The Unique Position Of The Medical Community

I think one thing that a huge number of people can agree on is that we need to fix our medical insurance system. Fact of the matter is that insurance has run rampant over us in just about every domain of society. And they seem to be able to manipulate legislatures and courts like puppeteers pulling the strings for their marionettes. But medical insurance cuts to the very heart of all of us (sometimes literally!).

Medical costs carry with them a very unique quality. Let's say that you went to the store to buy some eggs, and you paid for the eggs at the register. Then you got home, and a month later you get a bill from the guy who brought the eggs to the store. Funny, you had no idea that you were going to get such a bill. Then another week passed, and you get a bill from the farmer who raised the chickens. Geez, you might think. You might assume that such a thing had already been taken care of. Then a little more time passes, and you get a bill from the guy who sold the farmer the feed. Well, gosh, you might ponder, didn't the farmer take care of that? And then at the end, you get a bill from the guy who shoveled the chicken shit out of the coops. You might start getting a little pissed off.

But this is the sort of thing that regularly happens with medical care, particularly when you are hospitalized. If you are made of money, then it's not a problem. You're made of money, so you just clip your golden fingernails, and offer the shiny fingernail clippings as payment. But if you are made of money, likely you are not reading this.

And, you are told, those people all did the work, and they deserve to be paid. But so did the farmer, the feed store salesperson, the chicken truck driver, and the shit shoveler. Somehow, though, they have been taken care of without you even getting any notification of their payments.

So is it too much to ask that the hospital get together all those people and send you one bill? And is it too much to ask that the insurance make it easy to figure out what it is going to cover and not slide more and more costs onto the consumer, hidden in slippery and esoteric language about co-payments and co-insurance and lifetime deductibles and the like?

I had a bill once from a medical provider where they charged me several hundred dollars. And it was somebody who I had no idea was going to bill me, and it was after I had grilled the hospital about what my costs would be, and they had assured me that I would be billed a certain amount, and no more, and there would be no other bills. Believe me, I asked a ton of questions about it. So I was prepared to pay that certain amount.

Then I got the bill from the other folks. Well, of course, I hadn't budgeted for that, so I couldn't and didn't pay it right away. And I got notices that became nastier, telling me that insurance had covered its part and I had to pay, and they were gonna turn it over to collection, and, well, you know the drill.

Then a funny thing happened. About seventeen months after the original procedure, I got a notice telling me that the insurance had paid about eighty percent of it. Now, my understanding is that my insurance has eighteen months to pay a claim. So obviously, the provider (previously unknown to me until I got the bill from them) leaned on the insurance company, and got them to pay it under some perfectly legal and justifiable provision AT THE VERY LAST MINUTE. And that was after they had told me that insurance had already chipped in its part. Insurance companies are not in the charity business; they don't just volunteer to pay for stuff out of the goodness of their hearts. No, there has to be some contractual provision; albeit one that may be incomprehensible to the likes of regular folks like you and me.

So if I had paid that bill right away, I have a feeling that the insurance company would never have had any incentive to kick in those hundreds of dollars, and the little matter would have gone unmentioned, and I would have overpaid for the services I got.

Now, with stuff like that happening, how does anybody know that it is safe to pay any of those bills without getting ripped off?