My experience with Health Insurance companies for the last five years has been mildly benevolent, in that I made sure to pay them X amount a month and they made sure I was covered if my feet fell off. Things went decidedly south about 6 months ago when I decided to, god forbid, move.
- “Perhaps you shouldn’t have moved to Oregon, hippie.”
I’ve learned a lot of crappy things about the Health Insurance Industry in the last few months, and I feel like a lot of it was avoidable if I had known just a few key pieces of information before making some health related decisions. I’d like to share those lessons with you now so you can dodge some of these complications and headaches in your future dealings with the Healthcare system.
1. Health Insurance Companies Want to Eat Your Family.
After moving, I called my insurance broker and let her know my new address in Oregon. She went ahead and did her magic, and a month later I received my bill. Surprise (was it though?), my new premium for my wife and I just about doubled from $270 to $499.96 per month. I wanted to make sure my new donations were going to a good cause (like paying for the CEO’s stripper mistresses) so I called their customer service to find out what the deal was.
Turns out I was now out of network, so my premiums went up accordingly.
- I’d love to help you, but I’m kind of busy with my modeling career.
That would make sense, except that the quality of my plan went in the other direction (down). Since I was out of network, the percentages the insurance company contribute towards my expenses dropped from 80% to 25%. The 75% I was contributing was now going towards a deductible that had also doubled from $1500 to $3000.
In all fairness, all the info’s right there in the 60 page document they gave me when I signed up. I should have chosen to be a bit more curious and it’s all pretty standard operating procedure stuff for health insurance companies.
- It was filed alphabetically between “Screw” and “You”.
Fine right? No worries, just switch your insurance to a company that considers Oregon in-network… This leads us to lesson 2:
2. Don’t You Ever, As Long As You Live, Switch Insurance Companies.
Remember that one time you went to the doctor to get that insignificant thing checked out? I know, it wasn’t a big deal, but you’re going to have to include it on the application.
Remember that application for coverage you just sent in? Yeah, it got rejected because of that thing.
Last August, I ruptured my eardrum while Scuba Diving (because I make terrible decisions). I went to the doctor so that he could verify that I was an idiot, and then I was all done because this is an injury that heals all by itself like a cut. While we were there, we decided to check out an issue my wife was having which was some blockage in her salivary duct. I know, way too much info. There’s a reason I’m telling you though. The doctor suggested we get a CT scan to pinpoint exactly what’s going on, and then we went on our merry way.
Like the honest folks we are, we mentioned both events on our application to ODS with some assurance from our broker that he never sees anyone get rejected for such small issues.
We were both promptly rejected for coverage.
What blows me away, is that my wife is 26 and I’m 28, we’re both in good health (we stay fit, we don’t smoke, don’t drink, don’t eat fast food, don’t have any chronic conditions), and we’re honest on our applications for coverage. What is the health insurance company looking for? I was rejected for a condition that was completely resolved.
- “I think I left my daughter’s tuition payment in there…”
We appealed the decision. I had to go back to the doctor so that he could verify that everything was fine with my ear (4 months after the accident) and I typed a 4 page document attached to the doctor’s chart notes to try and let the insurance company know that my ear was fine, and that my wife’s issue was a minor annoyance that occurred maybe twice a year.
They accepted me and rejected my wife.
We’re now going with the statewide insurance plan for my 26 year old healthy wife because ODS is not willing to cover her. This is the Oregon plan that is the failsafe for residents who cannot otherwise get health insurance.
We’re now in a bad position because we wanted to check out a minor concern with a preventative mindset (and we were already at the ENT Doctor) when we would’ve been better served just ignoring it.
This leads me to point 3…
3. Don’t Ever Tell the Truth About Anything, Ever.
Seriously. If there’s one take away from any of this, remember that everything you tell your doctor will get marked down forever on your chart notes. Some day, if you even get individual health insurance, when you’re arguing with the company about your claim, they’ll point to it and say you never told them, or alternatively, that it was a preexisting condition. So don’t tell anyone, anything, ever.
- Just don’t lie to this Dr.
I don’t actually know too much about the current state of the health care system, but I don’t think I ever realized how crippling the system is until I finally had to deal with a different side of it. I’ve always been healthy, employed, and stable, so this was never (selfishly) a concern to me. One of those things changed, so now I’m in a different boat. I’m very lucky that I have a variety of resources and a bit of income and savings to handle the complications, but I can only imagine how difficult this must be for someone in a different situation. How broken is a system when young healthy people can’t even get affordable health insurance?
My wife and I are incredibly lucky to be physically sound and capable, so I know there’s a light at the end of the tunnel for us. But I have no idea how people are dealing with similar situations who have actual problems that need actual care.
- They go see this guy.
Knowing what I know now, I would be much more selective about what I would reveal to the health care system, which seems like a terrible solution to a ridiculous problem. I would rather risk my health by not getting something checked out than risk being denied in the future or seeing my rates jump astronomically.
Does that not sound crazy?
UPDATE (11/30/11 21:12): I’m incredibly blown away (sorry I keep using that phrase) by all of the comments! I’ve been a bit frustrated with my experience so far, but it’s certainly far more interesting to hear that it’s a commonly felt sentiment. And sad. Mostly sad.
It’s pretty striking that for such a developed country, we still have a healthcare system that seems to function pretty terribly, evidenced more by the disposition of the responses rather than the statistics you can find here or there. Originally, the post was meant to be a satirical look at what felt like a ridiculous situation, but I’m quickly finding that this story is hitting home for a ton of people, which again, blows me away. And again, feels pretty sad.
I started out trying to reply individually, but I’m quickly realizing that it’s a losing battle. Thank you so much for all the responses and I really appreciate everyone taking the time to read my blog, which I know is one of… Billions? I know there’s a lot of them, so I appreciate you spending some of your reading time with me. If you’d like to do it again sometime, please feel free to hit the follow button up top. Or alternatively, follow me on twitter, @MacsJF. (My apologies for the shameless self-promotion).
Thanks again!
-Max
Way Too Much Free Time 
Depressing, but an awesome post! Thank you!
Thanks! Much appreciated!
I find your learned remarks and findings very enlightening. Maybe you ought to publish a handbook on the subject. I am 67 and I am quite familiar with medical insurance, life insurance etc. Yes, they like collecting your money but when you need to enter hospital that is when the headache begins over clearance. There are so many hurdles to overcome and unless you are a lawyer or somebody, you will need to know the ropes on how to get them to pay. The other issue is when you get old. I had medical insurance and they were collecting good money from me, but my policy could not be continued after 60 (not because it could not but because the insurer was taken over by another mega company and they refused to accept me (my age was a liability). So one wonders what does medical insurance really do for you? Who does it really benefit?
Thanks! For me, as a healthy young person, I think of it more as a safeguard if something life threatening were to happen, but I can see that as I get older my needs are going to change pretty dramatically. Not really sure how the system is going to change to accomodate that or whether I’m just going to have to count on saving as much money as possible for the inevitable bills.
I am an American residing in France, originally resided in Germany. Originally had German insurance, then moved to France, continued coverage in both counries, then lost my job in Switzerland, and because of my residency in France, was forced to discontinue German insurance and maintain French insurance. Now, with a considerable health challenge which includes expensive PET scans, and medical maintenace therapy for three years(every two months, once a week therapy) that costs over 3,000 Euros for each treatment, now I am being told that I must wait for the decision of the Medical Council in Paris concerning whether I may continue with my German doctor and his treatment proposal, or whether my treatment will be covered at all. And remember, the French forced me to discontinue my German insurance. In other words, I changed my insurance carrier, as you did. Wrong move! When it comes to money, everybody scurries.
That sounds REMARKABLY frustrating. Sounds like Health Insurance has been more of a global issue for you. Sorry to hear about your troubles.
Sounds like a nightmare. I must admit living in the UK the concept of private healthcare is confusing and scary. The average UK male employed person would pay £3,300 in National Insurance ($5000)
And to date I’ve never been failed by the NHS, always seen promptly. I can see a doctor same day and working day of the week. This year alone I’ve had two operations and one minor medical procedure with no delay and short waiting times.
Yeah, I feel like I would prefer to pay higher taxes and be assured good care then have to constantly worry about whether or not I can make my doctor aware of one of my worries… It’s funny because I wasn’t really aware of my own opinion until I experienced one of the drawbacks. I feel a bit guilty really. Thanks for the comment!
Be careful when comparing. The UK National Insurance isn’t really covering healthcare, despite what it’s name implies. It is supposed to cover healthcare, unemployment, sickness and disability pay and state pensions but it’s takings are not really ringfenced (the government can “borrow” out of the ringfenced pot to spend on anything they like). Many have suggested eliminating National Insurance and just integrating it into the income tax system. Unfortunately many of the citizens are under the impression that it pays for healthcare and our NHS and it is easier for the government to manipulate the taxes while two apparently different taxes exist, particularly since one isn’t called a tax so raising it isn’t the same as raising taxes……..
In Sweden all healthcare is almost free. You pay 20 dollars for a visit to the Doctor and 50 in case you have to go to the emergency (that is including the ambulance coming to get you). When you´ve hit 140 dollars for one year, healthcare is completely free.
That is including a visit for a small cut to a by-pass operation.
We pay around 25 -30 % in taxes (which is not much when you start counting free healthcare, free schooling, even at university level among other things)
I am sad to read that in a country supposedly on top of the world (counting the income and possessions of everyone) normal people are in trouble if they get ill.
Thanks for this post.
Can you see another Doctor? I know recently when I felt my doctor was not dealing with my issues to the best of my ability I asked to see another and was quite pleased with his fresh eyes on my situation.
Regarding cost the above figures are based on the average pay for a full time working man http://career-advice.monster.co.uk/salary-benefits/pay-salary-advice/uk-average-salary-graphs/article.aspx
In the past when I have taken home less and indeed at one point when I was incapacitaed and took home no pay at all then the payments were much less and of course at one point not applicable
Yes Martin. You are free to change the clinic you belong to. I changed clinic when my doctor moved to another city. So now I have 20 min train ride to my docs clinic but feel more comfortable since she knows me well.
These are all really awesome perspectives guys, thanks for sharing!
@Rasta, ah no what I meant was a “Second Opinion” if your not happy with a decision your doctor has made you can ask to see an alternative without the need to change clinic
Hi again M.
I suppose so. Unfortunately I have been in and out of hospitals the last six years after an accident and if you don’t like the doctor you can ask for another one. Especially if you feel he/she is not doing his job.
I have been back another day for second opinion and it turned out that the kidney stone was a thrombosis (at the age of 33 – yet I never drink alcohol, coffee, soft drinks rarely, don´t smoke nor take any other drugs- it was due to dehydration in combination with hard physical training. So drink lots of water 🙂
My Swedish travel insurance even paid for US treatment after cracking my fibula playing basketball some 15 years ago. 4000 dollars was the price in the mid 90’s.
I am sorry to hear the US system is not really a health care system but more like a cash cow for insurances.
I’m surprised by all of this. Hasn’t everyone heard that the US health care system is “the best in the world”? Obviously your real life experiences aren’t corroborating what’s being said at Fox News, so you all must be delusional … I’d see a doctor.
Great info and sorry you went through that. Ethel Mae
Thanks Ethel! Much appreciated…
I will remember these! Sounds like a scary world.
It does get a bit wacky out there : ) Thanks for reading!
As a european (spanish concretely) we have to remember this story, because this is the way the health is going on here.
I think much of the problems you are listing are all about the private insurance, the national sistem it’s pretty more careful with their members. If our health is a matter of cash for the companies we’ll never make a step forward.
I know it’s weird for you, americans, to understand this, but it’s not comunism it’s common sense: one health system, for everyone, no excuses, for free, don’t you think?
Maybe it’s dreaming there, and here it’s a matter of time we’ll adapt your sistem, but anyway it’s a bad choice continuing this path.
Thanks for the European perspective! It’s interesting to see how the problem is getting addressed in other countries, and how people feel about the solutions provided by their respective governments and in this case, the direction you’re afraid it’s headed.
It’s such a zoo. Sometimes I want to just live off the grid.
Although even less health care out there : ) But it does get a bit overwhelming right?
Dear Max,
You made my day! Sorry about that. But you’re young and healthy and you’ve STILL been screwed by this great private health insurance scam in the United States of A. Did I say scam? I meant scheme.
I thought I was the only one. I became disabled after being almost killed in the Afghanistan War. Saved by U.S. Special Forces (read about it on Google, or my blog, http://stateofgrateful.wordpress.com).
Insurance firms were my friend as long as I was working full-time, then they dumped me faster than a stripper boyfriend (to turn your analogy around).
So, Max. Welcome to America. The country where you pay taxes. Where you believe(d), I am supposing, that neighbors helped neighbors.
The richest country in the world, which has the highest per capita cost of health care in the world … and shuns even 20-something, healthy men like you.
Sorry, Max. Please join our national conversation about what’s happening w/ this country: http://hireyourneighbor.wordpress.com.
Thanks for your voice, Max. Thanks for your courage in telling your story.
If more of us tell our stories — when we can’t get health insce even when we offer to pay — maybe, just maybe, other Americans will get it.
Thanks for reading my long msg. This is my favorite rant. For obvious reasons.
Good luck to you and your wife — may you always be healthy & not need any health care.
with gratitude, Kathleen Kenna
Hey Kathleen,
Thanks for the post! I read some of your blog and it sounds like you’ve been in a much more incredible situation than myself. It’s definitely pretty funky when it comes to the health care system, and I’ve got to say that I often feel like it’s such a sprawling issue that I have no idea how to even make a difference so I appreciate you putting the link out there!
Thanks so much for the good wishes and for reading the post!
Best,
Max
Yep, and some people will tell you we’ve got the best health care system in the world! It’s absurd. I’ve got a friend who quit drinking many years ago. He identifies himself as an alcoholic and was honest with his doctor about this. Guess what? It made it hard for him to find a company to accept him, and he’s having to pay through the nose. Meanwhile, active alcoholics lurch along, ruining their livers and causing accidents to themselves and others, but unless they get into trouble that taps their insurance, no problem! They’re covered.
It’s a very sick system, and all because some people feel that the free market (which we don’t have, by the way) is sacrosanct and people with any kind of problem are trash, and we’re all just “resources” for insurance companies.
I’m glad you’re young and healthy and are doing well, but what will you (and by extension, we) do if we are unable to prevent illnesses because we’re afraid to get an early diagnosis? Nuts.
It’s pretty sad that the population has to constantly consider whether to reveal information relevant to their health… And I agree, isn’t it dangerous that I have to do a risk assessment every time I have a genuine concern? Thanks for the post!
It’s wrong, just wrong, Max. Health insurance companies are reaping record profits and unemployment increases, so fewer people get health insurance. Hmmmm … wonder if there’s a link?
I guess we’ll see what happens right? Thanks for reading the post!
yes, we’ve had similar experiences for our family of five healthy people. no serious health issues to date (knock on wood!), so aren’t we the demographic ins companies want?
That’s what I thought also… It wasn’t even a concern of mine that we were going to be rejected. That’s what bums me out about it, if you’ve got a clean bill of health, is it worth the risk to actually go to the doctor for anything less than a life threatening issue? Thanks for reading!
The only demographic they want is people who will give them all their money and then promptly die. Of a bullet wound so you go fast and never need the money you forked over.
I know it is rather nasty when it comes to medical insurances and getting the claims paid. I work for a medical billing company so maybe these tips would make your [and the readers’] life at least a little bit easier.
1. If and when ever you change your insurance policy [even if it is like growing old and getting Medicare] ALWAYS update the coordination of benefits [COB]. Each insurance want you to call them and verify which is the primary insurance and which is the secondary. Till YOU call and do that, they will deny your claim saying they are not the primary insurance. [tip: the doctor’s office staff cannot update your COB on behalf of you, the insurance insist you have to call]
2. If an insurance send you a questionnaire of any document asking for information about accidents or preconditions, please complete it and send it back. They will not process your claim till you respond.
3. When you take a secondary policy, check if it covers the primary policy’s deductibles. Some insurances does not cover Medicare deductibles etc.
4. As you have mentioned, always check the coverage area. Going out of network is one of the most common problems we see.
5. Please check all your monthly bills. If you ignore a statement and later on if the doctor send your information to a collections agency, things will be unpleasant, Many insurances has a timely filing limit of 90 days. If there is something wrong with your claim and if the billing company is trying to get in touch with you, please respond. 🙂
6. Please keep all the payment proof you have made. Be it a credit card payment slip or check clearing details. The doctor’s front office may not always keep a sharp look and when you get a bill that you are sure you have paid, you have proof which you can produce through fax or email.
These are the most common issues I can think of right now. Hope this helped 🙂
Thanks for the tips! Admittedly, looking back, there were certainly precautions I could have taken that would have resulted in a better situation, I was just floating happily in my ignorance I suppose. I do appreciate the post! Thanks!
I NEVER EVEN HEARD OF A GODDAMNED COORDINATION OF BENEFITS BEFORE RIGHT NOW. Jesus Christ, I could DIE because of some stupid freakin paperwork bit of fluff that I don’t even know exists.
Wow, what an amazing post! I won’t even begin to try sharing my own story in this comment, but I will say thank you for writing this piece. And thanks to the editors at WordPress for Freshly Pressing it. More Americans need to know the truth about how broken the system is.
Kathy
Thanks Kathy! I was super excited when I got the notice that WordPress decided to Freshly Press the post… Kind of blew me away! Props definitely go out to the Automattic team!
Thanks so much for the kind words! I hope your story has a happy ending!
All the best,
Max
My goodness.. This is evil. Never thought such a ‘helpful’ system would end up screwing the public.. Thanks for sharing, Max.
Yeah Clarence, it does feel pretty broken right? I appreciate the post! Thanks!
Thanks for sharing about this. My dad has had similar difficulties, but being older and less healthy, I might go so far as to say his difficulties are worse. I myself am 32, healthy, employed, and have been uninsured for 5 years because premiums in nyc are ridiculous ($400/month isn’t unusual for an individual, and family plans easily climb over $1000 monthly). Although, in nyc, they can’t turn you down for any reason, they can only refuse to cover pre-existing conditions for the first 12 months of coverage. My dad asked a doctor friend a few years ago what happens to sick people who can’t get any kind of coverage. The answer was, “They die.” I know that’s not true in every case- I know people who’ve had pro bono cancer treatments, but still. In a system where it’s even possible to make that quip, there’s something seriously wrong.
Interesting response… Every quip has its shred of truth, and I think you’re right when you say there’s something seriously wrong with a country like ours when the joke is, no insurance = find a place to die. A bit dark… Thanks for the post!
If the government regulated the industry more then you wouldn’t have issues. They know that when you subscribe you aren’t going to read a 60 page document and the salesman isn’t going to tell you everything. No you probably didn’t get a lawyer to read it over either, no-one does! If you had government enforced standards looking after you then you wouldn’t be getting raped either. Obviously the insurance industry is not looking after you even if it claims so with lip service.
This is so relevant. Health insurance companies seem to make it their goal to a) confuse you and b) degrade you, all while piling on the paperwork so full of legal fine print that it’s like trying to read Sanskrit. I had a relative recently diagnosed with lupus, which is chronic and there is no cure for. Our insurance company labels most of the medications for her as “experimental” because there is no solid cure for this chronic illness. So, basically, be healthy, lie, and good luck with life. If you get sick, you’re SOL! Whoops! Love, your health insurance company.
Seriously though, thanks for the darkly humorous post!
Thanks Kate! That’s pretty terrible to hear about your friend… I can’t imagine how difficult it must be when you actually get a “real” condition and not something like a ruptured eardrum or blocked salivary gland.
Welcome to the stupidity of making human life subject to corporate profit. The scary part is, you’re one of the lucky ones. I have a pre-existing condition (ulcerative colitis), which I did not cause and for which there is no cure. Despite being otherwise healthy and exercising regularly, I cannot purchase individual health coverage. I’m entirely dependent on group coverage through an employer. And there are a lot of folks who have it even worse.
About 50% of bankruptcies in the U.S. are caused by healthcare expenses. This will only get worse over time. Thanks for adding your voice, and experience, to the discussion.
That’s a pretty crazy statistic… It’s actually the biggest reason I’m trying to make sure my wife and I are always covered, I don’t see any purpose in saving money or buying any assets if I’m not able to cover myself and her. All it takes is one condition or accident and everything you own is gone to cover the expenses.
Beautifully written and funny. I live in New Zealand but I also learnt lessons 1,2 and 3 when we changed insurance providers and I admitted to having had minor back problems post childbirth. Big mistake that lead to them offering to cover me minus my back which the salesperson admitted was a dumb infuriating rule that meant that even if I had a car accident and injured my back in a way totally unrelated to the original back complaint I would not be covered because it was the same body part. So I was forced to do some weird duo arrangement where part of my coverage is left with that original expensive company for the rest of my life because if I ever dare trying to change companies presumably everyones going to make the same stupid assessment. This type of system infuriates me because like yourself I’m an honest citizen and this is teaching us that we’re better off lying, which I hate.
That sounds nuts! It sucks when we realize afterwards what our words may have cost us… Sounds like a pretty terrible arrangement between the two insurance companies.
Thanks for the post!
I gave up my health insurance in 2004 and haven’t had real medical help since, at least not from regular (not alternative doctors). This bothers me on some nights.
Thanks for this information. You deliver it with humor, but it’s still kind of frightening.
I’m still not quite brave enough to risk getting rid of the health insurance… I’m not sure I’d be able to sleep at night : )
Thanks for the kind words!
I work in the healthcare system. I am also a student of psychology and have been taking courses in a shift from psych to public health administration.
I want to tell you, you are so right. The system is so horribly fragmented, and it doesn’t do shit for you. Insurance companies are half of the problem.
If there is any class I’d recommend everyone to take, it’s health care economics. Tells you all the dirty little tricks the insurance companies and hospitals pull. Amazing.
You must have an incredibly unique perspective on the system then… Any end in sight?
Sounds a bit crazy ^^
It’s definitely a bit crazy : )
I seriously enjoyed your post, especially the pic captions! Funny. I too learned a lesson about not telling the truth at a young age. Trying to get my first job, I applied at a grocery store where a friend of the family worked. They had a standard application with questions galore about (what else) shoplifting! So being the idiot I was at 16, I responded by telling them, yeah, I lifted a tube of lip gloss from Woolworth’s (is that showing my age and region?) when I was 12. DUH. Guess who didn’t get the job, looked bad in front of my family friend, never stole again, and, heck, probably didn’t want that job anyway?
Sounds like a valuable lesson thought… I’ll bet you didn’t mention it ever again right?
Thanks for the kind words!
Too bad everyone that gets screwed by the insurance companies (most everyone) could not get together and form their own insurance group……it also sucks in this country of plenty you have to wait months to get a doctors appointment, if you are a new patient it can take longer. I could go on forever complaining, but everyone knows the evils…does anyone have an answer?
I think that’s the trick right? One of those “somebody” should fix it issues and we’re all somebody… Not sure what the answer is though. I imagine it’s complex enough that really really intelligent people have to sit in a room and discuss it at length…
Try adding an actual pre-existing condition to that mix and you have an even worse nightmare. The system is crazy and as ridiculous as your story sounds, it’s more true than not for most Americans. Thanks for sharing.
I can only imagine how much more difficult that makes things… It’s the exact reason I’ll never let myself have a lapse in coverage (If I can help it).
It is baffling, for sure. I am a retired teacher who found cheaper insurance rather than continue with the school’s group. But then it went up to almost the same monthly premium after one year! I had the chance to return to the district on a part-time basis on the condition that I be included in the district plan once again, so I stayed with it when that stint ended. Thankfully I am a 58-year old who takes no medication, but I don’t seem to get a break even on preventive screenings actually recommended by the insurance company. My friends who take meds for blood pressure and cholesterol and diabetes seem to have it easier when it comes to money spent on health-related issues.
We seem to do it backwards. Would make sense to me to pay my doctor a monthly premium to help me stay well, and withhold it if I get sick. Then I wouldn’t think it’s all a racket to get my $$’s, and I would feel the industry had a real concern about my wellbeing.
It’s a crazy world.
It is indeed, a very crazy world… It does feel like there’s a real lack of emphasis put on preventative care, which I feel is a huge detriment to the current system.
This is a great post! It’s a little bit different in Canada but as a health care practitioner, I find insurance companies are a headache in any country.
Makes sense I suppose, their main purpose is to make a profit, and they make a profit either by charging or withholding cash. I can see how that would lead to headache territory regardless of where you live.
Thanks for the kind comment!
When I received an itemized bill from an hospital a few years ago, I swear to god I thought I was on a Japanese game show or something. I decided to be polite and let them know I wouldn’t be paying for the $110 hot water bottle that I never utilized while under their care. They responded in kind by reporting this to all three major credit bureaus, a special surprise I didn’t notice for another year. Cool!
It was in reviewing that bill I became familiar with my insurance company’s favorite term “reasonable and customary.” They mean: “We think the reasonable and customary charge for this hot water bottle is $8.99, but you’ll be responsible for taking the rest of that up your crapper.” That apparently goes for imaginary hot water bottles, too.
You made me laugh. You made me cry. Nice job. Great blogging thus far all the way around.
Wow, that’s pretty crazy… It’s like a Vegas nightclub up in those hospitals! $110 for a bottle?
Awesome to hear you enjoyed the blog… Thanks for the post!
Our daughter was just diagnosed with autism and we’re starting to realize what a joke our insurance is.
Have to say your post was a bit depressing, but the captions were hilarious. 😉
Congrats on being Freshly Pressed!
Thanks! It must be frustrating to deal with the insurance company after the diagnosis… Glad you were able to get a laugh out of the post despite the content!
Funny (in a very depressing kind of way)…but oh so true!!
Thanks Linda!
Wow! I was researching other insurance companies and considering moving our insurance due to a $100.00 increase in our school district next year. With a family of five and now your insightful and hilarious depiction of our screwy health care system, I think we’ll stay where we are!
I’m sure it’s worth taking a look, might just want to be careful about what you reveal is all : ) Thanks so much for the wonderfully kind words! Good luck if you decide to take a look at some other companies!
I don’t have a paragraph to write – I just wanted you to know that I dig your “writer’s voice.” Very engaging! And sorry you had to use it on this suck-ass topic.
Hahaha… Thanks Chris, much appreciated! I’ll keep posting on the blog, so hopefully one of the newer topics will be of a bit more interest. I actually just posted, but the topics “aight” at best. Stay tuned. I’ll have more.
Just some food for thought….
When you go to the doctor, what you are treated for or diagnosed with is given a code. The code is very precise. Thus, anyone familiar with these codes could determine if that wart was on your thumb, pointer finger, or pinkie.
Now, hang with me here.
We have moved away from paper charts and now every piece of information, including those codes, are in your chart. Guess who can ask to see them.
Now, not only can the doctors know everything about you, right down to the wart on your pinkie, but so can the insurance companies and government.
Just thought I would let you know that the wonderful concept of paperless charting is just another way for insurance companies to deny coverage.
That is aweful what you went through and honestly I’m not surprised. If it is of any use or help to you, the company I work for is not an insurance company but a discount program for dental/medical and more and they offer a free prescription card for discounts on pharmacy drugs. It never expires and there are no strings attached. I’m not trying to sell you in any way, just thought I would share it in case you are in need.
God Bless and someday our health will be restored.
Thanks so much for the reply! Maybe you can leave a link here as a reply so if anyone’s interested in looking at the program they can do it easily!
this is so true!
It is indeed, a true story : )
Nuts! just nuts!
It is so clear these insurance companies are always trying to get the most while giving out the least! it is shocking to me, who live in Mexico, to read all this debate about how social medicine equals socialism and comunsim (like thats so close to hell, right?) and then you have a VERY SOCIALIST school system in which kids get lunches, teachers, transportation, books, sports equipment and so much material and nobody complaints! Well not about the cost anyway, although the public school system in the US is as crappy as it is in Mexico; the only difference would be plumbers and carpenters make a lot more over there.
Anyway, I hope the system changes before half of the Americans have to fly down to Mexico to get treated… on a second thought…
I got the best dental care I’ve EVER gotten in Mexico. I had dental insurance through my employer that had not only a $1200 yearly max, it was full of exclusions and “waiting periods” not to mention the co-pays. I found it not only cheaper dollar-wise to go to Mexico, I found the best dental care there south of the border.
I’m glad to hear this! Most Americans believe our entire health system is run by butchers which is not true! Of course there are social gaps to be filled (public hospitals are crappy, private ones are great and fancy). As you said, dollar-wise it could be a good idea for you to fly south of the border to get some treatments.
Cheers
It’s an interesting option I’d never considered… Thanks for the other perspective!
I hear you about this, I went off Health Insurance because I was no longer covered by my parents and changed my Health Insurance I had. I went to see the doctor about a lower back strain, and THIS was going to be a reason why they didn’t cover me for the new Health Insurance. I had to fax my old health insurance card, send the information about my back, and do pretty much everything else. You have to jump through a ring of fire for health insurance, and it’s just ridiculous!
Yeah, I wish someone had told me to be careful about what I reveal, as it may affect my eligibility down the line. It’s unfortunate that it becomes a decision we have to make…
Thank you for making me feel less alone.
I loved your images and captions you included with your (sad) situation.
Turns out it’s a bit more common than we thought! Thanks for the kind words, glad you enjoyed the blog!
My mom works at a safety position at a manufacturer. She has to deal with any worker injury’s and the health insurance companies and she gets the run around with the insurance folks. She does wish it was easier to deal with the insurance people.
After my experience, I can imagine your mom’s job can be pretty difficult : )
Thanks for the post!
Awesome and witty! Our current healthcare system SUCKS for many of us in the U.S. REFORM. Now.
Thanks so much!
I with the rest of the of the commentators especially Pamanner—our healthcare stinks. When I wrote my Senator and Congressman I told them you would do something about healthcare if it effected either you or someone you love.
When I had a tumor in my head embolized, my insurance company deemed it unnecessary, expensive, reckless, and not in my best interest. I wrote back to them in more or less terms, “You expected me to have bled to death when the doctor removed tumor.” My final appeal was denied.
And don’t get me started on some doctors who are insurance company’s lapdogs. If one of my doctors who I named Doctor 6 had taken the time to do his own set of scans and examine me correctly I wouldn’t have been in the mess that I was in where I had to find another doctor to do the surgery because Doctor 6 operated on the wrong tumor. After that I had to find another doctor because of mishaps at Doctor 6’s hospital such as a CT scan on the wrong side of my head and error in judgement when the I had a MRI which caused me to shoot blood when the contrast was pumped into me. I wasn’t going to let anyone at that hospital touch me with a 1000 foot pole. But when I complained to my Unhealth insurance company, they said Doctor 6’s hospital acted in my best interest and even left me with the bill for the CT scan that was done on the wrong side of my head. My insurance company’s response when I complained about the hospital was the hospital acted in my best interest.
Sorry about the rant but you would be evil too if your Health Insurance Company is causing you to stress out and you went through hell with 13 of the 16 doctors you have seen.
That sounds like an incredibly stressful story… Really sorry to hear about it. I appreciate you taking the time to share it and hope you get some resolution!
Here in Canada, there was just a front page story in a national newspaper about how hospitals here found a loophole around the “can’t charge the patient” rule we have here. It seems that the high parking fees are being called extra billing, which is illegal.
The system here is pretty good — you don’t pay much out of pocket for medical care. Eleven years ago I had a parotid gland removed in a surgery that lasted over three hours and stayed in hospital for two days. I only had to wait a month for the surgery and the whole thing cost me a total of $1 Canadian, and that was a mandatory daily charge for having a phone in the semi-private room (they waived the charge for one of the two days). The premiums seem to be much lower than in the US as well. They come off your paycheque and at tax time if you overpay the capped premium, you get a refund. If I remember correctly, the capped annual premium is less than what your new monthly premium is, just about everything is covered, your premium is the same that everyone else pays, and you cannot be denied coverage. The only thing that I don’t like is that each province has its own plan so if you get sick away from home, sometimes it’s a headache and you might have to make up the difference of between what your province’s plan pays for a given procedure and what the other province pays doctors.
I really didn’t understand the argument against socialized medicine when the topic came up in the US… maybe the doctors didn’t like the idea of having their salaries capped and the insurance guys didn’t like having to go back to adjusting auto wrecks.
I am a Canadian nurse. They missed my cancer after 11 months. I left Mayo Clinic in the US and within a day informed I had 3 missed tumours. The Mayo was wonderful. In a day I had a double mastectomny and chemo. I am alive but have lost faith in our system. I have volunteered in humanitarian aid work and felt grateful for care until I got sick-
There are many Canadians who leave for care. I started a patient advocacy.
roadmapforchange.wordpress.com
I’m also in Canada (although a different part; it’s all via income tax here), and I’m likewise baffled at the rage that overtakes the US, or at least their media, at the prospect of socialized medicine. We’re NOT exposing our elderly on ice floes, there is NOT a “Termination Committee” examining whether health care will be offered, and we’re generally well looked-after. In fact, the doctor who saw to my father’s prostate cancer is regularly consulted by rich folks from the US, because he’s rather good at it.
Seems like a lot of interesting perspectives on a different style of health care… So on a scale of 1-10, how happy would you say you are with the Canadian system?
It depends on the location. I’m originally from Montreal where there are a couple of medical schools and teaching hospitals and there I’d score it a 9 because I’m not realy sure if there is not room for improvement. I now live in a small community of around 100,000 without any teaching hospitals to raise the bar for mediacal care so I guess I’d have to give this area a 7 or 7½, partly influenced by the difficulty I had convincing my GP to sign me up for colon cancer screening even though I met and exceeded the province’s criteria and after a long delay I got “scoped” and had to go to two different doctors, including a specialist for a difficult one that had two be taken out in sections on two different days, for three different polyp removal procedures. This would have been avoided had I been “allowed” to get this done when I originally asked. In Montreal doctors are more proactive and really seem to care.
So does that mean you’re fairly limited to the province or geographical area for your health care? Are you allowed to travel to other areas for care?
It’s a national plan, but administered provincially. Fees paid by Medicare to health professionals vary from province to province so if I’m a resident of a low-paying province injured in a higher-paying province, I have to make up the shortfall. That being said, the amounts people would have to pay out-of-pocket would tend to be very modest (I am led to believe), especially compared to what Americans pay in premiums or for services not covered by their plan. Actually, it’s works very well and you don’t hear of people having to choose between treatment and their homes and, in fact, even the homeless are covered.
I’m incredibly blown away (sorry I keep using that phrase) by all of the comments! I’ve been a bit frustrated with my experience so far, but it’s certainly far more interesting to hear that it’s a pretty commonly felt sentiment. And sad. Mostly sad.
It’s pretty striking that for such a developed country, we still have a healthcare system that seems to function pretty terribly, evidenced more by the disposition of the responses rather than the statistics you can find here or there. Originally, the post was meant to be a satirical look at what felt like a ridiculous situation, but I’m quickly finding that this story is hitting home for a ton of people, which again, blows me away. And again, feels pretty sad.
I started out trying to reply individually, but I’m quickly realizing that it’s a losing battle. Thank you so much for all the responses and I really appreciate everyone taking the time to read my blog, which I know is one of… Billions? I know there’s a lot of them, so I appreciate you spending some of your reading time with me.
Thanks again!
-Max
Stuff that everyone should know. The health insurance “industry” has no excuse for existing. It produces nothing. Only moves money around, mainly into its own pockets. We should all be covered that same way we’re covered for firefighting and policing when something does wrong. It’s a basic community need for a civilized society.
It is hitting home because the people who we elected in Washington are trying to sweep this issue under the rug. This issue infuriates a lot of people from parents of severely ill children to our seniors who sometimes have to make a sacrifices. Going through my experiences I found I was not alone and began interviewing people about their experiences with the health care system and doctors. Not one had a favorable review of their whole health care experience when they got sick. My friend always used to say, “Don’t get severely ill in America because your ass will be in debt and you will get sicker” She doesn’t say that around me anymore but she is right. My friends from overseas are just appalled on how I was treated and how others were treated. One friend wished he could have flown me to Germany to get better treatment. The whole world is smoking us in everything and that includes health care.
Oh I’m so glad I kept my French health insurance when I moved to the US!
Is it still pretty cost effective even though it’s international?
Hi there,
I read your post with a (fairly large) sense of shock and awe – and not in a good way! I live in Australia, I’ve changed my health insurance company three or four times since I’ve had health insurance, and the only time I had a hiccup was solved by *my* saying ‘no, you’re wrong’ and them saying “oh, so we are. No you don’t have to pay anything”. The company we’re with currently will cover us anywhere within our state, they bend over backwards to make sure we get as much loot out of them as we’re entitled to – in fact went out of their way to tell me how to claim something I didn’t even know I could claim! I have a pre-existing condition that I have been ignoring happily for about 20 years – I disclosed it to my insurance company, and they were all “no drama” about it. Of course, I am yet to test them on whether there is in fact a drama…
But we pay a mixture of private health insurance and medicare, and so far – everything we’ve wanted doing has been done. No fuss and bother at all. I hear stories from some of my American friends who have bucket loads of debt for what, for me, would have been a free service.
Sounds like you’re pretty happy with the level of care in Australia! Do you feel like that’s pretty common there?
My husband and I used to have minor medical things done in Mexico when we would go there for vacations. Then their would be no record of it in the U.S. Sometimes you have to be bigger jerks than the insurance companies, just for survival. Great post.
Thanks! One of the other readers mentioned that as a solution… How happy have you been with the level of care in Mexico?
I’m so glad I read this and that you shared it. Thank you!
Thanks for the wonderful comment!
Health Insurance companies should be abolished and replaced with mutual cooperatives. The function is to be there for the benefit of the insured not the stock holders or dividend pay out.
Is that an option that exists?
Awesome
nice
i like it so much !!thanks to share it !!!!!!!!!!
Thank you!
Excellent post. We had similar eye-opening experiences when our family of four was on private insurance when hubby and I were self-employed. One insurance company would take this person but not that one. Another company would take the “rejected” person but exclude certain conditions from coverage. And it’s not like any of us had anything major going on! I relate to your experiences 100%. I’m sad to see things are still so messed up with healthcare.
Your captions, by the way, are brilliant.
Peace, Graciela
Thanks Graciela! Sounds like your experience was pretty frustrating! Glad to hear you enjoyed the captions…
Our health care system is totally a bluff! I couldn’t imagine how people are against in reforming it. I feel like sometimes, I have to go to Mexico or Canada just to get tested and treated… now that’s quite sad. Great post btw! *hits the follow button*
Thanks!
I too, suffered an increase in premium when I moved a mere 10 miles from my previous address, resulting in a $12 monthly increase in my Cigna policy (its just me, but still). Feeling like I was fulfilling my duty of being a good proactive customer, I (like you) called notifying them of the move, unknowingly having just shot myself in the foot. Sad, but, ya gotta have it. PS- Love the captions.
Thanks! $12.00… It’s just enough to be annoying, not quite enough to drop the coverage for.
Hi ……. an amazing bit of an eye opener … its just how I feel about health care . Fortunately for me my eyes were opened by GOD (NO LESS) ABOUT HOW I CAN LITERALLY ELIMINATE ILLNESSES FROM MY LIFE. I FELT BLESSED, BELIEVED AND BENEFITED ULTIMATELY. I FELT COMPELLED TO WRITE A BOOK AND SHARE MY KNOWLEDGE
WITH THE WORLD AND ESPECIALLY AMERICA AS IT WAS GOING THROUGH AN ECONOMIC CRISIS. KNOWLEDGE HAS ITS OWN IDEALS …..IT BLESSES THE TRUE BELIEVER WITH ITS GIFTS WHEREAS THE DOUBTERS OF THE WORLD ARE LEFT BEHIND. LIFE IS TOUGH UNTIL YOU LEARN TO TAME IT AND HAVE IT WORKING FOR YOU INSTEAD OF YOU WORKING FOR YOUR LIFE !! THAT’S JUST THE WAY THINGS ARE SO WHEN YOU LEARN AT A YOUNGER AGE … MORE YEARS OF YOUR LIFE ARE IN RELATIVE COMFORT.
My daughter once fell off of her bike, broke her arm and the insurance company denied the claim. When I called about it they said it was denied because of a “pre-existing condition”. Really?? How in the world can a broken arm from falling off of a bike be a pre-existing condition. Once I called them out on it they paid. I think they count on people not questioning them about denials. What a scam!
That’s kind of how I felt about my appeal process… But a broken arm for a child? That sounds crazy.
very good post youre helping in people knowing the truth behind insurance companies .
Thank you much!
Your health system doesn’t actually care for your HEALTH. I struggle to comprehend how Americans in general can’t actually see that. Sad indeed.
Good on you for sharing. I’m facing a bill of about $15,000 for my husband’s hospital bill, despite having health insurance for over 10 years because we were late with a payment. And I’m in a country that brags of having a great “free” health care system.
I hope they don’t come and eat the kids!
In what country are you having that issue?
When you say your premiums doubled, is that per month or for the entire year? You should live here in NY. I don’t even have insurance. I dropped it when I decided to write from home. To keep myself covered, it would have cost over $600.00 per month. No way am I paying that. Thank God I’m healthy and that the cost to go for my yearly’s isn’t a hair compared to what it would have cost to keep myself covered.
http://valentinedefrancis.wordpress.com
Hi Valentine, it was per month… I’m a little petrified to drop my insurance entirely, what happens if you were to get sick?
God forbid of course…
Love your post and reminds me why I am so glad to live in the UK. However much we moan our health service is actually very good and is probably why many of us are fighting to keep it free at the point of delivery. (We do pay tax for it though!) I may forward your post to a few of our politicians who seem to want to privatise it by stealth!
Thanks so much! Feel free to forward it on to whoever you’d like : )
After reading this and many of the comments, I feel quite lucky to be Canadian. I’ve complained in the past about wait times at some walk-in clinics here in Toronto (a city of 5 million – understandable), but it’s nothing compared to the problems Americans face.
I was in Cleveland for a wedding in the summer and the topic of healthcare came up. A rather well-off ‘right-wing’ women at the table argued so strongly against public healthcare, but given her position, she could never feel the frustration of the private system that many other American friends have talked about. The unfortunate thing is people like her have your government in a choke hold that will prevent it from ever providing effective healthcare for ALL Americans and actually caring about the physical and mental well being of everyone through policy.
What your healthcare system needs is a complete overhaul – check out some of Canada’s provincial systems for ideas to propose to your local politicians. While I know many hate the idea of public healthcare, our systems aren’t some third-world ‘commie’ planned industries where the government controls your life. Here in Canada, we still have competitive market factors in play, doctors still make six-figure salaries, insurance companies still make billions off ‘additional-coverage-type’ plans (i.e. medication insurance), big pharma is still big, and you have the freedom to pick your own doctors and healthcare practitioners. The biggest difference? Everyone goes to bed less stressed knowing they are already covered.
Just my two cents. Cheers.
Are you kidding I am a Canadian nurse who was told she did not have cancer after waiting 11 months. I left Mayo Clinic and within a day I was told 3 tumours were missed and ended up with a double mastectomy and chemo. I would have never believed this until I experienced it myself and connected with a huge number of Canadians who have had their own personal horror stories. The politicians here do not want to hear we have a problem. I even called the White House to review their plans going forward. I started patient advocacy group and also to assist healthcare in process design to deliver a better service.
http://www.roadmapforchange.wordpress.com
Sounds like you both have had some pretty interesting experiences with your health care system… Sounds like no system is perfect.
I’m an American who has lived in Europe for 11 years. I could write pages about how infuriating the American health system is compared to my experiences over here, but what has been most infuriating in the past few years has been seeing Americans fight against healthcare reform. When healthcare became a hot issue 3-4 years ago, I was so happy. I thought, finally, people are getting angry and change will happen. But then people, often low and middle class people who would benefit from change, started yelling about how they didn’t want the government’s nose in their healthcare. I was baffled at how they saw the government as the big enemy, but put trust in profit-hungry corporations. And it all spiraled into this battle against what Obama proposed and claims that people who want universal healthcare are freeloaders. I don’t get it at all. I’m glad to see so many people desiring change responding here (though unfortunately often due to horrible circumstances), but many people are also afraid of it and choose congress members who want to remove or cut away at Obama’s plan. Though I think a better approach that Obama could have taken, instead of freaking everyone out with “making” them pay for universal health care, was to first try to change regulations on health insurance companies and fix some of the problems like you write about here. But then they probably have powerful lobbyists and that may have gone nowhere.
Unfortunately, what many don’t understand is that Obama has already made progress with his healthcare plan which is only further enabling the health insurance companies. Connecticut Medicaid has begun the process of rationing cancer care and it is only the beginning. The banks and insurance companies are thrilled at the deadlock in Washington because it means no one is really watching what’s going on.
Macs, one word of caution. Healthcare providers are on YOUR side, not the insurance companies. Hiding the truth from a doctor is something that you will ultimately regret.
Good luck!
Yeah but … TELLING the truth is something you will ultimately regret. Death by stoning or drowning. Take your pick.
Thanks so much, I certainly haven’t had any bad experiences with health care providers/doctors (my doctors have been great), it’s just the associated costs and the negative effects of checking out any health concerns. I certainly don’t want to hold back information from someone who ultimately can diagnose me, I just have to be more wary of what I reveal as the long term consequences may cancel any short term gains. And it’s pretty crappy I have to make that decision.
Thanks for the post!
Quite an eye opening article.
Thanks! Glad to hear it!
God how depressing. America is crazy with this kind of thing – although I guess all insurance companies are part of the same child-eating, death-sting wielding clan! 😦
Makes me feel a bit better about throwing caution into the wind though!
I don’t know about the future but for now I can get on my husband’s health insurance plan, no questions asked. They have such a big pool to draw on that it was $500 per year to add me and the kids. I’m grateful to all those other people who paid their premium and never got sick because I have more than used the $500 (probably 3 or 4 times that) for my life threatening condition. I have stabilized and will most likely return to perfect health but this will be on my “forever chart ” as you put it.
My story is a happy one but I read one in the newspaper last year that wasn’t. The man had a wife and two kids and a rare brain tumour. He used up all that his insurance would pay for, then the province refused to pay for the only drug that was having an effect. He would die months later.
Awesome to hear that your experience has been good, though sorry to hear about the other man’s story…
The healthcare system was specifically designed to kill the people.
very nice post! also think that your pics are brilliant 😉
Thanks so much! It takes a while to search them all out, so glad to hear they were enjoyed.
Wow – your post really hit home for me. I live in Massachusetts, the home of mandatory universal health care. It’s amazing that Massachusetts is very efficient at imposing penalties on those who don’t have coverage. My “affordable”
coverage premiums doubled in a year. My coverage went down. Yet, the insurance company CEOs are still getting their annual million dollar bonuses.
I shudder to think what Obama care will to this country. While the intentions of Massachusetts were good, the reality is the opposite.
Nancy
This is the reason people fear obamacare — not that they are fighting against their salvation, but that they know it will only make things worse. The guy was shoved over the line during the election by a committee that was headed by the CEO of Tufts Healthcare. Christ. Do you think that someone who could actually have made a difference could even have gotten elected?
The insurance companies and the bankers have their hands up the asses of all of the sockpuppets who run for office. No matter which puppet you vote for, it’s the same billionaire’s hand up his ass. And we make damned sure that the ones who CAN make a difference never get past the starting gate.
I need medical attention after reading this! Thank God for Canadian health care!
It may suck at times. but it beats the heck out of some of the alternatives.
Your paragraph titles rock!
Thanks! They’re all handpicked for freshness…
I’m glad I live in the UK where there is the NHS! If I ever move to the US, I’ll be sure to keep this post handy!
My son slipped between the cracks of broken insurance ethics when we attempted to switch policies to facilitate treatment with a well-respected doctor. Thank you for your beautifully crafted, relevant piece.
Thanks so much! Sorry to hear about your son’s situation, hope it worked out in the end!
This is terrifying! I’ve never actually had health insurance… as a full time student I’m on the ramen food plan so health insurance isn’t even an option. I’m too old to be put on my parent’s plan through their work… Three more semesters plus grad school means I can’t be sick for a while! I also will be moving a lot between Canada and the US… I think the best solution is becoming a Canadian citizen. As far as I know you may have to wait a while for a doctor but at least one has the right to be human, get sick, AND get help.
The ramen food plan, though ineffective as an insurance option is insanely delicious. I especially like Oriental flavor.
Wait til you get older. It gets worse. We pay for our own insurance for our family. The costs are astronomical. We have a $2500 deductible to reduce our monthly costs. We sweat this time of year, wondering what will be with the upcoming year. Will they reject us? Increase us? Even minor issues seem to be a reason for concern.
I recently told my doctor, that given the costs, I won’t go to the doctor, except in very extreme circumstances. It either comes back to haunt you (like it did in your case) and our costs will skyrocket, or they reject you. My doctor, a friend, was very upset to hear this. He supports socialized medicine (surprisingly). He was bemoaning his costs of providing insurance for his employees, and upset with the deductible for his staff. He, however, can afford it better than most.
Good luck!
Sorry to hear that! It must be aggravating to always be wondering what the next price increase is going to bring…
Im not sure I believe your story. But you’re funny. And i like that.
Michael Henry
1320 prospect
I’m not sure you’re not a spambot. But you complimented me. And I like that.
Max
Formerly 1320 Prospect
As some one who has read of the US health care system this was an eye opener. Thanks for sharing.
Thanks so much for reading!
I read this and it just makes one shake their head. Something to throw out there from a hotel in Florida…The Rosen.
The CEO of Rosen many years ago jumped through the hoops that the insurance provider asked of him and even though his employee accident rate dropped, his costs increased. He saw it as a losing battle so they did something very radical. They figuired out what it would cost to employee an onsite medical staff and became their own medical system. The cost to Rosen and their employees dropped dramatically. Now they are working with interested companies to do the same. Only the almighty dollar (or loss of) will promote change to the health care companies.
Sad that in our country it works this way…
Good read!
That sounds like a really interesting/creative solution… Actually the first time I’ve heard of a company putting that together by doing the math.
Thanks for the comment!
So sorry to hear of your troubles, what a headache!
Thanks! Could be worse I suppose : )
Wow, our system is really broken. I’ve been trying to get a claim paid since July that my insurance company keeps denying.
When I ask for the reason why they’re denying the claim they tell me I’m missing some information–information that I’ve faxed and re-faxed and re-re-faxed to them over and over again.
Ugh!
Bureaucracy is a great way to slow any process down. Sorry to hear about the troubles!
Thanks for the warning. I just got back to the US after 12 years in Asia, and I need some health insurance. Uh oh…
Could be troublesome… Just say no on EVERYTHING. But you know, don’t lie.
A good entertaining read on a essentially serious subject. Lesson seems to be to always lie. Anbout everything. And that medicine is a huge business. And insurance probably even a bigger one. I don’t know what’s the answer here Max- I used to live in the US so i am familair with the system there- I now live in the UK with a National healthcare System which is a complete shambolic joke- sure it won’t cost you a thing but will probably kill you. It seems to me the answer is money. if you have millions, you can afford to buy the care you need. The rest of us, seem to be shit out of luck.
So… I guess the new goal should just be millionaire status right?
It is a sad state of affairs when you get insurance on your own through your state (I have been laid off for about a year now) only to find out the exhorbitant fee every month really covers nothing (Like having all your clothes fly off during a hurricane and they give you a cocktail napkin to cover up and say ‘there there.. here you go, all better now See you in 6 months!”). To top it off, I decided I did not want to participate anymore, but!!! IF I choose to ever enroll in it again, I will have to pay ALL the premiums from the months that I did not have access to the insurance coverage before I will get that cocktail napkin back to cover my a$$!!! So sometimes even when you opt out of a bad situation, it stays there waiting to pounce on you and rip that cocktail napkin away!
That sounds crazy… And it’s state sponsored?
My favorite line from the insurance company is “We aren’t dictating your treatment, you can have the procedure/medication/test…we just aren’t going to pay for it.” I enjoyed your post a lot!!!
Thanks Aimee!
I could see how that would be a favorite.
I’m just going to keep punching, and if you happen to walk in front of me…
I don’t think showing a picture of a big black man and using him (even as a joke) as a threatening presence is a very good idea.
Why would you use that particular picture and not a picture of a big white man? I an curious as to the editorial process that went on when you made this decision. Or was there no thought process involved at all when you decided to post that?
Hey Kenneth,
He wasn’t chosen because he was black, he was chosen because he’s Dr. Dre. And you should never lie to Dr. Dre.
It’s Dr. Dre…
Just like a TYPICAL “Liberal”…ALWAYS show the white people as the threat.
Even though what picture he chose had absolutely *ZERO* to do with the post.
—
Anyway “Garavato”, congrats on ‘fresh pressed’.
Why would you even go there…? Gah!
It’s sad how many people have similar stories (and worse) to tell. After living 10 years in France (and being impressed by their health-care and medical system), coming back to the States as an adult was an eye-opener. I still fail to understand the condition of the health-care system, and entire medical system, tools available, prescription process here. There’s a lot of work to do to make this system more functional, more logical, and more aimed towards actually helping people’s health. I’m regularly shocked by the stories I hear, and I really have a hard time comprehending why nothing can/is done about it.
Thanks for this interesting and thought-provoking post, and congrats on a well-deserved freshly pressed.
Thanks so much! It does seem like it takes quite the time investment to understand the ins and outs… As a young person, I felt/feel pretty unprepared to deal with the system.
Insurance companies the world over are hated for exactly thee reasons. It seems health insurance is only any good if you don’t actually get sick. And your premium will only allow you to suffer in certain ways. Pay thousands but if you get sick another way it seems you are on your own, as if you have never been insured. Health insurance should be “pay your premium, if you get sick we fix you” but it isn’t and never will be. The money would be better off under your bed.
The idea that you are punished for preventative care is exactly why the US system does not work. Here in Canada, my husband was feeling minor heart flutters, so we went to the doc, did a stress test, everything was fine and everyone is happy. That’s how a health care system should work. But, you know, that would be “socialist.” Heaven’s forbid!
One thing, just one reason why we have problems with health insurance:
LAWSUITS.
——-
And Kenneth, right, brother, its only the white people that are threatening….
Never ever show a black person in a bad light. As if they are not normal, human..
I enjoyed this post and the comments. I’m the world’s only physician bluegrass fiction writer. My first novel, “The Mandolin Case,” (available on Amazon.com; check out the reviews) is a medical legal mystery resolved by musicians with the help of a hospital maintenance man/golf hustler. The sequel, “Acquisition Syndrome,” deals with the issues you raise. The subtitle is “From Healing Art to Business,” a trend I find unfortunate. It is due for release this spring.
Both novels are fiction; they show the truth but don’t tell any facts. This not only protects the guilty but also the writer!
All best wishes in dealing with a difficult system.
Dr. Tom Bibey
Thanks so much! I appreciate the comment!
Congrats on being Freshly Pressed! You are correct in noting how desperately sad in such a developed country the health care system is an absolute joke. Hahaha…”health care”…such a misnomer! Thank you for sharing your “discoveries” with us. I’ll definitely keep them in mind when filling out my paperwork with new doctors this coming January.
Thanks! Glad you were able to get some value out of the post… Good luck in January!
Great article, I really enjoyed it thanks! Very witty, yet a bit scary as I too have private insurance.
Thanks! It’s a bit petrifying when it comes to privately insuring yourself… the benefit of working for a company suddenly seems of so much more value!
Having dealt with health insurance companies over the years, personally and professionally, I feel your pain. But I had to learn to play their game. If anything I would rather be alive and in debt than DEAD and debt free.
Yes, the U.S. healthcare system needs to be reworked, but I would not trade it for any other system. You hear how great it is “over there” and how great “that system is”. I have read of people dying in the hallways in a hospital here in the U.S waiting for treatment, and also dying abroad, waiting in line, for months sometimes, for a simple operation, or just to see a doctor. The grass is always greener on the other side of the fence.
To transfer all the power and control of my health to the government who has clearly shown that it would have a hard time managing an out house, would be insane.
The term “free” is over used. It may be “at no direct cost to you” but not free. Very few things in this world are truly free. Definitely, healthcare is not free.
I hear ya, it doesn’t sound like there’s any sort of “easy” solution. Sounds like you can great or terrible care almost anywhere.
This hits home. I find it interesting that the US leaders are allowing the insurance companies to run peoples lives the way they do. My husband and I are self employed. The only insurance we can get is over $3000 a month for both of us and will not cover any preexisting conditions. That cost is more than ALL of our bills combined, including food and gas for our cars.
Consequently, we were in a car accident (thank goodness we had car insurance) and when I had an MRI on my back it showed a lesion on my spinal cord. I was told it was probably stage 4 cancer. This happened on my birthday in October. I didn’t have enough money to cover the tests to find out if it was cancer. We didn’t qualify for any charity that would help us pay for the tests. No doctor would see me, because I don’t have health insurance. Finally when I was able to get into see a general practioner he told me that it looked like cancer, but if I was still alive in April that I didn’t have it. It was a long 6 months.
A single payer system is the only way we can be relieved of the strangle hold the insurance companies have on our country.
That sounds like a really terrible story, very sorry to hear it… I hope it all works out for you!
Hooray for fascist capitalists making money off of sick people!
I feel your pain. I had to switch jobs a year ago and my husband (self-employed) was no longer covered, so we had to buy him health insurance. After being denied a few times, we finally found one that would accept him and not charge too insane of a price, but the coverage isn’t near as good as mine. It really is a horrible situation to be in.
Agreed, sorry to hear about your situation!
Maybe it just depends on the location or insurance. I live in the U.S., and my husband was diagnosed with final stage cancer (lymphoma). We’re working class…low income…and my husband had insurance through his job. Not a great job. But I’m so thankful we had it.
He received state of the art care, and it saved his life. Never once was he turned away for any treatment. As a matter of fact, he was offered a new, revolutionary procedure which was more aggressive and lifesaving. I will always be thankful for the care he received. Were we just lucky? Maybe. But in the midst of horror stories, I had to chip in a different perspective.
Of course, the insurance was not perfect, as I spent hours on the phone arguing over codes or prices. But it was all resolved. I quickly learned to be proactive. And yes, I read every word of every damn book they gave me. I made phone calls. I raised hell with doctors. I questioned until I understood every bit of fine print.
I’m not saying insurance is rosy. There are many problems. There will be problems for my husband down the road…and for myself (I’m not covered). And I’m not saying I’d be against changes in the system, if the changes are common sense.
It’s great to consider what other countries do, but we also have to consider our own lifestyles. And the mindset of our own politicians. They can’t even balance a budget. They (both sides) use healthcare as a political ploy for votes. Will they produce less red tape and idiotic bureaucracy? I have to wonder.
That sounds awesome! I’m glad to hear you’re experience was such a good one and it definitely shows a side of our health care system that probably doesn’t get as talked about. It sounds like you were pretty proactive in dealing with them, which seems like a good way to go about it. Thanks for the post!
You’re lucky enough to be young and healthy (for now). I’m in my mid 50s and haven’t had insurance for over 25 years. In the past 5 years my health has deteriorated, I’ve broken my foot and have asthma and haven’t seen a doctor in 15 years because I can’t afford it. America’s greed sucks.
That sounds pretty crappy… Sorry to hear about your troubles! I hope it all works out…
I have resolved to never go to the doctor again, unless something inherent falls off or something foreign grows on. I’m taking my chances; the single greatest threat to your health is for a doctor to find something wrong with you.
I hear ya! and they will if they can…it’s really all about the $$$
Definitely a “between a rock and a hard place” decision…
Health insurance is the one thing that has brain washed me into thinking I need to work for a giant mindless corporation. I have a feeling that if I don’t find a job soon with health insurance, the health insurance gremlins will come into my house at night and steal my neck. Why my neck? Because they’re crazy. Don’t try to figure them out.
haha…I think they’re after my pinky. Why my pinky? Because they’re CRAZY! 😀
Just don’t feed them after midnight.
http://en.wikipedia.org/wiki/Gremlins
I LOVE your post… I have suffered a lot of the same issues you have had but have also survived cancer and an autoimmune disease (still ongoing), and the one thing I hate more than anything is going to the doctor and having them tell me they want to run tests and then stopping before ordering them to ask what insurance I have. How about they take care of me like the right thing to do and not worry about that? It’s a business so I can’t expect to be treated like a patient I am, after all just a customer now!
Thanks Elizabeth! Sucks to hear about your ongoing autoimmune issue, but glad to hear you beat cancer! I can imagine it would get a bit frustrating after a while to hear the insurance question right off the bat… Kind of like getting asked at a restaurant how you plan on paying for your meal before ordering.
Hilarious captions! Whenever I read
Stuff like this it makes me so sad that you guys have such a crappy system. Everyone deserves better than that.
Thanks and thanks!
Great post! I’m 63 and my health insurance (Blue Cross) runs almost $1,100 per month. My deductible is $5000. This covers my wife and I. Up until about 2 years ago, I had never been hospitalized. After several operations for bladder cancer, I have had some interesting experiences concerning sanitation practices in the hospital. You might want to read about it. http://www.steveatkins.wordpress.com
Just read your latest post and it sounds like you’ve had an interesting array of experiences… Sorry to hear about the health issues! I’ve been in the food industry and it sounds like there’s some parallels to be drawn when it comes to sanitation…
Thanks for the post!
I would laugh but what you write is so true.
You can still laugh.
: )
My insurance was great until I got sick. Then it made me sicker. And I won’t be well until my deductible is paid off…months later and into the next calendar year.Thanks for bringing this to us in a way we all can relate to. Oregon is a decent place – enjoy!
Loving Oregon! Sorry to hear about the deductible! I’ll bet that’s a real pain…
great write-up. i want to get mad but i have no choice because everytime i switch employers, they also change my insurance.. :c
Thanks! And that was a huge burger.
I’m from Scotland and this post really horrifies me. While the NHS in the UK isn’t perfect, it seems to be a far better system than in the US. National Insurance is basically a tax that practically every working person pays, but that means that all healthcare is free at the point of use. If I want to go and see my doctor I’ll be seen that day and won’t have to pay a penny. I spent a year and a half in recovery after an operation, for the first six months a nurse visited my home every day to dress my wound and check on how it was healing. I have never recieved a bill for this nor ever will. While you do have to pay for prescriptions like antibiotics, those charges are capped, and you wouldn’t be billed per tablet for example. While it is money out of everyone’s pay, isn’t health insurance too? I know that all of my family will be treated regardless of if they work or whether they have an underlying condition.
Some of the stigma around the idea of a national health service for the US seems to come from the notion that it’s socialist and giving the government too much power. You can elect senators and presidents, but how much of a say do you have in how a health insurer is run?
Reading your post, you could take out almost every reference to healthcare and comfortably replace it with “car insurance.” When you can do that so easily when it’s the health and wellbeing of people’s family and loved ones you’re talking about, there’s something very wrong with the system.
I’m of mixed opinion about the idea of a national health service in the US, but not because I’m stupid and think that everything’s peachy keen and perfect or that our system is “the best in the world” or any of that rot. Let’s face it, we DON’T elect senators and presidents. The committee that got the current jug-eared idiot into the oval office, the one that refused its party’s floor vote, was chaired by the CEO of Tufts Healthcare. I cannot imagine that anything come up with by anyone venal and bought-off enough to succeed in running for public office would create ANY healthcare legislation that’ll do anything but put even more of my money in the hands of the puppetmasters that own them.
BOTH of the candidates in any presidential election are likely to be complete pawns, sockpuppets, with the same billionaire’s hands up their backsides anyway. There is no way that ANY system they are likely to come up with will do anything but make things worse. In order for the government to do any better, they’d have to not be owned lock, stock, and barrel in the first place by the evil motherfsckers who run the insurance companies that are trying to murder us all for profit.
THAT is my problem with government healthcare. And anyone who truly does have a snowball’s chance in hell of improving things will get kneecapped instantly by the media and said puppermasters, and kept from ever seeing the inside of the oval office. I fear national healthcare in the US because I have ZERO trust that it be anything but worse. If your government were to create the NHS nowdays instead of in the aftermath of WWII, you can bet it wouldn’t come up with the quite decent system you have now, either.
you have a great sense of humor. Even though this situation speaks volumes about our failing healthcare system and is pretty annoying, I was literally cracking up the entire post. great job!
Yep, insurance sucks!
Yup, I hear ya!!! I’ve been through sort of the similar nightmare of dealing with health insurance companies, all in all, they suck!!! Even if you want to pay for it, they’ll find a reason to not accept you, wheres that leave the average american?? Running up medical bills!!!
your post is very informing with a great touch of humor which i feel is essential.
going on my experience when you have a question about your health and feel you need an opinion from a doctor
there are many trustworthy people able to diagnose your condition in the field of “alternative medicince”.
you may have doubts but give it a try, its worked for many people i know.
the establishment do not classify homeopathic treatments so won’t affect your insurance.
We’re Canadian. My grandma fell and got a bloody chin scrap in Florida one day. Someone called an ambulance. Some how our family ended up paying $20,000. USD.
Do you reply too all posts, or only the ones from people you don’t know? and very impressive, BTW.
Thanks! I’m trying to respond to everyone… Just slowly trying to make my way down the comments section. It’s taking me a while : )
Now imagine what it’s like for a 23 year old with any kind of disease. I already know that whenever I get a job (I’m still in college, so I’m still under my parent’s health insurance), it has to have it because otherwise, I won’t be able to get anything.
What’s been really fascinating is the world without health insurance, which is where my dad and sister are at right now (and me in some regards). We get one of our eye drops for free and should get another one for free if my dad sent in the paper work. The doctors help us out and give us samples and so far, it’s been fine. So the problem isn’t the medical industry. The problem is the health insurance and in some regards, the government that mandates all the laws with the health insurance, like it must cover IVF.
I’m sure your story hits home for many. Healthcare is just one of the many problems with this country right now. With everyone bickering over ever single thing right now with nothing really getting done, the situation is grim.
Glad to know you and your wife stay fit and healthy. That’s really 75% of the solution. In other words, don’t always depend on others, but always look after yourself first.
Congrats on getting Freshly Pressed — enjoyed the article & all the posts. You certainly sparked a lot of interest and rightfully so…Americans are paying way too much for health insurance and getting far too little in return. Waiting periods, exclusions and co-pays in addition to high premiums? There’s an awful lot wrong with this picture. Thanks for sharing!
Thank God for universal health care.
I always find myself saying, “If only I were European…*sigh*” But I don’t really know what that actually means other than they have health insurance covered and they actually get vacation days each year…I was a salaried career maker for several years and after a round of health issues (E. Coli), I found myself at an entry level job making $10/hr with no insurance. The fact that I had to wait 90 days to be eligible for insurance was bothersome and even more bothersome is that as an hourly employee I get NO vacation days, work holidays, and am not paid for days I have off. It’s a depressing pit down here at the bottom and for me, it’s temporary. I have a master’s and I will find another, better paying job…but what about all the families that this is their reality? It’s a sad state of affairs, indeed. Occupy Wall Street needs to become #Occupy America.
Something really wrong with the medical charges in USA.
In 2005, I need a a total knee replacement to left knee . Had a limited insurance policy – all I could get – with a premium about 405 a month. After insurance company paid all they would pay . ($25,000.00 on a $67,000.00 hospital bill) I was left with a debt of over $42,000.00 to the hospital . The hospital allowed me to pay off them off monthly for the next 4 years with no interest.
By 2007 , the insurance company had increased my monthly premium to $605.00 with the same limited pay out for any arthritis related surgery of $25,000.00.
Same time I was told in 5-7 years I would need the other knee replaced.
I did the math. If I paid the $605.00 monthly premium for 5 years that would be $36,300.00 . Not allowing for additional premium increases. I would owe at least another 42,000.00 out of my own pocket to hospital. That meant I would spend $78.300.00 if I had insurance or about the same as paying the whole hospital bill myself. By then I had learn that the hospital and doctors give big discounts for being paid at time of service and/or paid in cash. Doctors and hospital honor credit cards same as cash. Also, I hope that if I could postponed the surgery until I was 65 in 2013. Medicare would cover me and pay the bill or most of it.
SO in 2007 I canceled my insurance policy . I put some of the money that would have gone for premiums in to savings and my IRA. During the next 5 years my medical cost were down due to me asking for discount for paying with cash at time of visit.
This year I had to have the right knee replaced. I spoke to doctor and hospital before being admitting and told them I was un-insured and asked for a cash discount. I SAVED 90% ON THE HOSPITAL BILL !!! Hospital bill was $180,000.00 but since I was not insured and was paying bill in full within 30 days it dropped to to a total of $18,000.00. I saved enough by canceling my insurance to more the pay the hospital bill.
If I had been insured my 20% deductible would have been $36,000. Of course , I assume the hospital make a profit with the first $18,000.00. The balance of $36,000. would have given the hospital an additional profit of $18,000.00. Then the hospital would have been paid more money by the insurance company, right? If the hospitals are billing 100 times the cost to patients with insurance. The insurance companies pays a percentage of the inflated amount . An even larger profit. Yet the hospital prices continue to raise. There is little to no money for hospitals to care for poor.
How much profit are the insurance companies , hospitals and hospital corporations really
making ? Where is the money going? Not to the hospital staff and not in lower hospital prices or insurance premiums. Obliviously ,the American public is being rip off — I think is by the hospital corporations and the insurance companies . Just plain greed .
I would like to see a posted menu of fees for all doctors and hospitals. If Doctor A at hospital B charges $3,500.00 for a nose job but Doctor C at hospital D charges $6,000.00 . Let my insurance company ( if I have one) tell me, in advance ,how much they will pay on the bills for a nose job by Dr A or Dr C. Let me decide which doctor I will use and if price is important to my decision.
great post! i suppose i’m a bit lucky to be living in canada, where we don’t have to worry about health insurance so much. although, our medical system isn’t so much better with the long wait times for surgeries and even just to get looked at in the ER.
Wow, this reminds me of this film that my last year English teacher show me about the reality of the health care industry. Definitively an informational post, sorry about your situation, I hope it get better.