The pandemic has highlighted just how broken our healthcare system is, and Dr. Andrew Carroll, MD has had enough of it.
"I think I'm finally broken." Dr. Andrew Carroll, MD posted on Twitter last week. "Insurance company denied a CT Chest on a young woman with post-COVID syndrome. And while describing why I wanted it, I broke down in tears." The doctor is the Board Director of the American Academy of Family Physicians. In his tweet, he was expressing the frustration he felt with the state of American healthcare. Unlike most modern, developed countries across the world, the United States is one of the only nations that are yet to establish a universal healthcare system. His tweet, of course, went viral, as thousands of individuals related to his exasperation.
Dr. Carroll continued, "It's too much. We want to do the right thing, and st*pid rules keep us from being effective for our patients." For those unfamiliar with how the US healthcare system can keep people from accessing the resources they need, not only is medical assistance incredibly expensive, but it also bridled with what seems like neverending paperwork. The doctor's tweet currently has over 18,000 retweets and more than 101,800 likes on the social media platform. In the replies, folks made suggestions regarding potential paths forward for Dr. Carroll and his patient.
One Twitter user asked, "Are you able to order it for her regardless? Does she have to pay for it upfront or will she be billed?" To this, he stated that he was asking his patient to get the chest x-ray her insurance company wanted to get done first (which would undoubtedly lead to more expenses and more radiation than necessary) before she can get the CT scan paid for so that he "can help give her a roadmap to recovery." As a means to get around this, several folks noted Health Insurance Portability and Accountability Act (HIPAA) guidelines that the doctor and/or patient may have found useful.
"Under HIPAA, if you are refused medication, tests, or surgeries, you have the right to the names and credentials of the insurance board that made the refusals," another Twitter user suggested. "Usually, after the information is requested, the decision gets reversed... It works. Good luck." Other doctors also weighed in, sharing similar experiences. Dr. Victoria Dooley posted, "I usually say, 'Give me somebody who can approve this now and save money. Because if you don’t, I’m sending them to the ER and I’m going to tell the patient exactly what to say to make sure no competent physician will let them leave without a CT. This will cost you more money.'"
However, the most poignant takeaway of the conversation that ensued on Twitter could be summarized by the following tweet: "In the United Kingdom, if she were the Queen or a homeless person, she would get the scan because we have a National Health Service for which we pay far less per head than the US. [I] needed a doctor for my daughter today, and a couple of hours later, antibiotics. No charge. Why doesn't the US do this?" The answer perhaps lies in the United States' unfettered relationship with capitalism. Although former President Barack Obama attempted to implement a universal healthcare system within the US, the program did not take off as planned. The question remains whether President Joe Biden will be able to complete the job he started as Vice President over a decade ago.
#COVID19 vaccine soft-launch today. 92yo, 80yo, 78yo, and 76yo. It feels GREAT immunizing my community and my patients. Patients trust their doctors, please give us the vaccine!— Andrew Carroll, MD (@drcarroll) January 26, 2021
Ironically, these couples are the Wolfs and the Fishes! 😄
Photos, names and ages by permission. pic.twitter.com/BBZEghZrHF