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How Can a Poor Man Stand Such Times and Live?

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I’m in a mood today where I am feeling angry about the rich getting richer. I’m not poor, so I can stand it and live on. But it makes me wonder why it is that some wealthy people (like Bruce Springsteen) and some middle-class people (like me) feel for the poor and wish for more evening out of income and opportunities, whereas others just get greedy.

I encounter this profiteering greed mostly through the arena of healthcare. I don’t have high-brow tastes—I don’t spend a lot of money on cars, or clothes, or jewelry, or furs (god forbid), or expensive vacations, or fancy wine, or recreational drugs, or makeovers, or the many other vanities that I’m not even aware of. I spend money on my health. I’ve been doing a lot of that especially over the past five years, as I’ve encountered several issues with my health.

To me, most of the time, it doesn’t seem as though it’s the physicians who are greedy. They may make a better living than I do, but they mostly seem still fundamentally upper middle-class in spite of (or because of) their BMWs in the parking lot.

But the corporate entities with which I deal make me crazy. Recent examples:

* Today I was told by Florida Hospital that I have to pre-pay more than $400 for a colonoscopy scheduled for next week. (It’s my first ever, and is enough to dread by itself.) My insurer told me that, no, a routine preventive procedure is covered at 100%. We (together) called the hospital back and were told that they charge for a diagnostic rather than routine procedure, even though the latter is what the doctor ordered. “Just in case,” the drone said, “they find something wrong.” So they are charging in advance for a service that I may or may not need and that the doctor didn’t order. How can that be?

Ultimately, of course, they will refund my money. But it will be in their coffers for six to eight weeks or more.

* I mentioned on Monday that my insulin pump company holds me hostage. Every time a pump goes bad, they send me an emergency loaner. But if I don’t buy my next permanent pump from them, they will charge me $3600 for 90 days’ use of the loaner. The pump itself is barely worth that much, as they send old, reconditioned ones.

They also constantly try to force me to sign up for automatic supplies deliveries and billing. But diabetes is not a condition where you take one pill every day for a stable dosage. No, use of insulin varies, and so use of supplies varies. I don’t want to get a new order until I need one. The customer service has become so problematic, however, that it now often takes more than a month between when I order supplies and when they arrive. Several times I have run completely out of supplies and had to call for an emergency overnight order. How can it be that I can get a book or a pair of shoes or some obscure piece of computer gear in two days, but it takes a month or more for vital, life-sustaining medical supplies?

* A few years ago, I was told by a dentist at Greenberg Dental that I needed a crown and perhaps a root canal. Both of these are procedures that my dental insurance was supposed to cover completely. But suddenly Greenberg told me that only their general dentists were in the insurance plan, whereas that those who do the root canals were not. So, I was forced to either pay for the root canal myself or find another dentist who would do it and then send me back to Greenberg for the crown, leaving several days in between when I’d have to walk around with a hole in my tooth. I did the latter, and it was then that Greenberg started adding on charges to the crown. First, they said it was a lab charge, but when I called my insurance, I was told no such charge was allowed. It took several days for Greenberg to back down. “We bill them this way all the time,” I was told. “People always pay it.” Not me. Eventually they took the false charge off the bill, but then they added another. This went back and forth while I had a hole in my tooth. Finally, I settled on a $30 overcharge for an item that had never been listed on any of the earlier estimates. It became clear to me that there was collusion between the health insurance company and Greenberg.

These stories are boring. Sorry. They accumulate and accumulate in my life. Even though they are boring, they make me angrier and angrier every time I encounter such practices.

Our health care system is just fucked up, plain and simple.

Even if you believe that profit is the best incentive for good medical care (I don’t but even if you do), the problem is that you can never talk to anyone who makes decisions. You get customer service representatives who spout platitudes, who tell you “that’s our policy” or “that’s just the way it is.” There is never anything they can do to change it. And there is never any use appealing to a sense of right and wrong or a sense of decency.

These people are paid to insulate the people at the top who are reaping all the financial benefit of these predatory and unethical practices. Every time I think of them, I think of Michael Moore. Michael Moore has his flaws, but, by god, he was right to go for the executives in Roger and Me and in Sicko. But notice that he could get at far fewer of them by the time of Sicko. (Roger and Me was released in 1989 and Sicko in 2007.) The wealthy protect themselves from the rest of us so effectively nowadays that there’s seemingly little we can ever do to affect their unconscionable greed.

And healthcare is just not like other, non-vital services and goods. Shopping is impossible or at least very inconvenient, if not dangerous.

I will encourage my gastroenterologist to establish a relationship with a testing center that has more responsible and fair billing practices, and to move his tests away from Florida Hospital. I will raise hell on the phone with the corporate shills at the front line of “customer service” just on the off-chance that, like politicians’ offices, they keep track of “customer reactions.”

It doesn’t seem like enough. I languish today in my inability to change the practices of an industry that affects my life all too much.

You can watch Sicko in its entirety here if you haven’t seen it already:

But at least watch the trailer to remind yourself that things have not improved since Moore made Sicko. In fact, the profiteering continues to rise, and the healthcare industry continues to use unethical practices that make it look less profitable than it is.

How do people get so corrupt? Why do our laws no longer protect us, the people, but only the powers that be? We live in dangerous, dangerous times.

2 responses »

  1. I’m only beginning to encounter this, as I am a young person who has been diagnosed with a chronic illness for two years. I, too, pre-paid for a colonoscopy, only I paid $700, and I pre-paid $500 for GI-tract imaging (forgot what that’s called). Now, our insurance companies are different, and that’s fine. What is this pre-charging only to–possibly–hand the money back later, though? What is that?

    You’re probably one of the few people actually checking her bills.

    There is so much I can say on the topic of politeness and use of knowledge in the healthcare industry that I should write my own blog post about it. The people at the bottom deliberately have little knowledge of what’s going on around them so that they can give their platitudes with conviction (at least that’s what I’d like to think).

    I can’t tell you how used I feel when I sit in the doctor’s office for 45 minutes after my appointment time to be seen or get the phone tree thing only to never be called back or never encounter a place to leave a message. That is not okay. We’ve become less than consumers–the respect is all but gone, and usually the doctors and nurses themselves are the only ones giving it, unless, of course, they’re too busy and overrun to smile.

    I’ll look forward to your future posts on this topic.

  2. You are absolutely right that we have become less than consumers. One event I didn’t mention from earlier this year made this so plain. I needed to have two tests done at my neurologist’s office. When they called me to schedule them, they noted that one of them would only take a few minutes, but then proceeded to schedule them on different days. I said, “Why can’t we just do them both the same day?” Answer: the health insurance won’t cover them on the same day.

    What this meant, of course, was that I had to make two trips instead of one–half an hour each way. I lost an hour of my life because of health insurance rules that are stupid. The only way they can possible save the company money is by discouraging people from having the tests they need. If we go ahead and have them, this rule saves the company nothing. It just loses me an hour of my life, which is already shortened by illness. Can anyone wonder why I hate the f’ers responsible for these policies?

    What this means across the board is that our time is worth nothing. We are continually inconvenienced and humiliated.

    And the fact is that there’s no such thing as “comparison shopping” in medicine. You just can’t get the information that would make doing so possible. So the consumer model is all wrong anyway.

    Ah, well, we have no choice, you and I and so many others. We have to keep going, tolerating the barely tolerable in order not to face worse. I am constantly thankful that I do have health insurance, but I do not love the insurers. I do not embrace the hand that feeds and beats me simultaneously. I recognize abuse when I experience it.

    Anyway, good to hear from you. More on email…


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