Costa Plenty

©2012 Edward C. Lunnon

Tuesday 31 January 2012: 5 years 4 months on … Deuce

Last week I wrote about the grounding of the Costa Concordia in Italy. I read recently that this mishap will become the largest maritime insurance claim ever. Costa Plenty!

Life’s like that!

Just when we think our life’s a cruise, the wind gets taken out of our sails. There’s no plain sailing. And every now and then we end up on the rocks.

Even being ill with one affliction doesn’t preclude one from getting another.

And so the last two weeks have seen a few more rounds of doctor’s visits and more pills and more medication.

Things seem to be getting better slowly – hopefully soon I will be feeling “OK” and will only have the CBD to contend with again. That, anyway, is an exercise of strength and survival. Sometimes, I feel like the captain of that ill-fated ship and wonder if it’s just not easier getting off this ship early – “falling into a lifeboat” as he so vividly described his leaving the ship before many of his passengers.

But for the meantime, I’m here till the end and have to handle what comes my way. And it all “costa plenty”, too.

Last Monday I went for my annual check-up.  The only reason I go for an annual is because I need a specialist report to send to my Insurers to inform them that I haven’t yet had a miraculous recovery. Other than that, I get ten minutes in which I do most of the talking, get a few yawns from the doctor, have my elbows and knees tapped with a silver hammer, flick my fingers and get to pay R500. R500 for 10 minutes equals a R3000 hourly rate. Costa Plenty!

Just as an exercise, I thought I would check around to see what the recommended rates are for such a visit.

I felt a bit uneasy phoning doctors to find out what their rates are. I don’t know why because that’s what we do with any other purchase we make – looking for the best deal. But somehow, we don’t seem to do that with medical services. It’s something that I think we have learned along the way. After all, doctors always do things in our best interest – or do they?

It was quite amusing listening to the responses that I got – from sheer disbelief that I had the audacity to ask such a question to plain rudeness that I even dare ask such a question! And, in between, a few splutters and excuses for not being able to share the tariff list with me. How unusual that anyone should ask such a question and how damn forward of me to even consider making such a phone call!

I then went to the internet to see if I could fare better there. After having googled a few times and coming up with different suggestions of reading material, I discovered that this was no easy task.

Understanding the acronyms, organisations, rules and laws that govern the medical profession in our country would take far more than my diseased brain to understand.

All I realised was that we have another organisation in disarray and that in the meantime we should just fork up and pay. And it would appear that the big guns running the medical industry right now are the medical aid societies. (* See note below)

In fact, the one receptionist told me that her doctor didn’t have a set tariff – it all depended on what the medical aid paid him as to what the charge to me, the patient, would be. It sort of reminded me that if you went shopping for goods at Woolies, the price would depend on whether you were paying by Woolies card, Mastercard or Visa – that your bank would determine the price of the goods you were purchasing.

The bottom line is that it would appear that there is no such thing as a standard tariff – there’s no one price fits all, and if you don’t shop around, you are going to end up paying the maximum! Yip, it “costa plenty” to become ill!

And, as in my case, when I haven’t worked for five years, my ability to earn an income has been curtailed. Taking into account an annual salary 5 years ago of, say, R250 000, a simple calculation and without costing inflation, bonuses, etc, would  highlight that my illness has cost me an income so far in excess of one and a quarter million rand!

Make sure that you have planned for the day when your cruise liner hits the rocks. It’s bound to “costa plenty”!

 * Read this note – I hope you understand it!


08 November 2011

Regulation 8 ruling should prompt new era of tariff negotiation – SAMA

 While welcoming the North Gauteng High Court ruling that Regulation 8 of the Medical Schemes Act (131 of 1998) – that medical schemes must pay in full for all PMB conditions – SA Medical Association (SAMA) chairman, Dr Norman Mabasa, has again stressed that the Competition Commission ruling banning medical schemes and provider groups from negotiating tariffs should be revisited.

“We have spent a lot of time and effort supporting the Council for Medical Schemes (CMS) in its defence of Regulation 8,” said Mabasa when commenting on the ruling which came as a result of the Board of Healthcare Funders (BHF) asking the court to pronounce on it almost a year ago. The BHF was later joined by the SA Municipal Workers Union National Medical Scheme in seeking to have Regulation 8 interpreted to mean that schemes must pay for PMB conditions only up to the scheme tariff, effectively changing the meaning and purpose of the PMB provisions in the Act.

“Yes, it is a victory for the CMS, for those of us who backed the CMS cause, and particularly for medical scheme members, but this is another one of those issues that should never have ended up in court,” Mabasa added.

“This was not a misunderstanding of the PMB rules,” he explained, “but a development that can be directly attributed to absolutely no mechanism being available for providers and schemes to negotiate on tariffs and possible issues surrounding them.

“We hope that the medical schemes will now join SAMA in pushing for a new era when provider groups and funders can engage positively on pricing requirements,” said Mabasa.



(Un)Lucky 13

©2012 Edward C. Lunnon

Friday 13 January 2012: 5 years 4 months on … Deuce

Tuesday 24 January 2012 … Advantage CBD

I started writing this blog on the evening of Friday 13 January 2012. Other than writing a title I did not write anything else – simply because I started watching, on Sky, the breaking news of the running aground in the Mediterranean Sea of the 4000-odd passenger liner, Costa Concordia, on the coastline of the tiny Tuscan island of Giglio, just off the western coast of Italy.

 It was news in the making – another human tragedy playing itself off on TV. I enjoy watching these real life “reality shows”!  Life is just not, excuse the pun, plain sailing!

And quite frankly I have not been in the mood lately to write much.

Saturday morning was the “Run in the Parks” and after my 5km walk, I was even less inclined to continue writing. By Sunday, I had developed a rash around the top of my left leg, just where my leg brace ends. By Monday, the itchiness was driving me mad – so yet another visit to the Doctor.

More pills (celestamine: 3x day for 5 days) and the aptly-named Stopitch cream were prescribed.

The rest of that week and this week, I have been miserable. Intense heat and humidity, a rash increasing rather than decreasing and the non-use of my brace (simply because it aggravates the itchiness) have all contributed to my frame of mind.

Other than attempting to attend to some administrative things (like paying accounts and filing!), I have not been too productive, and that makes me even more negative. It’s a spiralling whirlpool of emotion and self-pity. And having been ill now for almost five and a half years doesn’t make things any easier.

I’ve become like a computer that just “hangs”. You know the feeling – it’s when nothing happens on the computer; the little sand-timer just whirrs away on the screen but everything freezes. It won’t move forwards and it won’t move backwards. The only solution is to switch off and start all over again. In computer terms, they talk about “re-booting”.

And so these are the times that I have to re-boot myself, and this time it’s taking longer than ever before.

By last Sunday, one week on, the heat continued unabated, the itch was driving me mad, my right leg – for the first time – has shown weakness related to the CBD, and I slipped twice during the week, and the rescue divers had found 13 bodies in the partially submerged wreckage of the Costa Concordia.

That evening, we watched on TV, the movie Apollo 13.

It took me back many years to 1970 when I was in Standard 6 and 13 years old! Apollo 13 was to be the third mission to land men on the moon, but on 13 April 1970, a massive explosion in an oxygen tank put an end to the mission to land on the moon and, from then on, it was also news in the making – how to get the three astronauts safely back to Earth.

Those were the pre-TV days, but I remember, so vividly, my little black Hitachi transistor radio with its brown leather carrying case and aerial, and an earphone to listen to the human drama late at night in bed when I should have been sleeping!

I remember the voices from deep space, whining and hissing on the English programme (there were only three programmes: English or the A station, Afrikaans or the B station and Springbok Radio). The drama of that rescue and the eventual safe recovery of the three astronauts from the Pacific Ocean remain in my mind, and became so real as we watched the pictures for the first time – 42 years later!

(So sorry that I can’t remember what I had for breakfast anymore, or where I put my note book in which I wrote my notes to remind me what to do today!)

Monday morning at 10am saw me return to the doctor – now I’m on Maxaderm and Difluzole and hopefully that will get rid of the rash! At 1pm it was my daily visit to the biokineticist, at 3pm, my annual visit to the neurologist and at 4pm a visit to the psychologist. It’s just another day in the human drama of living with CBD!

(“Well maybe, just maybe, it isn’t CBD – after all you’ve been around five years now and our statistics show that patients with CBD don’t really last this long …” – that’s the comforting news that I get at my “annual” … – “but then it’s definitely some kind of extra pyramidal neurological disorder, and who knows, if you hang around long enough, they may just find a cure … after all, they are doing a lot of research … “.

Yes, it’s comforting to know that we can land men on the moon and bring them back safely to Earth, we can float multi-passenger ocean liners on the sea (and double-decker Boeings in the air, for that matter), and we can save thousands when the liners hit the rocks (and lose just a few) – but, a hundred years after documenting the first cases of motor neurone disease, we are still no closer to rescuing  those human beings who, on their life’s journey, become stranded by that disease. Or have an itchy rash for that matter … 

 (to be continued …)