Category: Health Insurance

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The present American medical system is a mess. It is a system that nobody understands. Trying to explain the American system to somebody from a different country is virtually impossible. Co-pays, insurance approvals, denial of coverage, cost deductions based on different insurance carriers, Medicare versus Medicaid, write offs between the insurance company and the medical provider, it is head spinningly difficult to explain to any person from the western world. Yet Americans think they have the best healthcare in the world.

There is a disconnect between actual care and how the bills are paid. I am basically happy with the physicians, nurses and drugs I receive. What makes me unhappy is arguing with insurance companies about my bills. These are two very different aspects of the health system. I am happy with one and unhappy with the other. Care is not payment but when someone asks what do you think of your healthcare. You are probably going to think doctors and nurses and not the toll-free customer service representative who can’t explain your bill based on your understanding of your insurance and their somewhat different understanding of it.

Here is the thing, I, of course want the insurance companies to pay for everything. Knowing that is impossible, I would like to know going into any medical procedure, how much I actually owe and I want to understand what the division between my costs and the insurance company’s. I should be able to understand it so that when I look at my bill, it makes sense to me. Is that really too much to ask for? Apparently.

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I was appalled to read that Mary Lou Retton, Olympic Gold Medal winner, doesn’t have health insurance and has to raise money for her hospital stay through an on-line fund raiser. She has a life-threatening pneumonia and is in critical condition. She has been in the hospital for over a week, so you can imagine the cost already and she isn’t out of the woods.

How does someone so well connected not have health insurance? This absolutely blew me away. If Retton is taking risks regarding health insurance, then the number of people who faces these choices must be much larger than I imagined. This doesn’t mean that they decide not to get health insurance either, they may decide for health insurance but what are they doing without. This is about life on the margins where the cost of health insurance might make people sacrifice other necessities of life — like not paying the mortgage, half dosing prescription medicine, skipping meals. But, then, there will be people who will argue that this is good, Retton will make better decisions in the future from the lessons she learned from not having health insurance.

Like delaying necessary treatment because she doesn’t have health insurance. I can’t imagine what I would do if I were sick and didn’t have health insurance. You don’t know if you will get off easy with $100 bill for a doctor’s visit and prescription or a $50,000 hospital stay. And even if you only have to pay $100, it may be $100 you don’t have, so what do you do? How is not taking care of your health beneficial to society?

Then when you are so sick you have to seek medical treatment, who pays the bills when the person involved is not America’s sweetheart? What happens to a person who is an asshole and people hate the person so much that they are angry at you for even thinking of helping the asshole. Though it pains me to say this — even assholes deserve healthcare and they probably won’t fare well in the Go Fund Me Route. So instead of contributing to every Go Fund Me asking for help with medical bills, our system is set up to treat everyone through a universal health care system.

That won’t happen because that is socialism and socialism is bad. I honestly don’t care how it is done either. If you can propose a way to do it through the markets and it is both affordable and universal, I am cool. But I haven’t heard one yet so there is that. The Republicans, who I would assume after bitching for 8 years about Obamacare, would have passed reform bills with these market solutions incorporated when they took over, but they didn’t so it looks very much like they don’t have anything. Which is unsurprising but nonetheless disappointing.

Until then I will continue to enjoy the best medical care in the world.