Posts Tagged ‘health care’

I’m in Hawaii a few weeks back, the Big Island. First couple days are great, dining in Kona, a little boogie boarding, getting yelled at by the Safeway clerk for trying to buy a single bottle of Kona beer from one of the six packs*. But then Monday rolls around and I get this freaky-ass pain in the side of my chest, next to my heart, so I spend the rest of the week wondering if I’m on the verge of having a heart attack. But sometimes the pain goes away and I enjoy my vacation for awhile…until it comes back, but by then it’s dinner time and I’m downing a Mai Tai on an empty stomach.

Why didn’t I go to the emergency room or one of the scattered urgent care centers on the island? Because last time I did that (see my kidney stone post in the archives) I was out $4000, guilted into being grateful that it wasn’t the $16,000 billed to my insurance. Despite all the anxiety the chest pain caused (and the resulting symptoms that too much anxiety cause) I knew in my–ahem–heart that my breathing was fine and this was obviously the paranoid part of my brain throwing firecrackers at the rational part. Not to mention the symptoms were never actually getting worse; they were simply coming and going at various intensities no worse than, say, a four on a 1-10 scale. So I drank more alcohol than usual to calm the anxiety (not a recommended lifestyle remedy, but it works on vacation), determined to enjoy my vacation!

I got home, saw my doctor the next morning, so I’d only have to pay $30 office visit. I just saw him two weeks earlier for a checkup on some blood work, as I’ve got some high blood sugar and underactive thyroid needing monitoring. I was prescribed pravastatin for high cholesterol (95%+ vegan…go figure) and an upgraded dosage of levothyroxine for my alleged thyroid problem. The doc puts a stethoscope to my heart, determines my ticker is fine, says it’s probably a muscular/skeletal issue and to relax, so I saved $300-2000 bucks by not having this checked in Hawaii. Yay me.

But my chest is still aching, and the whole time I’ve been avoiding any mention of the…bathroom issue that causes bowel movements to turn into…liquid. I’ve crossed over 40 and I still can’t say diarrhea? WHAT’S GOING ON???

Someone smarter than me in these issues suggests looking up side effects to pravastatin and levothyroxine. And what do you know, chest pains, anxiety, skitters, and a bunch of other symptoms I’ve felt in the three weeks consuming these pills! Would have been nice if my doctor had connected the chest pain to the pills HE’D JUST PRESCRIBED, but hey, I don’t think discomfort counts as malpractice. It’s nice to nail down the answers.

This stuff along with the current REPUBLICAN shutdown** has gotten me doing more thinking about how to really deal with health care costs. Because regardless of Obamacare/AFA most of us know our health care system is still broken glass, a few of the pieces glues back together. I’ve spent years railing against insurance companies jacking up premiums yearly while footing me with huge portions of whatever bill I get. I’ve also put on boxing gloves against hospitals charging retarded (YES, retarded–mentally deficient) prices that cripple finances beyond reason. I get the basics of this madness. Hospitals make up these absurd costs, sucking excess cash from those who “can” pay to cover the costs of those who can’t, the insurance companies basically playing the same game on the surface, each passing the blame back and forth.

But the big question finally being addressed by the mainstream media is WHY health care is so expensive and the revelation that hospitals can charge wildly different fees for the same procedures. I’m making up numbers, but I’ve heard more than one source say something along the lines of one hospital billing $50,000 while another charges $20,000 for the same procedure. When we pitch single payer or universal health care those against it say that’s against capitalism and free market…

But is it really free market when I can’t find out how much a procedure costs before going to the hospital?

I only get to find out afterwards, when the bill has all ready been charged. Where can we go to price compare? I’ve found a few sites that have potential, but still speak in generalities. It would be cool if there were a Wikileaks-type of site where charge masters of various hospitals are posted. Some of that data has come out through some government databases, as this Huffpost article details. But how sweet would it be if there was a popular Wiki site where we could research prices by hospital, by insurance plan, etc.?

Get that kind of information out to the public then we’ll see some real competition in the market place. Might even get that Costco ER I’ve been dreaming about.

*Apparently I’m not allowed to do that in Kona, though my neighbor used to work at a Mill Valley Safeway and he said it’s cool, except they charge you more for the single bottle. But, man, the Kona clerk was PISSED when I did it. She started ranting about how the Japanese were the worst offenders of bottle separating. I guess therapy is more expensive in HI because there are fewer therapists because WHO CAN BE SO FREAKING MISERABLE AND ANGRY IN HAWAII???!

**Hey, the law passed. Why not let it go into effect and kick Democrats to the curb if it fails? Oh, because you’ve already been to our National Parks…


Read Full Post »

I’ve devoted a notable amount of personal time to picking fights with insurance companies. Mostly because along with hospitals they treat the unemployed like animal poop stuck on the back of your heel.

One of my arguments years back was over a $2 fee Anthem decided to start charging for mailing me my premium statements.

Consider that for a moment. They wanted me to pay $2 a month so they could tell me how much money I owe them for the following month. This was on top of paying about $3600 a year for the privilege of paying the first $5000 of any yearly medical expenses. As the comedians say, you can’t make this stuff up.

On top of arbitrary, unjustified* rate increases made once or twice a year and other bull such as charging me an extra $60 a month because I spent maybe $40 A YEAR on a generic seasonal allergy inhaler they demanded I give them my bank account number so they could debit my account monthly for premium fees. In many cases that might be an easy, convenient thing to do…but they had to threaten the $2 fee if I simply wanted to continue receiving paper bills.

My neurosis said nope, that won’t do at all!

But as usual when dealing with an arrogant “non-profit” able to pay their CEOs millions while driving people into bankruptcy, BC said I wasn’t allowed to keep things the status quo. Give up my account number or start paying $24 a year to cover their (rough guestimating) $3-5.00 a year it might actually cost to mail me my bills normally.

I was a self-employed musician at the time and hate wasting money on things I don’t have to. So I refused to give up my account number for a few more months before leaving them for Blue Shield.

So it was a satisfying surprise to see paperwork for  a class action lawsuit show up in my mailbox last week. As quoted from this link:

“The Anthem Blue Cross settlement resolves a 2011 class action lawsuit (Andrea Kreuzhage et al. v. Blue Cross of California et al.) that challenged certain fees the insurer charged, including a $2 fee charged to those who opted to pay through paper bills rather than other forms of billing, such as automatic withdrawal. Plaintiffs claimed it was illegal for Anthem to charge and collect these $2 paper bill fees.

Anthem denies any wrongdoing but has agreed to establish a class action lawsuit settlement fund that will provide $4.2 million in refunds and another $20 million in savings to eligible policyholders.”

Gotta love that “Anthem denies any wrongdoing” line of bull. I don’t know how these people sleep at night believing such a fee is justified, but it’s satisfying to know a higher force with leverage could at least hold their face to the pile of poop and scold, “NO!”

But the victory rings hollow as I read David Lazarus’ article about another victim of the hospital system and it’s mysterious medical billing. There’s some serious Matrix-level deception coming undone here…

*Well, they always justified it by saying medical care costs simply went up without explaining what that meant…we’re too dumb to understand or something.

Read Full Post »

Bracing for the latest kick to the chops by Blue Shield, as my rates are set to increase by another $30 bucks a month starting in March. That will bring my monthly premium to around $260 a month, which I know to many is a drop in the bucket compared to many who see their rates jump hundreds a month. Not to mention this is still cheaper than I would be paying had I stayed with the criminals at Anthem Blue Cross, which I’m guessing would have been in the neighborhood of $400+ a month…with a $5000 deductible–a curious figure when you read the fine print and discover that there’s A LOT of flexibility as to what charges go towards the deductible. Found that out when I got my kidney stone from hell a few years back…$2500 deductible and I still owed over $4000 because when it comes to ER visits they only pay a percentage of this and that. The deductible…that only applies to other medical visits hazily defined.

So I’m watching The Daily Show this morning and the guest is this guy named Steven Brill. He just wrote this killer piece for Time Magazine where he gets into an area of this debate rarely covered; WHY are medical bills so expensive??? He was angry that the health care debate a few years back was mainly focused on how to pay for it without tackling that former question. And why is it so confusing trying to understand why you’re being charged.

I remember reading the five or so bills I got for my kidney stone…one was for $63, another for $400, another for $3200. I look at the back pages and find confusing medical code, look back at the front again and see the bigger number I was “supposed” to be charged, along with some sort of bull discount followed by another adjustment required by Blue Shield. It’s a wildly complex display of smoke & mirrors that I’m just expected to pay without question

Just this one quote (I’m sort of paraphrasing) on The Daily Show got me fired up: “The ambulance industry takes in more money than Hollywood.” A quick ambulance visit of four miles can easily reach $1000. Bizarre that this isn’t questioned–or perhaps regulated.

I’ve read a good chunk of the Time article and it’s a quality read.

Read Full Post »

I was listening to a rep for justifyrates.org last week. The goal is to get enough signatures to create a ballot measure that would make health insurance companies in CA hold public hearings to justify their rate increases and the insurance commissioner the power to reject those increases if deemed invalid. A solution to out of control health care costs…don’t I wish. But as I’m in the middle of paying off my $4000 kidney stone (oh, but it would have been $18,000 if I didn’t have coverage! How thoughtful!), trapped in the latest premium increase for hitting my next age bracket I can’t help feeling like this initiative might be important. MIGHT be…I’m still going through the details.

But all you folks out there with your health benefits through your job, maybe even some of you who call any attempt at reform “Obamacare” or “Liberal” I beg you to consider the other side beyond your own views. For people to go from paying $50 a month to $100, $300, $600, $1200 and up year after year and still have to cough thousands of dollars when they inevitably have an accident is simply a cruel business model. Sure, I’d love to have it in my budget to pay $1400 a month for me & my wife to get full coverage of any and everything hospital related, but in this economy I’m struggling with a job that barely covers that–and I still gotta keep the other life essentials afloat.

And though I’m not an accountant auditing these health insurance companies I still come across regular headlines detailing their profits in the BILLIONS, even in this rotten economy. They make their billions while I’m saddled with multi-year debt said insurance wouldn’t cover.

It ain’t right, no sir.

Read Full Post »

Ah, the health care industry. The love just keeps coming…

I got my first kidney stone several months ago. A big one. Had to spend several hours in the hospital getting GOOD drugs because the initial Vicodin the doc sent me home with didn’t help with the alternating stone movements and vomiting. Definitely appreciated the help at the time and knew I’d have some out of pocket expenses in this visit despite my health insurance.

I expected it to be around $16,000 charged. How much of that would I have to pay…praying for a low number…praying it’s something my meager guitar teacher salary can handle…

Four separate bills totaling $3790.

At the time I was averaging around $3000 a month from my teaching job, a number that was dropping because the corrupt music store owner where I was teaching was sending all new students to his favorite teacher…favorite because he put the guy on a salary and kept a huge part of his profits instead of charging him rent like the rest of us. Then there’s the other mountain of debt that builds up through usual life stuff.

I apply for financial assistance from Sutter Health, send in a fat envelope of paperwork detailing how I haven’t had a vacation in years, my car is ten years old, my 30-year-old countertops are being held together with packing tape…which I suppose I was happy to give up the night I had a stone traveling through me.

In the six months of waiting for a response to my FA request I was forced into a retail job, the situation with corrupt store owner unbearable. SERIOUS pay cut, dealing with commission and all that. So when I finally get my rejection letter last week it’s pointless because my financial situation actually got WORSE in the time after I submitted my request.

But in the form letter they sent I realize the whole effort was pointless. In the five boxes available to check off as reasons for rejection the following was checked off: Property/Assets exceed Novato Hospital’s guidelines.

Surely they’re not referring to my condo…which is deeply underwater? Or my lone rental property, which breaks even every month and would leave me with some pocket change after the real estate agent and IRS took their cut of my selling it?

Then I see articles like this one at SF Gate. YES, doctors and nurses should be paid well for their services…as I appreciated first hand with my kidney stone. But while $3790 is a drop in the bucket to them, it’s the universe to my currently $2000/month, most of that paying the mortgage and bills. How am I supposed to pay $3800? Oh…I can pay it off in a year, split over 12 monthly payments! How generous…except I was originally told it could be paid over 18 months. But no, it now had to be 12 months!

I explained my current job situation and how some months that might be workable and other months it certainly wouldn’t, meaning they would damage my frail credit sending it into collections. It took a day making phone calls to various offices to get it back to that 18 months. Whoopie.

Part of me has this horrible wish that hospital administrations and health insurance officials were struck with horrible diseases and cancer to understand the financial prisons they put us in. But I’m guessing said people have fantastic coverage that pays for everything, so there wouldn’t be any light bulb of compassion. Just the usual, “I got mine, now you pay for yours.”

What next? I’m on the verge of needing dental work, crowns, root canals. I was supposed to get yearly freckle exams because I’m seriously white and need to keep an eye on the moles & stuff. But each one they find suspicious needs to be removed and biopsied…the last time that happened I was out $600. Don’t have it, credit is dangerously close to maxing out

They should have warned me about this stuff when I was pursuing my Film Studies degree.

Read Full Post »

As a guitar teacher/composer dude, I’ve been taking a beating by the joke known as self-employed insurance for a decade. I started with full coverage and $15 copays for $63 a month and was eventually squeezed into a $5000 deductible policy that started around $120 a month and was making its way to $500 a month.

Every year the plan would increase $30-150 a month, sometimes TWICE a year. And if I needed a simple blood test, a mole biopsied or the one time I crashed the ER thinking I had food poisoning I’m out another several hundred dollars plus.

I accept that I need to pay for some of my health care, but hell…I’m a guitar teacher making barely enough to pay my bills, hopefully throw a hundred bucks a month into a retirement account. I can’t raise my rates at the same pace as my health care expenses–I’m already lucky enough to get $30/half hour.

I’m not thrilled with the BS surrounding this bill, but friggin’ AY, something got passed. Leaders took responsibility and lead. If our country goes to hell because of this then fine, the naysayers will be right. I’ll get a skywriter to write it in the clouds. But how many more decades do we need to talk about it, put together a bill, scrap it and start over?

This is one of those issues where anyone can cherry pick their facts, right or wrong. There will be no consensus that makes everyone happy–it’s impossible. So President Obama and Co finally came together and got something signed into law. It wasn’t forced down our throats; it was driven through after a year (and past decades) of debate before inept leaders driven by special interests could derail it AGAIN.

There are flaws now and there will be more problems down the road. We’ll fix them. Complain about the bill’s flaws…they’re legit. But to say we should continue doing nothing until it’s perfect is LAME!


Read Full Post »

I was listening to KGO’s Gil Gross passively mentioning The Greed’s latest insanity, raising their health care premiums by up to 39%. I confirmed the article mentioned here.

Wonderful how this article is barely a couple paragraphs and there’s no mention of it on SFGate’s front page. Which is understandable…the front page needs space for Britney Spears’ sister dumping her baby’s father–right in the center of tonight’s features. This is important information people need!

The article mentions that only individual plans are getting screwed here…which would have been me if I hadn’t jumped for Blue Shield last year. But I fear it’s only a matter of time before the same ax falls on me. Christ, how do they come up with a number like that…39%? It’s amazing with the health care debate that they’re still doing this. Then again, I’m not surprised with all the fear mongering and inept congressional “leaders” who spent more time pandering to lobbyists and senators fighting for perks than starting with, perhaps:

1. Tort reform.
2. Letting us buy insurance across state lines.
3. No denying coverage for jacking rates for pre-existing conditions.

Pick any ONE of those and we’d be off to a likable start.

I hate conspiracy theories and fear tactics, but this health care industry is going to face a serious revolution if they continue their current path. With more and more folks losing their coverage and being unable to afford steady, outrageous increases they’re going to get desperate when illness finally strikes, willing to do ANYTHING to treat themselves or their loved ones.


Making health care a privilege of the upper class is going to make everyone else a bit more…resentful? And there’s far more of everyone else, ya know?

Read Full Post »

Older Posts »