From now on, I will refer to all non-governmental health "insurance" providers as health unsurance. This is because we can never be sure what our premium will be from one year to the next (one of the contributing editors at BlogHer just told me that her "provider" raised her premium by a whopping 82% this year...), and then once we pay into the "system" (aka - the wallets of the CEOs and other executive staff of the unsurance companies), we are not sure if they will actually pay for services that we need.
I'm even pretty lucky that my unsurance generally covers what I need. Husband's employer pays the entire premium, too, which is an amazing benefit.* Still, it is obvious that even under the best of circumstances, our current health system is fucked up. From referrals to outright denials, the corporate fat cats make some serious bucks off of a population held hostage to their whims. I don't know what the answer is, but universal unsurance is certainly a proven failure.
*Although a big problem in the past. Because they are so generous, they will not cover a spouse whose employer also offers unsurance. As a result, a few years ago I had extremely subpar unsurance that forced me to get my first mammogram at a place that had lost its certification for a while. Later, my employer offered a better plan, but my share of the premium was $160 per month. I felt that Husband's employer discriminated against people with working spouses by not even allowing people to opt to pay into the system, which may or may not have saved us money, but it certainly would have been fair. But I digress...
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Interesting. I know that when I was underemployed I tried to get insurance, and I was refused for having asthma. I love that -- if you're not in PERFECT health, we can't insure you. And I overheard someone at the emergency room on Monday who had that insurance: his co-pay was $100. Sucks to decide between groceries and a visit to the emergency room.
ReplyDeletesuzanne, that totally sucks. did the doctor talk to the insurance company about why s/he ordered that specific test? we often have to get pre-auths for radiologic testing in the clinic for the big blue insurance company & it regularly goes up for review where the ordering doc must explain the reason for the procedure.
ReplyDeletei scheduled a patient yesterday & i'm gonna totally get in trouble for it. she can't get state assistance because she can't afford to get a copy of her birth certificate. (she was born at the state hospital she's coming to.) she said she can't even afford the bus ride to the hospital (local bus) & we're going to ask her to pay 60% up front for the appointment because we're a specialty clinic & no longer accept 'delinquent' patients. tomorrow i'll have to call & tell her she can't come without making that pre-payment. of course, she can afford a cell phone... (but maybe it's a prepaid)
i wish this country were more concerned about the healthcare of its citizens.
Have you seen SiCKO yet? I watched it with my friend this weekend. Amazing and infuriating.
ReplyDeletei'm slowly learning about how hospitals get paid for services through medicaid/medicare. (i don't know shit about private "unsurances"). anyway, i learned some interesting things. for example, for a malnourished patient who undergoes major surgery, the hospital will get paid one fee, but if the doctor writes "severe protein calorie malnutrition" in the chart instead of plain old "malnutrition" the hospital will get paid almost double the amount... since most doctors don't know this, medicaid can avoid paying the hospitals for services it actually provided b/c it wasn't documented using their bizarro terminology. its all about wording, totally whack...
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