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I don't know anyone who doesn't complain about the costs of health care and health insurance these days. They are outrageous!

My husband's employer just started a new benefits year on Nov. 1. Each year, of course, like everyone else's insurance, their premiums go up, and because they are a small company, they don't have a whole lot of choices for reasonably-priced insurance. This year, they decided to control costs by switching back to referral-based medical care. For the last few years, we didn't need referrals, and it was wonderful.

In case you don't know what referrals are, though I suspect many of you do, in a referral-based health insurance system, your PCP - primary care provider (which is insurance-talk for your Internist, Family Medical Physician, or Pediatrician, if you are under 21) acts as your "gate keeper" to specialists. If you want to go to the ophthalmologist for your annual eye exam, for example, you have to call your PCP to get a referral, which is like written permission. If you don't, your insurance company won't cover that visit.

It's like they're telling us that we don't know when we need our own eyes examined.

For a family like mine, where three of the four of us see specialists on a regular basis, referrals are not just a minor inconvenience but also an annoyance that requires a lot of patience and effort.

I see a chiropractor two to three times a week. This started back in October, when I developed muscle spasms in my upper back. At that time, we were still on a non-referral based program. I could simply make my appointments, (staying within the large directory of doctors my insurance offered, of course) knowing my insurance would cover the visit, as long as I shelled out my $50 co-pay, of course.

On Nov. 1, though, I had to start "getting written permission from my PCP" to see specialists. Knowing that I would need these little pieces of paper to prove I need to go to these doctors, I wrote out a list for my PCP's office so they could supply me with a bunch for my chiropractor (since I go two to three times a week, every week) and my gastroenterologist, since I can be hit with a flare up of Crohn's disease at any time.

I waited more than week for these pieces of paper. When they didn't come, I called my PCP's secretary.

She insisted she never received my list of referral requests. Since it was handed to her personally by my husband, I can't imagine where it went.

Then she insisted that I didn't need referrals "in advance of making an actual appointment." She didn't want to write one for my gastroenterologist. She said she'd simply write the referral "the minute I get sick" and fax it to my gastro. so I could see her. Well, that was all well and good of her, I said, but I could get sick on a day when my PCP isn't in to write the referral. See, Crohn's disease is funny that way. It doesn't care if the doctor is on vacation when it decides to strike.

I suspect that my doctor's office is somehow compensated for NOT writing referrals, as writing referrals means the insurance company is going to have to pay specialists for appointments at a higher rate than if my PCP treated me I can't figure out why else the office would be so hesitant to fill out the paperwork otherwise. (I should point out that she finally did fill out the referral slips for me and that I really do like my PCP, a lot.)

I'm so tired of the way health care is delivered in this country. It's just absurd that I have to beg for permission to see my own doctors. I'm not thrilled with the amount of money I'm shelling out for the insurance, doctor, and my medication, either.

I realize the problem is complicated, and that I personally have no good solution to it. I usually ascribe to the "don't complain unless you have a solution" idea. But I am complaining, and I do want someone to solve this. Anyone? Anyone?

Judy Walters is a freelance writer who lives in Kendall Park. She is also a regular blogger at parentjuice.com, with the user name "Judy226". She can be reached at JWRWAND2@aol.com.