Not Included

I’ve been trying to figure out where this concept came from. I’m troubled by this because apparently, it’s a phrase that is applicable to almost everything. I think it started in the 80’s with battery powered toys. I remember how my father or mother would come home with a present, hand me the toy, I’d rip the box open and say something to the effect of “it doesn’t work”. Dad would have a look, and then immediately the disappointment on his face would be evident. He didn’t recognize that batteries were required, let alone “batteries not included”.

Few of us have effectively learned the lesson from this experience. I too suffer from this error, and admit I repeat it often with my own 6 year old. Ok, so it started with toys, but it seems to have grown way out of proportion. Because today, “Not included” is a function of everything we buy and every service we seek. I went to a car dealer last week. The base price of the car, was the reason I went to see it. It said 39k for a luxury vehicle. Perhaps I’m naïve, but I expected to get a luxury vehicle for this price. Apparently, the price doesn’t even include the steering wheel, or the tires, or the radio or the highly touted safety features. So, if you want to be able to drive, turn and be safe, the price is actually 52k and then if you want the luxury features, the number grows quickly. Yea, sorry that’s too much for me.

The sad truth, is that even health insurance has adapted this practice. Copays, coinsurance, and deductibles have risen considerably. I may even be able to defend the nature of the growing shared financial responsibility as a means to limit wasted medical expenses. But that’s not what this article is about. It’s that in the realm of the services and products we seek for our health and wellness there is a growing statement “not covered”.
Not Covered! Translated, “that’s extra”. That’s insurance jargon adapted from the toy store: Not Included.

The difference between the toy store and the medical office can be summarized with the word ‘blame’. We don’t blame our credit card company, when the battery is not included. We don’t blame the toy store or the toy manufacturer. However, when presented with that’s ‘not covered” by the doctor, we don’t blame the insurance company, but we do blame the doctor. Many of us choose our wallet instead of our wellness when posed with the option. I smile, because yes, we ALL do this, myself included. We do it for our teeth when we could really use an implant, and we do it for our eyes when we could really use a new pair of glasses and we do it for our injuries. Justified by, it hurts, but not that bad. Similar to my car conclusion I’ll just drive my current car a little longer. So, I’ll limp for a while.

The sadder truth is, in some practices, even the Doctor is not included – you only get the PA or the nurse. This is not something to simply be accepted. No, you shouldn’t have to push off your wellbeing or comfort. Is NOT COVERED something we can fix? Sorry, I can’t make that claim. But I can promise to be your advocate. I can tell you we actively engage insurance carriers to cover your needs. And while we are not successful all time, we certainly try.

And as afar who attends to you during your visit….. you get me! Because it’s my direct treatment advice, explanation, guidance, care and concern that you came for. I am included!
When you need a doctor who goes the extra mile, come see us at Lower Westchester Foot & Ankle. You don’t have to limp, you don’t have to wait. You can expect more.

Ari Rubinstein, DPM
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