicals costing us?

How often is something serious actually detected?

How often is something prescribed coming out of those physicals due to the marketing of the pharmaceutical industries?

Even if a doctor finds something wrong (high cholesterol, e.g.) is there really anything he can tell you that you didn’t already know about your diet & exercise, and does a prescription he’d offer really do what it is supposed to do (e.g. does lipitor just reduce your cholesterol or does it actually reduce your odds of having a heart attack or arteriosclerosis?)

We act like there’s no cost too high to pay for the remote possibility of a doctor finding something bad. But, people just don’t vocalize my side. There’s no money to be made from it – there’s no edge to arguing it. You’ll be opposed by an industry. To be sure, a lot of people believe it. A lot of people act my way (especially men). They just say things like, “I forgot to go” or “I don’t have time”. Really, if it was important, they’d do it.

All we’re at is an arbitrary level that we’re comfortable with. There’s nothing special about the annual care we receive.

1 year?

I say 6 MONTHS!!!

And, I say breast exams for men, complete CT scans for everyone! EEGs and EKGs!!

If they could convince us of that. . .they would, and people would say, “you haven’t had your bi-annual month CT scan, what’s wrong with you?”

They’ve just found that sweet spot where they get to continue to make money, and we’re comfortable with how much they’re siphoning from us.
[/QUOTE]

Well, I’ll leave it to someone who doesn’t have chronic health problems to debate this with you. I’m sure there are a lot of relatively healthy people who believe in seeing a doctor regularly. I don’t have that luxury. The fact that my kidneys suck means I get to see doctors way more often than once a year. :frowning:

Well, on second thought, just disregard that frownie-face. I get feeling sorry for myself sometimes, though I really am glad we have good health insurance, and I’m even more glad there’s not something more serious wrong with me than troublesome kidneys.

25

I don’t need it. They do. They need to show me that it is medically-effective and cost-effective for that frequency of check-up. Not through a PSA that says you should. That’s an advertisement, not a medical study.

Your post (and others in this thread) has that air of “deference to authority” that permeates this industry. People think medicine is a science. I’d call it 1/3 art, 1/3 business, 1/3 science. Maybe weight that “business” part a little more.

People don’t realize how much of the industry is based on statistics, not truths. And, the job of the marketers is to get you to worry about the rare negatives of your risks, and get you to ignore the negatives of their treatments (costs, drug side-effects, surgery side-effects). One of the greatest tricks of the insurance industry is to get you to not realize what you’re paying for stuff (like you’re $15 copay).

It eventually boils down to is tolerance for risk. What is really going to hurt me if I go every 5 years versus if I go every 1 year? They get numbers for your RISK FACTORS with these visits. Long term risks for various diseases. You don’t go from normal blood pressure to heart attack in a year. They’re not catching and preventing your pancreatic cancer because you went every year instead of every 5.

And, individuals have no intuition for this, so we rely on the people who make money off us to tell us what to do. They get away with it because of the DOCTOR as GOD meme that the industry, and society, perpetuates.

26

[QUOTE=Trunk]
What is really going to hurt me if I go every 5 years versus if I go every 1 year?
[/QUOTE]
It’s been over 6 years for me. That’s why I started this thread. I’d like to know about my risk factors. A lot can change between 20 and 26.

27

[QUOTE=Trunk]
I don’t need it. They do. They need to show me that it is medically-effective and cost-effective for that frequency of check-up. Not through a PSA that says you should. That’s an advertisement, not a medical study.
[/quote]

No, see, for the purposes of this thread, you’re making a positive assertion, that “they” (whoever they are, that’s still not really clear) are advising yearly physicals for reasons other than the health of patients. You’ve made the assertion here. Back it up, if you can.

See, this is a very different proposition than what you’ve said before, and I agree with your assessment that it’s about risk tolerance. However, I would like to see your medical credentialing or other supporting evidence for the notion that medical conditions can’t or don’t change rapidly.

No, we rely on the people who have spent years in study, training and practice. Just like those of us who don’t possess any given skill set seek out those with that skill set if we need something done that requires those skills. Whether or not society or whoever sees doctors as God (and we’ve all heard the punchline “God doesn’t think he’s a doctor”) seems less than relevant to the fact that it is the doctors who possess the skill set for performing medicine.

28

[QUOTE=Otto]
No, see, for the purposes of this thread, you’re making a positive assertion, that “they” (whoever they are, that’s still not really clear) are advising yearly physicals for reasons other than the health of patients. You’ve made the assertion here. Back it up, if you can.
[/quote]
It’s not something that has to be.

You and them are making the claim that a yearly check-up is necessary for your health. What’s their measure?

The question they need to ANSWER is : what terrible things are going to happen to me in 2 years that they could have detected if I didn’t skip a year AND are those terrible things worth the additional cost of going every year?

So, they discovered my BP went from 120 to 140? It would have been 130 if I came in last year and the doctor would have said, “keep an eye on your salt intake” but it’s not bad right now. So what. . .we’re taking about a risk factor for something that might affect me 20 years from now. Was that worth the hundreds extra in health care costs?

Right. Like you rely on a realtor to tell you that right now is a good time to buy.

And you rely on a dentist to tell you to get a check up every six months.

And you rely on a bartender to tell you you could use a drink.

If we didn’t hero-worship doctors, you’d take it like you take the rest of those recommendations.

29

[QUOTE=Trunk]
You and them are making the claim that a yearly check-up is necessary for your health. What’s their measure?
[/quote]

I’m not claiming that an annual physical is “necessary” for my health. I’m saying that an annual physical is a reasonable part of overall health maintenance. You are claiming that the suggestion of an annual physical comes from a place of greed. I would like you to offer some support for your position.

Actually, if you went to my doctor, he would have told you that unless you’re African American, there’s been little to no connection demonstrated between sodium intake and hypertension. One of the bits of misinformation he exploded for me during my visit.

Two of these three attempted comparisons convince me that you are talking out of a place where your words could best be heard by a proctologist.

30

[QUOTE=Otto]
Two of these three attempted comparisons convince me that you are talking out of a place where your words could best be heard by a proctologist.
[/QUOTE]
And that indicates to me that you’re far too enamored of “authority” for you to ever get what I’m saying.

31

[QUOTE=Trunk]
And that indicates to me that you’re far too enamored of “authority” for you to ever get what I’m saying.
[/QUOTE]

Uh huh.

Just because I disagree with you doesn’t mean I don’t or can’t understand what you’re saying. Believe me, what you’re spouting is completely understood on this end. I just think a goodly chunk of it is bullshit, that’s all.

32

<mod>

TWEET!

Time out you two. Keep this semi on-topic, please. Your vitriol is showing and no one wishes to see your vitriol in an IMHO thread.

Take it to the Pit or GD.

</mod>

33

[QUOTE=Trunk]
I don’t need it. They do. They need to show me that it is medically-effective and cost-effective for that frequency of check-up. Not through a PSA that says you should. That’s an advertisement, not a medical study.

[/quote]

How old are you? The answer of how long between checkups varies a lot between 20 and 50.

I don’t know the percentages, but medicine has made a lot of progress even in my lifetime. In 1962 my father, who was fairly young, was in the hospital for months with a clot. Two years ago, at 90, he was in the hospital for two days with a more serious problem. Medicine has made measurable improvements. I could go on and on.

When you are dealing with large numbers of people with a lot of variation, you have to use statistics. Who is ignoring risks? Ever look at a PDR? And when I had surgery the potential problems were very clearly spelled out.

I went from normal to fibrillation in a matter of weeks. I know because it showed up in my pulse which got tested just weeks before the person taking my pulse before donating blood found the problem. This is not to say you need to get checkups very frequently, but that things may turn up faster than you think.