left our open thread: 160/100

Tuesday, March 06, 2007

160/100


My insurance company, being oh so interested in keeping its policyholders healthy as long as it doesn't cost them anything, displays a list of tips for keeping one's blood pressure low on the front page of its website. Having begun to test the limits of my coverage in part to determine if my terrible cardiac genes have finally kicked in, I actually read their suggestions and discovered a serious omission. Namely, to keep one's blood pressure low, DO NOT READ YOUR INSURANCE COMPANY'S WEBSITE. And yes, I am shouting. Isn't venting a heart-healthy choice?

Discovering that the physician-finder feature is now entirely non-functional was annoying enough. No matter how I phrase my search, it refuses to admit there's a participating provider within 100 miles of me. Given that I have participated with providers up the wazoo (and, ladies, we all know how uncomfortable that can be) in recent weeks, I beg to differ, but it would be nice to be able to get some advance information from this supposedly informational site.

On second thought, maybe it wouldn't, as the information the site does provide does little but infuriate me.

I know I'm lucky to have insurance, having occasionally gone without or made do with policies that would only kick in if I were to kick in if I were hit by the proverbial bus. But I also know my access to subsidized medical care is more tenuous than it may seem. If I had to cover my family on my school district's policy, for example, I'd have to do without or quit my job--that premium would steal 40 percent of my take-home pay.

So, for now, I'm on the right side of the equation, where the constants are twenty dollar co-pays and the variables are few. It's how this equation is balanced, though, that sends my blood pressure soaring. Case in point, I had some blood work done for which the lab charged $476.39. Total benefit paid? $31.81! For those discount shoppers out there, that's a 94 percent discount. Ninety-four percent! The claim is closed, the lab is satisfied, and I'm not responsible for the remaining $444.58. Who is? The poor schmuck who needs the same care I did but doesn't have an insurance company to foot the bill or whittle it down to nothing. Of course, that's not entirely true, as someone without coverage is more likely to go without than pony up a non-urgent $500, but the fact remains that those who can least afford it are expected to face the bill-collector or the consequences.

It's wrong, it's unsustainable, and if I think about it too much more, I'll be filing another claim by morning.

5 Comments:

Anonymous said...

Ooh, look I'm leaving a comment on your blog. Anyway, even after all this time I still get gobsmacked over stories on the healthcare system there. Good luck and glad yours is generally covered and you have 'only' the health problems to think about. Here's hoping for boring test results!
cheers, Miriam

Allison said...

The US has a healthcare system? Who knew!

Allison said...

Why yes, I am going to obsess on this for a while:

Today a claim for "op misc services" from the ER came through.

Total charge: $2389.30
Network discount: $2051.30

$338 (9.9%) paid by insurance, $100 paid by me,
$2051.30 paid by all of us, eventually, somehow.

Allison said...

typo: ins. paid $228.

Doesn't matter, I know.

Anonymous said...

Hmmm, evidence of some sloppy arithmetic there ..... hey! Wait a minute. You could be a claims adjuster.
Painkiller - actual cost - 30 cents
Doctor visit - actual cost - 15 dollars.

Total charge: 3000 dollars!