6 min read

I need to tell you about Dr. Death

I expected more from Pacey!

Thanks for reading this weekly newsletter supported by folks like you. I have been writing this for over two years and in the spirit of self-care, I need to take a short break. Like, until the end of August. With the addition of going on tour in October, my projects have bottlenecked and I need some time to catch up on the things I owe subscribers. I think of it like a working vacation. I'll be back in September with a bunch of new things, better than ever. Thank you for understanding and not unsubscribing!

Until then, you can follow my art practice over on Instagram, and if you're in Los Angeles you can come see me (and Cass!) at Unique Markets on August 28 and 29 in DTLA.

I'm also playing an outdoor show in San Diego on August 15 at Green Flash Brewing (originally supposed to be at the Casbah but it has been moved to an outdoor venue!). I was very excited to go see one of my favorite bands, The Arrivals, the night before which would've been my first live show since the flip flop but the event organizers are not asking people to be vaccinated or trying to keep people masked indoors so quite frankly, fuck that. In this particular moment in Los Angeles, that's irresponsible and lazy and I am not here for it. I love the Arrivals and I hope they have a great show and also that no one gets COVID.

illustration by Lauren Denitzio

Before I sign off for a month, I wanted to talk about the podcast, tv drama, and documentary series Dr. Death without any spoilers, because there are some important takeaways from the story that don't involve hyperbole or extreme fear. Even if you know nothing about the backstory, obviously it's about a horrible doctor. A horrible doctor who took entirely too long to be stopped by the medical board. That's really all you need to know for what I'm about to say.

Odds are you'll never be treated by a willfully awful medical professional, and I'm not suggesting that you start being scared to trust your doctor. However, with the way the medical system is set up in the US, I don't think everyone understands the ways that you can and should make sure you're seeing the best doctors possible. The only way you can do that is by having insurance that covers those doctors and hospitals.

Didn't think this newsletter was about doctor stuff, huh? Well, your friend here has more experience in that department than I wish I did and this very much falls under the heading of "Getting It Together."

Don't pick a doctor by internet reviews

After watching Dr. Death, it seems to be the case that word of mouth brought him many of his patients. He had a great website, video testimonials, the whole nine yards. But he was pretty young, and without that many surgical cases under his belt. You can't fault anyone for believing the hype because patients are not taught to advocate for themselves or to do additional research. You can't fault anyone for falling for good PR.

If you're going to see a specialist, please don't pick someone just because they pop up first on ZocDoc or a hospital's website. It's usually pretty easy to see where they were trained, how many years of experience they have, what medical journals they've been published in, etc. So when you have a choice, why not find the person who is the most experienced or most specialized in your issue? A hospital may put someone on a billboard but that doesn't mean they're the right doctor for you.

Again, the likelihood of you accidentally seeing a truly terrible doctor are slim, but who wants to be treated by a mediocre oncologist? When it comes to a major diagnosis or surgical recommendation, always get a second opinion.  

You need health insurance.

All of this is really dependent on having health insurance. If you don't have health insurance but can afford it, get it. If you don't think you can afford it, look into it on healthcare.gov anyway, just in case, or see if you qualify for Medicaid. I cannot emphasize enough how much one emergency surgery without health insurance could mean instant bankruptcy. This is the system's fault, not yours, but it doesn't change the reality of the situation. If you need to see a specialist but don't have health insurance, odds are you're shit outta luck (unless you're independently wealthy, in which case the rules don't apply to you anyway).

For example, I have a heart condition and needed to be seen by a cardiologist every 6 months. Not just any cardiologist, but someone who specialized in my condition and who could tell me when it was time for surgery. I couldn't pay for those visits or surgery without insurance. Because my surgery wasn't an emergency, I wouldn't have been able to have it without insurance. Not like "it would've been too expensive" but as in I would've shown up at the hospital and they would've told me to go home. If I didn't have insurance and just waited until it became an emergency, I probably would've died. AMERICA!

The network really REALLY matters

Whether you have health insurance through your employer, through the public exchange, or you buy it privately, the network of doctors that are covered is very important. This network varies from plan to plan. Specifically, plans on the exchange very often do not cover major hospitals or the most sought-after doctors.

Let's say you go to the website of the best private hospital in your area and they list "Health Insurance Company X" as being accepted. You think, ok, the insurance plan I have through the exchange is Health Insurance Company X, awesome!

NOPE! NOT NECESSARILY! Your specific plan with that insurance company might not cover that hospital. For example, almost none of the insurance plans offered through the exchange in Pennsylvania, New York, and California are accepted by the highest-ranked major hospitals. Those hospitals are out-of-network. If you check the private plans or plans offered through employers though, those hospitals and doctors are in-network. It's fucked.

So when you're choosing a plan or renewing during open enrollment at the end of the year, check the network. Do some googling, figure out the best private hospital in your area, the best cancer center near you, the best ER, and see if that facility is in-network for your specific plan. If they're not, make sure you have options that you feel good about.

If you're currently followed by a doctor or really like your general practitioner (the person you go to for regular check-ups, if that's a thing you're able to do) make sure that any plan you're switching to covers them as well. Because, of course, just because an insurance plan covers the hospital where the doctor works doesn't mean it covers that specific doctor's practice! Isn't this fun?!

Fight for universal healthcare

None of this should be determined by health insurance. None of it. No one should be turned away because their employer picked a shitty health insurance plan, or because they got laid off and have insurance from the exchange, or because they just don't make enough money. I shouldn't have to be writing any of this. If you have never been laughed at by friends from basically any other country when they hear about these problems then you have never truly lived.

Health insurance companies shouldn't be for-profit institutions that can charge whatever they want for premiums and negotiate how much they're willing to pay hospitals. We're in the middle of a global health crisis and the fact that anyone should have to consider how they can pay for COVID treatment is shameful. Obviously, this makes me really angry, and I'll stop here before I give myself a panic attack, but for the record, I would GLADY pay a few hundred dollars more in taxes every year if it meant I never had to pay health insurance or a medical bill ever again. What the actual fuck is wrong with people.