Thursday, September 10, 2009

A joke about healthcare and the insurance companies

This isn't about me but about the fallacy in what health care pays.

Last February I was informed by my former employer that my former promised coverage of health care would be dropped and I would have to find new coverage or pay for the same coverage through them with full payment. Well, having pre-existing conditions took out the option of finding my own so I had to elect to do the "self-pay" plan. This would make my costs go from $143 a month to $1495 a month in just thirty days. I had no choice and was somewhat nervous because things had to fall into place or I could be out on a limb and the saw would be cutting behind me. I have a pacemaker and I knew I was due a new one because the battery were running down. No plug in hybrid here. No recharge.

In March, about one week before the insurance needed to transfer to solely me, I got the pacemaker. This, as you can imagine, set me up in the 'you met your quota or you're payed out' for the year situation.

Now we will get to what this is all about. Had I had to change insurance companies I would have been turned down by all. Too many pre-existing conditions, heart, cancer et, al. Under the law of Ohio I do believe I could get insurance but the insurance company is totally protected in that they can charge you somewhere north of $3000 or $4000 a month. Another fluke to insurance companies is that if I did not have these conditions and I developed some sort of condition afterwards, there is a clause that lets them drop you like a hot potato(e), your choice on spelling. If they don't drop you and you contract something like cancer, it is up to them as to what drug you can take or not have access to. All this is a cost savings effort on their part to make the insurance cost effective. Or you can say it is a way to not payout funds that would cut into the profits. After all, they are in the business of gambling on your health and they have the guns to roll the dice as needed.

Well, they just showed me that all they say about watching the costs and the fighting with hospitals is really a big fat hoax. I just received a EBO showing what has been paid and there was an entry for $72. At first I ignored it because I didn't owe anything. I had been to see a doctor at Kettering Medical Center recently but I had never seen this before. Curiosity always gets the cat. The better half of this couple called to get an answer from the doctor and ended up calling the hospital. Come to find out the insurance company is willing to pay for my use of the doctors office because it helps the hospital. I have seen this doctor maybe four or five times before this and this bill has never been there. At the end of this visit he asks us if we would like to see him at a satellite office. We said yes because it is about 2 miles vs. 10 miles and much easier to get into. We think he knew about the bill but didn't say anything.

We were never informed of this potential bill by the hospital or the doctor. In talking to a neighbor we find that this is a standard practice that has been going on. I can't say whether I would pay to protect my credit or that I would tell them to find the turnip and get the blood from it. This hospital is building a new wing (huge) and since it is named after an individual I would assume that the costs are covered somehow. Maybe the office charge is for the increased parking areas required but to charge me fees to walk into a facility, sit in a waiting room and then leave fifteen minutes later is not acceptable. If I have to see a doctor in a medical facility in the future I will be asking if there is a charge to me for this 'privilege'. I am now wondering what the doctor has to pay for this office space.

Next time you go to the doctor in a hospital, ask the question, is there a seperate charge for the use of this office to me. Always get an itemized statement from a hospital if you need to use one and look it over. Question everything that you don't understand. It takes time but you can possibly save money you owe this way. They will cut deals if needed.


Gene said...

I agree with all you have said and want to add my 2 cents. When we go to buy grocery's we see the price on the food we buy and choose by brand or price. When we go to buy a car we see the price and decide if we want that car. But when we go to the doctors or the hospital we have no idea what a test cost or what a room cost or what a doctor cost. I just bet if you were to ask that they dont have any idea. Need to see the bill man. This has to change and we need to make our own minds if we want to pay the price they are asking. Just my thought for the day

Butch said...

This is so true. One of the biggest costs in your life is health care. Most people don't ask as long as it is "covered" by their insurance. People with higher deductibles or out of pocket requirments will ask. I've learned to ask even if they say we contacted your insurance and the procedure is covered. They tend to fail to say to what extent it is covered. What is your out of pocket or co-insurance. Two kinds of CT scans and one is double of the other. It's better but is it needed.

Discussions with the doctor is important. Most don't do it like you said.

After getting all the info and getting stressed out about it you need to see the doc again for some meds to calm you down or a shrink to find out why your so stressed out. It's never ending. Eh!