Posted in Body Politics, Politics

The only thing worse than dealing with insurance is dealing with not having insurance

I had just raised my head from my puke bucket for the umpteenth time when a young man came up, all brisk efficiency, pushing what looked like vitals monitor cart with a laptop on it, and I was encouraged, because someone in scrubs was back, after an initial flurry of activity and then a long time of just Scott and I sitting alone in the ER bay, to help me.

But he wasn’t there to help me.  He was there to ask for my credit card, because I had a $450 ER copay, and they were going to get it right now.  Even in my dizzy, nauseated stupor, I had the sense that if they didn’t get it, no one would be back for me again.  It didn’t matter that I was miserably sick and afraid that I’d either had a stroke, or something malignant was happening in my brain to put me in this state.  TMC was getting paid right-the-fuck-now.  Before I left, someone from billing showed up–in a white coat no less–to talk to me about payment again. Really, people whose jobs are financial at the hospital have no business wearing scrubs or white coats.

screenshot-2017-01-25-at-1-27-24-pm

I’m sharing this because this is the collection of bills I received for my trip to the ER in December which included (only) a CT scan, an MRI, meclizine, valium, and Pepcid, and a lot of saline, chicken broth and crackers, plus breakfast and lunch, and consults with the ER doc and 3 neurologists who put me in a room for observation.  (I have bills for 4 doctors, though I have no idea who Salvatore Tirrito is, but he billed my insurance.  I never saw him.  Never spoke to him. Never heard his name mentioned by any of the people I DID speak to.)

That is to say, the bulk of my visit was me lying around, and everyone hoping I wouldn’t die; there wasn’t a lot of hands-on medicating or treatment. And yet you see the total here (and there’s another $154 of MRI that somehow didn’t make it on here, but did on the actual bill from Radiology Ltd.). And it will be paid by my BCBS insurance which I’ve had through the ACA for the past 3 years, because it was far more affordable than just being added on to my husband’s insurance (which is what I did after I retired, but before the ACA existed); with the ACA, my insurance premium was HALF of what I would’ve paid through Scott’s job, and that’s without any subsidies, which we don’t qualify for.

If I hadn’t had insurance, I’d be under an extreme amount of stress right now, trying to figure out how I was going to come up with over $21,000 to pay for a very scary overnight. But as it is, I’m only under minor stress, because as you can see, my share is only $1K and change. And I’m fortunate at this time in my life that that’s doable, but there are years at a stretch in my adult life where an unexpected $1000 bill would’ve been ruinous, and I have many friends and family for whom that has been, and remains, the case.

BCBS raised my monthly premium $35-60 each of the last 2 years, and this year, decided to opt out entirely of the Marketplace, meaning that the insurance company that has covered me most of my life, both as a child and as a working adult, decided I was no longer a reasonable risk, primarily because they weren’t making enough money through the marketplace, and didn’t appreciate the requirements the ACA placed on them in regards to what they had to offer their insured. The insurance companies are the problem, not ACA. Insurance companies believe they should be able to take your premium money endlessly, and balk at paying when you need to use it, or kick you off entirely, if they ever let you on to begin with. The ACA changed that. And now Congress and Dear Leader are fixin’ to change it again. They can just decide to not insure anyone if they don’t get their way.  They’ve already done that; many major insurers have.

Because I’m fortunate to have a working husband, and the upcoming election made things so precarious in regards to the ACA, I bailed on the SINGLE policy option I had and signed up for through the Marketplace, (a policy that not only raised my rates considerably, but also my copays, not to mention my deductible went through the roof, and for all that, I got less for my money and would’ve had to find both a new PCP and a new GYN), and got back on Scott’s insurance. Oddly enough, BCBS had no problem reinsuring me through an employer plan, despite dropping me through the Marketplace. This is why employer-based insurance is a problem–for people like me. And the bulk of my regular healthcare I pay for out of pocket, despite having insurance. But I still get sick sometimes. I still have emergencies. I need it. Because I don’t have $21K lying around just waiting for mornings when I wake up, can’t walk straight, and can’t stop puking. Who does?

What I didn’t have is options for insurance in Arizona as homemaker. And if I weren’t lucky enough to be married to an insured person, I’d be SOL. Single folks don’t have that option. We need universal health coverage, and it needs to be single-payer, so that your access to health care isn’t determined by your employment status, your employer’s values, or your marital status. Government health is not the problem; greedy insurance companies IS. They have been raising rates 20% annually for years; if you didn’t realize that, you were either uninsured, or your employer absorbed the costs.  They’ve been doing it forever; and once they had all of us (which had to be included in the law, or the insurers wouldn’t have played ball at all), they gouged their captive audience and then hung us out to dry.

I look at my bill for this one night in the hospital and think, “What if it HAD been a stroke?” I would’ve been in for a month like my dad, to the tune of $200K.  If it had been a tumor, I would be trying to figure out how to pay for cancer treatment (if I were lucky and it was treatable; a lot of brain tumors are not), and probably opted not to, because I wouldn’t want to bankrupt us, or Scott if I died anyway.

Because that is LITERALLY what we’re talking about when we talk about taking insurance and health care access away from people:  Death.  People will actually die because they can’t afford their medicines, or the treatment available to them, or will die when they go hungry and lose their homes because they took out a second mortgage to pay the hospital bills.  I’m not willing to let other people die for money, and I am dumbfounded that other people are.  The idea that any human being, anywhere, dies because of profit, offends my soul on a deep level.

If you’re mad about insurance rates going up, I’m right there with you.  But at least have the decency to be mad at the correct people:  those engaged in medical profiteering, insurance companies being among the worst, followed closely by drug companies.  Because when you cheer for the end of the ACA, what you’re really cheering for is the end of actual human lives.  And if you’re okay with that, I can never be okay with you.

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Author:

I've been doing some form of creative writing since 9th grade, and have been a blogger since 2003. Like most bloggers, I've quit blogging multiple times. But the words always come back, asking to be written down, and they pester me if I don't. So here we are. Thanks for reading.

2 thoughts on “The only thing worse than dealing with insurance is dealing with not having insurance

  1. hospitals are an effin racket, man. if you’re billing me for anything, i better have given consent. otherwise i’m liable to pay a quarter a month until you write that crap off. it’s ridiculous.

    1. When I had one of my ovaries taken out in 2008, I had an out-of-network surgeon in the room. Evidently, my surgeon, my COVERED, in-network surgeon, had asked her to help out, unbeknownst to me. It had not been discussed in all the pre-surgery discussion and paperwork. And when she showed up, I was passed out on the table in the OR. I was seriously annoyed that that could even happen.

      But I will say that I think the insurance companies are in large part to blame for the hospital costs also. Let’s say the doc decides his services are worth $50. He sends the bill into the insurance company, who say, “No, that’s only worth $25, because we want our $25, too.” So in order to get the $50 he needs, next time, he thinks he’s smart and asks for $75, figuring he’ll get the $50 he wants. And the insurance companies say, well, if he’s getting more, we should get more, so they say, “Nope, you’re only getting $35 this time, because you signed that contract with us.” So the doc is still $15 short, so he keeps upping what he bills, trying to get that same $50, and the insurance companies keep low-balling, and eventually your bill is $18,373.57, and the insurance company says, “You can have $5045.53, minus the patient’s co-pay.” Except if you DON’T have insurance, you’re looking at the same $18K because unless you argue and beg, they won’t give you a cash discount (and I don’t how much that would amount to anyway), and you’re now bankrupt, because you only make $23K a year. Or you default, and everyone else who comes into the ER after you pays for it because the hospital and docs have to charge you more, because they’re certainly not going to eat the delinquent costs. So we all pay for it regardless; at least with single-payer, there’s no longer the middle-man insurer trying to make a profit, screwing both patients and providfers, and everyone contributes.

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