I love our health insurance system.  In order to visit a specialist, I must first get a referral from my Primary Care Physician.  Many insured Americans will be familiar with this song and dance.

It’s clearly meant to model traditional doctor-patient interactions.  If my doctor diagnosed a heart problem he felt unqualified to treat, he’d refer me to a cardiologist.  If he diagnosed a digestive problem, he’d choose instead a good gastroenterologist.  He treats general illnesses, and recommends specialists to treat specialized illnesses.

In this case, I’ve diagnosed my problem without his assistance: I have poor eyesight.  I know I should be careful performing self diagnoses even in the Internet era, but I’m confident about this one.  You can check my work.  First, I removed my glasses and then counted how many events made me say “ouch!” in the following two minute period.  I then replaced my glasses and repeated the test.  (Let’s just say it was a smaller number and leave it at that.)

Now, I know I need to see an ophthalmologist.  You know I need to see an ophthalmologist.  My doctor would know I need to see an ophthalmologist.  My insurance company knows I need to see an ophthalmologist.  Some people reading this post will now even know how to correctly spell ophthalmologist!  Yet if I just went to an ophthalmologist, I’d have to pay the entire cost of the visit.

So instead I make a phone call.  I do not call my doctor.  I do not call my insurance company.  I call my doctor’s receptionist, Mrs. McMeaneyPants III (that’s the name on her birth certificate, I think), and ask for a referral.  She (reluctantly) fills out a form.

I have never — not once — even met my doctor, since I have not had any general health problems since signing up for this plan.  Moreover, because Mrs. McMeaneyPants outright refused to let me fill out a patient history for his office to have on file in case I ever do need to see him, there’s no real record of me as a patient there.

I really feel like this is the medical equivalent to investing illicit funds in an off-shore holding company.