Monday, November 21, 2016

Strange But True

A while back I was diagnosed with nasal polyps and got my nose reamed by Dr. Phlegm.  It was one of those in-hospital jobbies, two hours, put out by anesthesia and the whole works.  It was a first for me. 


I'm still using a steroidal flush and spray and so far they haven't returned as they are wont to do on occasion.  That's the good news.    The bad news was the cost.  I had costs to the Palms of Pasadena hospital, Dr. Phlegm and the anesthesiologist.  Total cost was around $89,000, so you can kind of get a feel for my costs with insurance.  Yeah, uh huh.  So I got the hospital and doctor paid off and then I got the anesthesiologist's bill, let's call him Dr. Gasbag.  It was for $2,432.   

By now I'd had about enough. The bill said something about paying $800 which was what I would normally have to pay if insurance had covered it, but since Dr. Gasbag wasn't in my network I owed the entire $2400.00.   I sent him $800 then contacted my insurance company.  I also became an opponent of Obamacare.

After about a 9 months of pleading to my insurance company about this I received this letter from United Healthcare which was a CC to Dr. Gasbag.  In essence they called him a crook - "In other words, our payment to you was higher than the amount charged by 90% of practitioners for these services in your geozip."

Okay, I was able to save a couple thousand, but what about all the other families out there who didn't or can't.  We need to get healthcare costs down where people don't have to choose between pills or food.  Until someone smarter than me can explain it with some clarity I am a fan of the universal system favored by most western countries.  All except us.  Somewhere along the way we handed it all over to our insurance companies.  These are the same companies that have denied coverage of my steroidal medicines prescribed by my specialist.   I have to get my elixir from some back alley pharmacist in Miami not covered by insurance now.

Now, I'm no insurance genius.  But it seems to me the cradle-to-grave plans of other wealthy Western nations would be at least something to consider.  We Americans are so insular.  We wave our flags and blindly recite the "USA, USA" mantra and think we have everything figured out.  Truth is we pay more money for healthcare than any other Western Industrialized nation and get the least for it.  According to the Commonwealth Fund, a private foundation started in 1918 to promote better healthcare for Americans says that of the following 11 nations (Australia, Germany, Canada, France, Netherlands, New Zealand, Norway, Sweden, Switzerland, and England, the United States ranks LAST in areas of 1) Healthcare system quality, 2) efficiency, 3) access to care, 4) equity, 5) and healthy lives.  I repeat - last. 1 

When I worked at the Mary one of the things we did with regularity was to visit other state detention centers and probation departments to find out how they did things - perhaps utilize other methods to improve our methods.  Too bad we think we are so perfect - we might learn something from someone else.  Oh, my! Can't do it like the Brits or the Canucks - it's Socialism.  (Psst - so is Social Security, Medicare, Education subsidies, farming subsidies, Medicaid, G.I. Bill, Veteran's Benefits, Pell Grants, Unemployment Insurance, Home Mortgage deduction, Food Stamps, Child and Dependent Care Tax credit, and I can go on and on.  We are neck deep in social programs.  Don't need any of them, then count yourself among the blessed.  If you do, well,  it can make a world of difference.  We are all hanging by a thin thread that can snap at any time.  Be thankful we have a nation that devotes such resources to our fellow citizens.  But until we can control and manage our healthcare system we will be a poor nation in spirit.   

Let's hope that Congress has some plan that will save the American families from outrageous healthcare costs.  Otherwise we'll be getting letters from attorneys handling our bankruptcies.

How's that for starting off Thanksgiving week?    



1 comment:

  1. It would appear the new Congress and President elect intend to repeal the Affordable Care Act with no plan in place to replace it. Some 20 million or so who currently have insurance will lose coverage. I agree with you that universal coverage, cradle to grave, with a single payer is ideal. I've heard too many talk about the Canadian system as a reason not to make the change. All of the Canadians I have spoken to like their system. You try to explain how it works here and they think we are nuts. They are correct.