Tuesday, October 02, 2007

The Ankle Bone Connects To The Wallet Bone

I need an MRI for my right ankle.

My doctor recommended the place where he sends all his patients but I don't like my doctor. He's smarmy, like Charlie Sheen on Two and A Half Men. And since I love to shop I like to look around for the best deal. Turns out they do not have imaging machines anywhere on Rodeo Drive, which I found annoying, but I did get a look at the Fall collections and they are spectacular.

So I called imaging centers elsewhere, places outside of LA that might be cheaper, like Egg Whites, Idaho, and I was quoted a price of $585.

I asked if that's the best they could do they said, "Well, if you had insurance it would be $1,750."

So doctors charge the insurance companies three times what the procedure actually costs? A friend of mine knows someone who was pregnant with twins and had to be hospitalized for months before the birth. That cost her insurance company 3 million dollars. Or, based on my MRI experience, it really only cost 1 million dollars?

On Oprah last Thursday, Michael Moore was a guest and so was the President of People Screwing, an insurance conglomerate that oversees the insurance business. As this woman tried to explain that the Armed Forces have socialized medicine, ditto the fire and police departments, she had a difficult time explaining why we, the rest of the country, are not able to get it. It's because insurance companies would not be entitled to make the huge profits they are making off that twin birth, not to mention my beautifully turned out ankle.

Oprah highlighted some of the worst cases, people with and without insurance. One person with insurance contracted leukemia. The total cost was $400,000 but his insurance only covered $150,000. Turns out there's this little thing in his policy called Fine Print that most people don't read because let's face it, none of us have ever read Fine Print since they invented it. Fine Print is just Spanish for Ways We Will Fuck You Over Eventually.

My favorite part was when the President of People Screwing urged all Americans to call their reps in Congress and ask President Bush to NOT veto the bill on child care insurance he's promised to veto. Michael Moore turned to her and said, "Uh...shouldn't you be making that call? In that you ARE the insurance industry and your call might help more than ours?" She did not reply.

But this quote from USA Today should piss off all people with insurance. Bush’s ‘Affordable Choice’ grants will not involve any new federal money. It will instead “redirect some of the $30 billion the government spends annually to care for people without health insurance who show up at hospitals and emergency rooms."

30 billion for those of us who do not have insurance. Annually. 30 billion dollars. If you're reading this and you don't have insurance, you have this information. Use it.

End of People Screwing chat.

8 comments:

  1. Good points.

    I work in the insurance industry (NOT health), so I know there are some problems to which my industry contributes. I also know that it has become too easy to simply blame the insurance companies for all our social ills. The medical profession bears a great deal of the responsibility as well. People become doctors to get rich -- and they will, no matter what. Then there is the plaintiff's bar who takes every opportunity to sue the medical profession, which is insured by insurance companies. So the same doctors who triple bill insurance companies then turn to the same company they are screwing to defend them when they get screwed by the lawyers, who then also screw the insurance companies. It's a vicious circle since the insurance companies, who are required by law to be solvent, have to mitigate exposure by raising rates and diminishing benefits.

    Insurance companies, like any other, are in business to make a profit -- and they do. Doctors are in business to make a profit -- and they do. Lawyers are in business to make a profit -- and they do. And the beat goes on. It's complicated and frustrating and leaves us all individually and collectively fleeced (aka screwed). Something substantial has to change at ALL levels of the establishment before the system has any chance of being fixed.

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  2. I watched part of that Oprah show until I got too annoyed with the woman who clearly did not get it. She said things that were not true, like hospitals making a profit, only private hospitals make a profit, not 'not-for-profit' hospitals.
    And, hospitals are not supposed to charge insurance companies more for procedures than self pay people but they do.
    And, insurance companies have a set amount they will pay for a procedure like an MRI. If the hospital charges more, the insurance will not pay more, but it is illegal for the hospital to charge the patient for the remainder! Of course I mean an MRI APPROVED by the insurance company.
    Anyways, good luck with the MRI. I hope your ankle is not too painful.

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  3. Michael, the whole thing is messed up from start to finish.

    gm, I think we know so little of how the entire system works that we get screwed. Remember that my internist got billed $22,000 that his insurance didn't cover, for one night in the hospital. And the doctor who performed the surgery did it for free!

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  4. Anonymous11:55 AM

    Suzy,
    As you know, three of my younger siblings have already died of cancer, so each year I get a CA 125 test, to determine if ovarian cancer is lurking. This is not covered by insurance (yet a PSA test for men is, go figure...) My doctor, a truly kind and wonderful man, has arranged a deal with the lab. If they billed the insurance company, I would have to pay $90 when it comes back "not covered." Since I pre-pay in advance it's $36. A difference of $54? Yes, that's what it has been determined costs the lab to process the insurance company paperwork.
    Aloha,
    Martha Jane

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  5. surcie2:58 PM

    PODUS says he's going to veto that kids' healthcare bill because it taxes "working people." (Like he cares about them.) In reality, it's a cigarette tax.

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  6. MJ, wow, a job that pays $54 dollar an hour, right? It's paperwork, not changing the oil in your car. Ridick.

    surcie, the beauty of Bush is that he's taking the entire Republican party down with him. Bye-bye 'Publicans!

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  7. i hate fine print- but now that you've defined it for me , now i totally get it :)

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  8. I've started and scrapped my entry for today four times. I start talking about Bush's veto of the child healthcare bill and go insane. Healthcare in the US is fucked up beyond all reason, and I go ballistic whenever I stop and think about it. Why do we continue to elect dumbfucks who can't fix healthcare in the wealthiest nation on earth?

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