🤯Unknown Unknowns #79 - Frustration

It's the end of the year, the time when you realize you have to get your annual doctors' appointments and not waste the insurance.

I have two problems:
1) How do you find a doctor?
2) Insurance is impossible to navigate.

Problem 1

I want a doctor to give the tests that I want and contextualize them. I want a doctor to not interrogate me about why I want the tests. I want a doctor to be open to the newest technology. I want a doctor to help me navigate the insurance companies.

In other words, I'm looking for Dr. Peter Attia.  But he lives in Austin and he's not taking new patients.

But Dr. Attia wrote an essay on how to find a doctor.  He says to look for four criteria: advocacy, affability, availability, and ability. He also gives ten questions to ask to see how well a doctor fulfills these criteria. The only problem is, I've never been able to get a doctor on the phone before becoming a patient. Dr. Attia was developing a directory of doctors, but he never finished that project.  

Finding a doctor is trying to hit a bull’s eye blindfolded.  The only time I can talk to a doctor is during an annual checkup, which happens, you guessed it, once a year.  Most people default either to a recommendation from a friend, which is more dependent on bedside manner than skill or searching for a doctor based on convenience.

It’s crazy that it’s 100x harder to find a doctor than a great restaurant.  It should only be 10x harder.  Does anyone have any solutions?  How did you find your doctor?  How do people in other countries find doctors?

Problem 2

Navigating health insurance in America is frustrating.  You usually don't get billed for a doctor's visit until months later, after you've forgotten what happened.  You're then presented with a bill that is always higher than expected, with illegible billing codes.  You spend weeks arguing with the doctor's office and insurance company over how much you actually owe.

Problems I've had with insurance:
1) Annual physicals are covered unless it finds something, in which case it becomes a doctor visit (which costs money).
2) If a doctor's office tells you that a procedure is "covered by insurance" this means that insurance could pay for as little as 1% of the bill and this would still count as "covered."
3) Coverage may depend if a doctor codes a test as "preventative" (covered) or "diagnostic" (not covered).
4) You have separate medical insurance and vision. Ophthalmologists take medical, optometrists take vision. Annual visits are only in vision plans.

Anyone else have frustrating experiences with the health system?

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Discoveries:

Ben Hunt at Epsilon Theory applies Hitchcock’s MacGuffin concept to the narratives in today’s world.

A MacGuffin is an Object of Desire, around which merry plots are constructed to thrill/amuse/frighten/engage the viewer.

Every piece of content in today’s short-attention-span world is driven by a narrative.  While MacGuffin’s were used in film to direct the viewer’s attention, they’re now used to direct the attention of information consumers.  MacGuffins are used to polarize.

Nat Eliason describes how modern lives have become collections of pursuits rather than integrated wholes.  He calls this “atomization”.  I encourage you to read his essay to get a fuller idea of the concept.

Atomization encourages us to reduce multivariate experiences, often the most important parts of life, to their single most obvious element.

Scott Alexander at Slate Star Codex has a concept called Moloch. Moloch is the primordial god of abstract concepts. It's the compulsion to win zero-sum games.

Ben, Nat, and Scott are all describing how abstraction has taken over the world.  We live our lives in accordance to ideas rather than reality.  

David Foster Wallace wrote about the phenomenon in his famous “This is Water” speech:

If you worship money and things, if they are where you tap real meaning in life, then you will never have enough, never feel you have enough... Worship your body and beauty and sexual allure and you will always feel ugly... Worship power, you will end up feeling weak and afraid, and you will need ever more power over others to numb you to your own fear. Worship your intellect, being seen as smart, you will end up feeling stupid, a fraud, always on the verge of being found out. - David Foster Wallace - This is Water

What is the solution?

McGilchrist talks about the need for real world experience to originate in the right hemisphere, to be moved to the left for processing, but then returned to the right for synthesis into its global context. The musician hears a piece of beautiful music, deconstructs it into notes and learns it painstakingly, then eventually performs it intuitively. Problems emerge when we fail to do the essential final stage of putting the pieces back together.

The solution, as Nat and Iain McGilchrist say, is integration. If you worship money, don't just look at the number, ask yourself what you will do with it. If you worship your intellect, what can you build? If you worship your body, test it. What can you accomplish in your life?

Test your abstract pursuits in the real world.  You can start with the 5 Whys Exercise.  Of course, if you don’t test out your final “why”, the exercise is useless.

1️⃣🔗 The MacGuffin

2️⃣🔗 De-Atomization is the Secret to Happiness

3️⃣🔗 Meditations on Moloch

4️⃣🔗 Insights from “The Matter with Things.”

5️⃣🔗 This is Water

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Quote of the Week:

“Once you label me you negate me.” - Soren Kierkegaard

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Something Fun:

The author, Séamas O'Reilly @shockproofbeats

Been about five years since I first read this, on the English language's *completely universal but totally invisible* adjective hierarchy, and I can honestly say I've thought about it most days since.

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You can find more of my writing at chr.iswong.com.

Questions, suggestions, complaints?  Email me at [email protected].  Feedback welcome.

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Leaving you in peace,

Chris