Wednesday, October 22, 2008

Flash!

Me, 2008

NEWSFLASH: I am voting for Obama.

I deserve health insurance! Barack's plan will outlaw the pre-existing conditions clause on insurance applications. This is my issue. It affects me. I worry about health care costs every single day, and it's making me sick.

Because of pre-existing health conditions, we have been denied coverage. We aren't poor enough or old enough to qualify for any low-cost programs. Occasionally when I tell a doctor I'm uninsured he will knock down the office-call charge to the rate the insurance companies pay, but not always. Many offices will not even book an appointment when they find out I have no insurance. I've been told this doesn't happen (always by people with health insurance) but it has happened to me.

When I am told I need a certain procedure (blood test, lab work, etc.) my first question is "How much will that cost?" I'm always surprised that nobody knows. The doctor doesn't, the secretary doesn't, even the billing department doesn't. They just know the code for the procedure. An insurance company has a certain rate they pay when they are billed, so that's what it costs. Since different insurance companies pay different amounts, there is often no definite fee. "It depends."

In August I went to a highly recommended new doctor for advice about hot flashes. I was required to pay the $225 new-patient fee when I checked in for my appointment. (Actually, I had to pay half of it over the phone when I scheduled.) I spent 5 minutes with the physician's assistant who listened to my woes and directed me across the hall for some blood work, explaining that until she had those results she would have no answers for me.

She left town, and it was 2 weeks until I heard back from her. I recieved the $1,100.00 bill for the lab work a full week before she called. A week later I got a notice that payment must be made in full immediately and I already had a $20 late charge.

Trying to reach my PA was crazy. Remember the days when a secretary just answered the phone and said, "Who's calling please?" Eventually, the physician's assistant's assistant called me back and said the doctor (who I still haven't ever seen) wanted me to have a CT scan because my blood test indicated I could have a tumor. Scary! I was transferred immediately to some other helpful person who gave me the appropriate phone number and the all-important code. No, she was sorry, but she had no idea how much this would cost.

The radiology department didn't know either, and the hospital billing department didn't know, but they'd let me know. In the meantime, I could have a tumor growing somewhere and we better find out about it. In this case, I was scheduled instantly even though they had no guarantee of my ability to pay.

A cute girl with troubled eyes pushed me into the cylinder and then told me to call my doctor for results on Wednesday. Although she already knew the results, she couldn't tell me. "It's above my pay grade," she said.

Two days passed slowly. Wednesday there were no results. Thursday morning the recording told me the doctor's office was closed until after Labor Day. Five more days passed slowly. I received the $3,300.00 bill for the CT scan and the $486.00 bill for the radiologist (to read the scan) the next Tuesday, but still my doctor hadn't returned my call.

Ten days after the CT scan I reached some poor innocent voice on the other end of the phone and unloaded all my frustration on her. Full of sympathy, she said someone would call me back within an hour. A different physician's assistant's assistant called, asking where I'd had my MRI done, because they hadn't received any results. I explained it wasn't an MRI, it was a CT scan AND I WANTED TO TALK TO A FLIPPIN' DOCTOR!!!!

Two days later the actual doctor called. She said there was no tumor, and she was not concerned that I could have cancer. She was concerned, however, that one ovary was larger than the other. She recommended that I have a hysterectomy. I told her I didn't have insurance. "Why don't you check with the hospital, get your ducks in a row, and schedule an appointment with me in a couple of weeks so we can talk about your options here." I asked her if this was urgent. What was her reasoning? What about the hot flashes?

"I'm not sure your hot flashes have anything to do with all this. It's not an urgent situation, but I think at your age it has to be done sooner than later. I'll transfer you to the front so you can make an appointment and we'll talk more then."

Well, my ducks are not in a row. The hospital financial aid guy said we made too much to qualify for any help. The hospital costs could be anywhere from $8,000-$15,000, and the doctor will charge about $2,500. Of course I'd also need an anestheisologist and a pathologist and a person to read the charts. And it would hurt!

The front desk answered. "Because you've been in before, your consultation with the doctor will only be $125. What's your insurance number? Oh?? Well, we'll need to put half of it on a credit card to book the appointment."

It gave me a hot flash.

I'm voting for Obama.








11 comments:

kenju said...

ME too. I am lucky now to be of the age where I get Medicare, and without it - we would be up the proverbial creek. Sorry about your need for surgery, but I'd get a second opinion. (Yes, I know it costs). If they say it has to be done sooner than later - I'd want to be sure they are right.

Christie said...

Health care is truly a joke. It definitely needs some revamping for people like you. I hope somebody can do it.

Kay Dennison said...

Arrrrrrrgh!!!!!!!!! I was without health insurance until March of this year when they finally admitted that I have a disability -- and I had to fight for it despite being handicapped from my stroke 30 years ago -- and they gave me Medicare. It's not perfect but it beats nothing.

I'm with Judy -- a second opinion is a good idea.

Keri(th) said...

Amen to that! It is absolutely appalling that insurance companies can choose to deny whomever they want to. I just wrote a post about Ayden being denied any healthcare coverage - at age 5! The costs are also outrageous, and I completely empathize with your frustration about getting an actual live human being on the other end of the ringer for some solid answers. I'm not sure what we'll do when our Cobra option runs out next year. I'm hoping that Obama will be in, and his healthcare plan will have taken effect.

... glad it's not a Tumor!

Sheri said...

Well, I'm glad to hear you're voting for Obama, but I'm so sorry to hear what you've had to go through! YIKES! What an ordeal. And without insurance. So glad it wasn't cancer.

My cellulitis infection last year cost over $30,000 (and even with insurance, we're still paying our cost on monthly installments). My monthly medication cost is over $3000, and our cost is about $200-250. I guess I wouldn't be alive without insurance.

It may be socialistic, but I think good healthcare is everyone's RIGHT. I'd rather pay next to nothing for healthcare as in Canada and Europe. Our insurance premiums are too high and we still end up paying more in med-bills than we can afford.

I hope Obama is elected and I hope somehow he can fix the healthcare problems!!

Nancy said...

Marty,

I am really sorry that you are having all this trouble. It's a tragedy that on top of being ill and not really knowing what the trouble is, you have to struggle with having no insurance.

Contrast this with the experience we have just been through with my husband's 92 year old brother.

Thanks to Medicare , which the Republicans fought tooth and nail, and which the Democrats INSISTED upon, my BIL was in the hospital for more than 3 weeks with a bad knee. Then, he was sent to rehab in a very nice nursing home and the total cost to him was 00000000
000000000000000000000!!!!!!!!!

Of course, he had supplimental insurance through his former employer, but that was only part of all the money that was spent on him. He had every test and Xray in the books and it cost him NOTHING..

I will definitely vote for Barack Obama in the hope that every American will be able to have their health needs attended to at no cost to them.

We should all be ready to pay a little more in taxes so our friends and neighbors do not have to go through what is happening to you.

The Republicans are always trying to frighten us with how terrible Socialized medicine is. Could it be any worse that your situation?

You travel all over the World, do you see the free care that Europeans get? The Republicans will tell you that under Universal Health Care you will have to wait and wait for an appointment and then you will get inferior care. Does that sound familiar to you?

VOTE OBAMA !!!!! FOR A CHANGE !!!!

Keri(th) said...

I have to comment again after reading both Sheri and Nancy's comments.

Though I agree that socialism is not necessarily the best thing for America, I do think that an inclusive healthcare plan could be.

I am a Canadian citizen and had absolutely no idea that people actually paid for their healthcare until I came to the USA in 1992. I couldn't believe that people were charged for surgeries, medications, or diagnostic testing. Worse yet, it was incomprehensible to me that if a person had no insurance they were forced to sell their home, declare bankruptcy, or pay installments for the rest of their lives. It's so very wrong.

I think that we could completely revolutionize healthcare in this country by simply restructuring it to resemble a socialized plan, but with more freedom of choice. And if it were done correctly, the cost would be entirely minimal.

With six children who were constantly in and out of the ER with broken bones, illness, and surgeries, my parents knew that no matter what was wrong, no matter what the cost, they would never be held liable for it.

That is a peace of mind that most Americans would be very happy to have.

Bev said...

I share your worry and outrage at the whole "wrongness" of the health care system.

We have some experience with the injustice of the system right in our own home. My husband, who worked for one company for 25 years will have both his medicare and his supplimental for the rest of his life. Until he turned 65, his company's retirement agreement INCLUDED my health insurance.

We never had any advance warning that when he turned 65 I would be out on my own trying to find insurance.

I'm right there with you whenever the doctor says "I want you to have this test or I'm going to prescribe this medication" -- the first question out of my mouth is not "what will the test tell us or how does the medication work" -- No, it's "What will that cost"

I have about 8 more years before I'm even eligible for Medicare, and so until then I can not get sick -- we simply could not afford it.

marta said...

wow mom, way to go. i was wondering if anyone would bring up who they were voting for.. and there you go being the brave one! i like obama too. he's a good guy and seems to me will do a good job. lucky for you, my bet is he will win by a landslide!

gab said...

You put the OMA in ObaMA!

ell said...

I'm always appalled to hear stories like yours. It's mind-boggling to Canadians like me and citizens of most western countries that Americans without insurance cannot obtain healthcare without going into debt.

Further, I do not understand the irrational (to me) fear of the "S" word. Surely, Americans realize that some of your state and federal programs are already socialized (e.g. Veterans medical coverage and VA hospitals, public schools, etc). It defies logic that arguably one of the wealthiest nations in the world does not provide adequate healthcare as a basic right for its citizens.