(Here's a pretty fascinating health care story from a Montanan. Forward Montana is actually embarking on a big campaign to gather more thoughts like this. Interested folks can join us on Saturday for what promises to be a very cool campaign -- "House Calls 4 Health Care." Otherwise, check out Heartland's story and share your own thoughts below. - promoted by Matt Singer)
Last December, shoving some paper into a waste basket that had some broken glass in it, I cut my thumb deep into the joint, severing the two tendons that let a person extend the thumb. It became an inadvertent test of my health insurance. Now, I'm self-employed. I pay almost $900/mo. for my wife and I. We're mid to early 50's, and healthy. My insurance has a $2,500 deductible, and does not cover vision or dental, but does have drug coverage. Between premiums, vision, dental and deductibles, as well as paying for a policy for my college age daughter, I came up with right around $16,000 for "Health Care" in 2007, $11,700 of which paid premiums and bought nothing in terms of actual "Care".
Now when I went to the hospital shortly after the accident, unable to move my thumb on my right hand, I got good, prompt attention. I grilled every nurse, ER Doc, X-ray tech, the woman at admissions--asking them if they were "approved providers", and stressing that my only means of paying the impending costs was with insurance. I questioned the need for every bandage, bag, whatever--trying to be a good consumer, as I'm supposed to be, right?
Now to be fair to my insurance, they paid the amount over my deductible for this injury, but since the injury happened on Dec. 15, I had the $2,500 deductible from 2007, and the deductible for 2008 to apply to the bill. Insurance paid about $2,400, BUT NOT UNTIL giving me 5 days to to respond to a form asking these questions, among others:
1. Is another party liable for this accident, injury or condition?
2. Has a court action been filed against the responsible parties?
3. If this accident, injury, or condition is not motor vehicle related, please list the name of he party responsible for the accident or injury and the name of THEIR insurance company.
4. Has a claim for benefits under Worker's Comp. or similar laws been filed?
and other questions. I called my insurance agent and went through this form with her as I filled it out, so as not to commit some inadvertent error that would give the "insurance" company an excuse not to pay.
Now, lawyers get the rap for driving up health care costs, but it seems clear to me after this that it's the insurance company that's seeking to make sure that any concievable scapegoat is identified and sued prior to paying the health care professionals who took care of me. My doctor was paid by the insurance company almost 90 days after he rendered his services to me. How expensive is that? As someone who's self employed, all I can say is it's very expensive.
Heath insurance buys nothing in terms of HEALTH CARE. It buys private sector bureaucracy, delay, excessive profits and useless overhead. It does not buy "Choice". In an emergency you don't "Shop" for health care. It makes health care providers wait a long time for payment.
Now my accident was minor, but it's clear to me that my health care dollars are a monumental waste of resources, at least the ones going to the insurance company. We need to cut out the middle man. We need to get rid of the overhead. Let the doctors make a profit, not the insurance companys. I now lobby my representatives for single-payer health care at every opportunity. My Canadian friends pity me for the extreme cost of health care in the US, and the pathetic lengths we have to go to in order to assure that insurance will actually PAY for the care we recieve. |
