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I guess I just assume everybody knows how horrible it is to get sick in George Bush’s America. I dashed off that post yesterday about the medical collection vultures at Grant & Weber because they had just called to hound me and I was pissed, I didn’t expect it to reverberate. But that’s just the very small tip of the iceberg.
Click on the Blue Cross claim at the left. This was the bill from just one (count ‘em ONE) of the three surgeons who operated on me in January. Notice the part that says “it is your responsibilty to pay…” Notice the “denial message.” Notice that my deductible ($2500) has already been satisfied for the year, as has the total $11,000 out-of-pocket for 2007 (although the claim form doesn’t mention that). Which also had to be satisfied for 2006. Now multiply this by all the tests, four months of chemo, expensive drugs that Blue Cross doesn’t consider “necessary,” and the two more surgeries I have to have this year. And I am someone who is counted as “fully insured” in George Bush’s America, although I think Eve has it right when she calls it “death murder by spreadsheet.”
It’s not like the disease isn’t bad enough on its own.
Now here’s a picture of Marcy sitting in my new chair which Jeff Lomonaco found for me.
Sometimes you just have to blast through it and accentuate the positive, know what I mean?
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zedunofitzaroo?
perris @ 1
Congrats…
JANE!
perris @ 1
YES, I SCORE A ZEDUNOFITZAROO!
YAYYYYY
*sigh, it’s saturday night and I ain’t got nobody, I got some money cause I just got paid
am scoring a zeduno fitzaroo…I am one lonely single man…sigh*
Here, here. What to do? Keep on the Sunny Side?
Geez, Jane. You are a case in point for Sicko. Horrible.
perris @ 4
What’s Firday Night, Lonely Guy?
sorry jane, this is one post I did not want to be first with a zeduno, I hit the response before I read the post
Oh god, it says to see the last page for important information…
Jane,
I hate medical care in the U.S.
I’m lucky. I’ve had few medical problems.
My message to Americans: Take care of yourselves in terms of diet and exercise.
Don’t rely on the government.
Oh, it’s Fixed.
But, hon, didja get paid?
I should note that the surgeon hopped up and down mad and dashed off an angry letter to Blue Cross, who paid another $1,400 of his fee. Which brought what I owed down to $14,000.
Sadly this is just one of literally dozens of claims at this point.
Amen, Jane! It is serious Fuckery that needs to end most rickety-tick! No one in the UK, Canada, France, Cuba, etc… files for bankruptcy for medical bills!!! WTF??? *g*
I just read a story on the Earthlink news that the government wants to set up machine-readable ID cards for first responders, so they can chase off all the volunteers more easily (reading between the lines: they didn’t use that phrase). They have a great line about how they get too many unqualified volunteers after disasters (specifically citing 9/11 and Katrina) but they still haven’t explained their own actions (or inactions) after those. I guess we can count on not getting any help if there’s a disaster in any of our neighborhoods.
I am totally with you Jane. I am self-insured. It costs a ton. And then you pay and pay for service anyway.
The only good thing I can say is that WITH insurance, when I got (West Nile) encephalitis a couple of years ago, I got treated quickly and am still able to walk and talk because I got the needed tests and the luck of the draw–good ER docs–who diagnosed and treated quickly.
Otherwise, maybe dead. But it was only when I was doing my taxes the next spring that I found that I had been denied for the service of a doctor who said I had “psychosis.”
Since I did not have psychosis. I recall no doctor who did that diagnosis, but I was out of my mind, so what did I know? Eventually I did get it covered, and they refunded the money I had paid for that. But only because I found it and raised hell.
Yep, it is a crap shoot. And they can take every advantage of the billing because when you are sick, how can you fight, or even pay attention to what is on the piles of papers they send.
I wish you the best. You fight like hell, and they gonna know it.
Oh, you. Just for you, from Cat Stevens!
You gots lotsa somebodys. Me included.
Jane Hamsher @ 12
Fuckers are making INSURED Americans fight hard for every buck…
demi @ 11
my worries are nothing to compare with jane and people in her boat
this is why we need single payer health insurance, this is why private industry can not be the people that decide what is allowed and what is not
commons must be administered by the government otherwise it fails
health care needs to be a commons, like water, roads, bridges and clean air
these must be administered by the governement, that is why we band together in a society, so we will all have a common goal and a common cuase
and common solutions when we are faced with uncommon diversity
demi @ 16
Love Cat but my favorite version of this is Sam Cooke.
too bad the insurance and pharmaceutical industries have already bought off Hillary Clinton with the money they extract from the people.
how many phone calls and emails from the grassrots does it take to neutralize even one $100,000 donation?
we may never know.
wow – good writing and babes with beers…
An EarthFirst!er could get to like it here.
Jane,
Okay, the medical industry, along with so much else, sucks.
How does your personal fight affect your views toward the your political outlook outside of the insurance industry?
I know I’m dying. I just don’t know specifically why? Know what I mean?
Just wondering what your current personal situaltion does for your global outlook.
Jane,
I’m sorry your ordeal had to be the foundation for this object lesson about “the way things are” in this country regarding our healthcare but thank you for this post.
Is it bad to say that Marcy has nice legs on a
“female” website ? God, I sure hope not.
let me explain what commons are and why they need to be administered by the government and not by private industry;
there are certain services that everyone requires to survive
there’s clean air, clean water, our roads, our bridges, education
money
these are all services that everyone requires including industy
when private industry provides a good or service that is not required they must price effficiently or nobody will buy their product
that is when profit margin is properly reflective
however when the service IS required, they no longer have to price attractively, they can price as high as possible
and they do
health care needs to be a commons just as water and roads
now making health care a commons is NOT soc*al*sm becuase there will STILL be private suppliers and a person will still be able to pay for more care then the commons provides
thus the commons is satisfied yet private industry can also sell their service
simple stuff here
~~~ModNote: Edited for content to clear filters.~~~
Kirk at 21
lots of babes here
especially on Saturday morning
perris at 24 is for some reason waiting moderation
when gets a chance, please to release?
and could you tell me what triggered the filter?…I don’t see anything suspect in the post
Tim @ 23
If it is, I’m really in trouble for 21…
Jane,
First, I assume you either are not in a PPO or these docs are not in your network. If they are, BCBS can’t pay whatever they like; their contract with your provider regulates what they pay, and you do not owe the rest.
Second, regarding the “medically necessary” issue, even if some of your treatment is “cutting edge,” can you find out – through your docs or otherwise – whether BCBS has ever paid for particular treatments. I know you have significantly more important ways to spend your time – like getting well and doing the FDL thing, but it is sometimes possible to argue discrimination…….. Probably you know all this. You need someone to take over this issue. This is not good for you. Bonne Chance!!!
Twain,
For You!
Also the one I grew up with. (If I Did Grow Up).
This issue ties in with Eli’s as well. When a union (say all of the education employees in several districts) get to pool employees for health benefits, we get a much better deal than if we had to go out and individually look for policies.
Not that this is ideal, by any means. All Americans should be covered.
Thanks Kirk ! Off the hook !!
newtonusr @ 17
And thanks to shrub and other rethug legislation that he signed, we have fewer rights to challenge or appeal when we get fleeced than we did 10 years ago, and they have fewer obligations to tell us about what our rights are or to inform us what’s going on.
This is what happens when idealogues get themselves a country to run… 15 years ago, if someone told me that we would living the nightmare that we are today, I would’ve bopped them.. now the joke is on me. Urghhh.
Things have really gone down hill in so far as medical insurance is concerned. Ten years ago while living in Cali I had over $159,000 in medical bills for just one year. My co-payment on all this? $10.00. Just ten dollars.
demi @ 29
sam cooke…a golden voice for sure
demi @ 28
Thank you. I have always loved his music – gone too soon. Please don’t grow up. It makes people get old fast – my granddaughter says I am “swoopy”.
I’ll settle for that.
sporkovat @ 20
Loo Hoo,
I ran into my son’s 6th grade teacher at a restaurant last night and heard a 15 minute apology for his part of a Hugely horrendous ordeal we had gone throug.
I shook his hand and accepted his Sorry. But, he just kept goin’ on.
I’ll tell ya the story, if ya wanna know.
It was an accusation that involved the Bathroom.
He told me that my son would have felt far reaching psychological ramifications had I not been the ONLY one to stand up for him.
demi @ 22
Since I’ve been battling cancer for 14 years now not much has changed. It’s still a fucked system, just more and more Americans are in a position where the combination McJob wages and lack of health insurance benefits are putting good health care out of their reach.
As Eve has noted, and the American Cancer Society (finally) too, this makes people frightened to go get the tests they need and survival rates are dropping. More people are dying, which doesn’t seem to bother George Bush at all, but he’s a psychopath. That’s a truly horrible place to be in, afraid you are sick and too scared of financial ruin to get treated.
I have friends who have (or have had) cancer and the pressure is just too much. It takes every bit of energy they have just to fight the disease and when the hounding starts from the collction agencies they just withdraw from the world, don’t answer their phones and stop opening their mail and then the disease starts to eat them alive. And they’re the lucky ones, the ones who have some sort of insurance and they get treated in the first place.
The whole thing sucks.
gotta go watch the “scream fest” AKA McLaughlin Report featuring the “hardest talk”.
Please continue without me….
Jonathan @ 10
uhhh….Jonathan…
Big Insurance is corporate.
Blue Cross/Blue Shield are businesses.
The industrial democracies who all beat us in health care – they all have government health care systems.
In the US, “overhead” (profit and costs) for the private insurance corps is up to 40%.
Except for Medicare – the government program. Their overhead is 0.5% to 1.5%.
(Except for the Bushie goopers’ Part D and Medicare Advvantadge – both designed with very high overheads as a gooper gift to – you guessed it – Big Health and Big Insurance.
Oh – and the Bushie goopers who did it? Wholly-owned corporate tools.)
Jane, I hope Michael Moore puts you on the dvd version of SICKO. Any and all humiliation of BC is deserved.
How can anyone describe FDL as a bunch of DFHs?
I’m 61. I pick up that most persons here are middle-aged and are professionals.
My Mom is in the hospital yet again. She was in acute care for all of 5 days (now in an ARU), and they sent me the itemized statement the other day (I’m the next-ok-kin POA and health care surrogate). Twelve pages totalling $38,089.13. Looks like all of it will be covered by Medicare, but the rehab unit may be another story. She’s probably gonna be in the ARU a total of two weeks or more.
I have a stack of United Healthcare & Tricare EOB denials (their secondary and tertiary carriers) a foot high from my folks’ other care episodes in recent years, and recently paid off about $4,000 of misc bills from various providers.
The pricing/accounting/billing is beyond anyone’s comprehension. None of this shit does anything to keep people healthy or heal them. But, lotsa people are just fine with that (until they become patients); every misspent health care dollar is part of someone’s paycheck.
Do our politicians worry about their health care coverage?
CTuttle @ 13
And fewer in the US are filing bankruptcy because of medical bills. Not because of fewer people bankrupt, but because of our fine Congress who couldn’t stand up to the insurance companies.
Jane Hamsher @ 37
Oh, Dear. So much sucks. If it ain’t cancer, it’s something else. I hope you realize how much people out here in the blogospher are lifting you up!
You are One. Gutsy. Gal.
(hearts on ya, babe!)
Hoping Kobe’s tummy feels better.
I have a Brindle, Plott Hound with a big chest, and I’m paying attention.
Oklahoma kiddo @ 43
Ask Bu’ush.
He gets a platinum-plated free ride the rest of his life.
Having no health insurance is cruel and unusual punishment.
Parrot-heads Unite! Here’s my theme song…
http://www.youtube.com/watch?v=AzUhzRgk9xk
Jane, As one who stands proudly among the Jane Hamshers of the Left, I respect your opinion and I admire you. Do you believe that Hillary will fix our health care system to your satisfaction?
TheOtherWA @ 41
Kinda like having Exxon Mobile writing energy legislation.
Jane,
If you ran for president, which I’d support, you’d gain lots of votes for having Kobe and Lucy by your side — pulling at the jack toy.
Jane Hamsher @ 38
The truly sad thing is that at least one fundie rethug (from Florida, I should add) explained the depths of their collective dementia to me… that there are really people out there, including our president, who believe that God’s law means the deserving get rewarded with material riches and tacky mcmansions, and everyone else is punished for failing to exercise “personal responsibility”.. that a country filled with needy, wanting people, completely dependent on charity from the faithful, is actually closer to their vision of the perfect America than what we have today. Its all unspeakably perverse, and I despair that, between those leaders who are psychopaths and those who are simply bought and paid for, anyone electable will deliver us from this nightmare.
Loo Hoo. @ 50
Wow – I’m having a flashback of the last six years.
Y’see, the problem with health care in this country, according to (handsomely indemnified) Hoover Institute-istas et al, is that we are oversinsured. Makes us bad “shoppers.”
“Moral Hazard” bullshit.
CTuttle @ 49
Dang, CTuttle. Great song, but I don’t think I’ve ever seen such a white crowd!
Jane
The last thing you need in your recovery is the hassle of the insurance companies.
Without wishing to totally depress you, let me describe how the system works in Canada. In July, 2006 my wife was diagnosed with breast cancer. Her mastectomy was in early September and she chose to have reconstruction with some fat from her tummy used to rebuild her breast. The surgery went fine but she bled, a condition known as DIC, which required two return trips to the OR and she was five days in hospital rather than the scheduled three.
She had four chemotherapy treatments and has since been on Arimidex (and, as an added bonus for me, anyway, her hair has come back curly).
The healthcare system paid for all of the costs except the Arimidex.
This Canadian hopes that the next President and Congress will institute a public healthcare system which provides similar benefits for its citizens.
John
Loo Hoo. @ 50
Huh?
Jane,
May I share a song that I heard from Late Night, last night?
Here For You.
It ain’t the big C, but, there’s something about life and death, and what we deal with.
I think it might have been Wangdang, or…? It made me tear up. Seriously.
This American does too. Best of luck to you and your wife.
Perhaps there needs to be a non-political fundraiser.
perris @ 24
And what’s wrong with soc*al*sm again?
~~~ModNote: Edited for content to clear filters.~~~
Loo Hoo @ 36
the voting record looks ok, doesn’t it?
I was referencing whose interests would be serviced if she becomes chief executive.
he who pays the piper, calls the tune. Voters, for the most part, are easily gulled in even numbered years, especially if they are convinced they have no choice but to vote for the least worst.
CNN just now: 1/4th of Americans get NO vacation at all. Working harder, discarded when we get sick.
TheOtherWA @ 58
That doesn’t make sense, does it. Clicked on the wrong comment.
Jane,
Re the song. It’s about Who Do You Trust?
That’s a hard one in this Day And Age.
We get jaded. We Move On.
I thing the only one we can trust is…
Our Selves.
Ya Think?
hackworth @ 50
I don’t think any President can fix our healthcare system to my satisfaction, the institutional roadblocks are too great. In the immediate future I think what we’ll be facing is what is possible, and when it comes to that I don’t know if she’ll do any worse than anyone else (even though there are others running who are less compromised and have much better intent). That sounds cynical and I hope it’s not true but I fear that it is.
sangemon @ 62
you can’t say “soc*al*sm” on this blog?
~~~ModNote: Edited for content to clear filters.~~~
How evil is Big Insurance?
This evil – if it’s cheaper for them for you to die, you’ll die.
One of the very experienced nurse coordinators I knew left a ttansplant unit (with toxic issues) and took a break as a nurse coordinator for travel plans.
No biggie, right?
The Big Insurance Co (”Atlantic Care”? “Caribbean Care”? – now which one was it?) she worked for had a policyholder in Russia who needed medevac back to the US.
The policyholder was in the back of the freakin’ Russian beyond, the company found – and the airlift would cost a fortune.
So the Big Insurance carrier figured the cost of the lawsuit if they didn’t cover – ad went ahead and let the policyholder die in Russia.
No medevac – it was just a policyholder, after all.
Just let him die.
Peasant.
((((((Jane)))))),
The big positive is that you’re still here, and still raising cane! Thanks for exposing your personal insurance scam.
I am lucky in that I have not run into the insurance swampland like you have, and insurance has kept me alive to now. But there’s no justice in the kinds of battles, not only with cancer, but with insurance companies, that you have to endure. May you soon be vindicated!
Bob in HI
I just cannot see how much of anything is going to change as long as campaign financing remains untouched.
Loo Hoo. @ 56
Alright, Mr. Utley might have a word to say…
http://www.youtube.com/watch?v=sxuaUaS4rU0
Campaign finance is right behind Iraq on my issues list. For these reasons we have been discussing, among others.
Blub @ 53
That is exactly what the authoritarian, “Strict Father” crowd believes. They believe poverty is a moral failure and that to be rich mean that you have ‘taken personal responsibility’, and are therefore a moral person. So to care for the poor without shaming and punishing them is enabling their immorality. They’re all for faith-based care for the poor, so they can dole it out (or withhold it) as they please and decide who is ‘deserving’ and who is not. Health care falls under that same umbrella.
It’s sickening, but that’s what they think.
sporkovat @ 63
I think she’s got a darn good voting record overall, except of course the authorization to go into Iraq and the patriot act. I frankly don’t care who she takes money from as long as she votes the right way.
bg @ 73
speaking of Iraq, check out this from think progress;
Global warming is going to place additional strain on the health care industry.
When my Daddy was transferred to the local hospital four days before he passed, we all zoomed ther. The ER was really busy ’cause there had been a Local Stabbing. They made us wait and wait ti see him.
I finally started pushing through Authorised Emplyees Door to find him.
It wasn’t a popular thing (family) to have done. But, I was with him and kissed and talked before he was intebated (right spelling?) and was sedated before….well, the inevitbale. I’m still glad I did.
CTuttle @ 49
Yay! I love Jimmy Boofay!
If we couldn’t laugh we would all go insane!!!!!
I found this Jane:
Grant & Weber Date: November 13, 2006
I received a call from a guy claiming to be with “Grant Weber,” with an 818 area code. He got extremely aggressive when I asked who he was, why he was calling and what Grant Weber was. He wouldn’t answer any of my questions, and got really agitated when I wouldn’t say who I was. This reached an apex when I told him I would not pass along his message to the person he was asking for (me). I told him I wouldn’t pass along “secret messages from someone claiming he has ‘personal business’ to discuss or claims that he ‘does business with.’ He responded by asking if I was the person they are looking for, which I didn’t answer. He then demanded to know who I was, claiming he has a “right to know who (I am).” My next move was to tell him that I do not take calls from people “playing telemarketing games.” Then he got even more verbally upset and I hung up on him. Less than 30 seconds later he called back! And he was even more aggressive. He kept yelling, insisting that I pass along the message. He kept yelling about how this is important, how “he needs this information,” etc. After this amusing and rather fun game I researched “Grant Weber.” Turns out it is Grant & Weber, which specializes in medical collections. They are quite proud of being “recognized” by the various trade groups of their field. They also claim to their clients they offer a “soft touch” that they claim is more effective than the tactics of their competitors. This man certainly did not live up to that creed.
lurcher @ 57
so could it be said that
the money for proper health care is being side-tracked to corporate privateers in Iraq?
simplistic but true?
And is one of the most unchristian things I’ve ever read. It’s a complete perversion of everything Jesus stood for. Phooey on all of those selfish nutcases.
sangemon @ 68
Take off the so at the front and the m at the end and see what word you’re left with.
One thing I very much resent is how much accounting is required to know in order to maintain one’s health.
In our experience, we have been denied coverage because a doctor didn’t use the appropriate CODE NUMBER on the claim. We had to have the doctor resubmit with the CORRECT CODE and we all know how much we all like to be corrected in our professional venues, we all wait for the thing to work itself out while holding off the people who want their money from us.
I’m lucky. my hubby majored in accounting and has no qualms about telling collectors to feck off in total confidence.
But it’s a job in and of itself to audit all this crap and esp. difficult when you are flat on your back, at home because the insurance won’t cover one more day in the hospital.
I feel for you Jane. And all those reading and in similar straits. It totally sucks.
Take care and remember to laugh at absurdity which surrounds us every day.
speaking just for myself, not my daughter, not my brother
when my time comes, I want to go out into the southeastern AZ desert, and croak
and let the wild animals feast upon me
do-si-do @ 79
it’ fuve o’clock somewhere . .
I have not found it mentioned anywhere in the liberal/progressive/netroots blogosphere, except in a dkos diary, that people are trying to organize a general strike on 9/11/2007. There are a lot of reasons, in my opinion, to strike, and certainly our for profit ’system’ of health care is one of them.
I’d like to ask all of you to consider this question: Is there reason (or reasons) enough for me to participate in a general strike?
And if you answer no, then please ask yourself: What would make me strike? Anything?
The curious part of all of this is who in America has a positive health care story? Nobody I know, so how can anyone say our system is good? I guess if you’re part of the billionaire elite you don’t have a worry.
The GOP minionists are an unbelievably deluded lot, parroting whatever their masters tell them is the correct thoughts to have. I’m just gobsmacked at how fucking stupid Americans have become, fighting so virulently against their own self interests.
WhomeverMod
You are so kind. And, I’m sure, so cute.
(I love the mods at this site. — Photo of Suzanne coming. Saw here last week in Boulder Creek and got a coupla shots.) Film’s at the Place as we write.
I know it’s preaching to the choir, but:
Why can’t we have universal health care? (As every other developed — and many less developed countries — do.)
Why can’t we have equal access to education, regardless of economic circumstance?
Why can’t we have a physical infrastructure that is sound and secure?
Why were some people so afraid of the progressive policies and programs started with FDR and continued through LBJ (and really didn’t get rolled back until Saint Ronnie of the Ranch arrived)?
My 84 year old mother had emergency gall bladder surgery last year, and ended up spending 10 days in the hospital. The bill was $84,000. Thankfully, all but $1000.00 was covered by Medicare and her supplemental insurance — but it took both of our considerable knowledge of the health care system to ensure that it all got paid My father ran up $200,000.00 in medical bill prior to his death last year, and I’m fairly certain there are still people looking to get paid.
I’m truly sorry that you have to experience this, Jane. It’s a g*d d*mned disgrace.
Jane Hamsher @ 38
Jane, my heart goes out to you, along with an enormous sense of admiration. You are a model for all those who struggle with disease–you don’t give in to it. There is all kinds of evidence that one’s attitude effects the immune system, and I believe that is working for you. All the best, may I be reading your great posts forever!!
TheOtherWA @ 82
But they loves themselves the Old Testament.
my bold
I have what many would consider good insurance and it still cost me 10 grand for medical out of my pocket last year. What a fucking joke.
Dick Durata @ 85
I have a day full of chronically and severely ill patients scheduled in the County clinic I work in.
No strike for me.
newtonusr @ 92
Exactly. I wonder what Bible these people read? The ‘King George Version’?
puppethead @ 88
I wonder what they eat? Do they eat the beef that was fed chicken sh*t like the rest of us? Where can you buy beef that hasn’t been fed chicken sh*t?
((((demi))))
Alicia @ 74
….and so we have to suffer and die for THEIR morality
btw, anyone see the press lately about the latest fad among the morally impaired: insurers sending their patients abroad, to developing countries, for cheaper surgery.
http://www.usatoday.com/money/…..usat_x.htm
do-si-do @ 79
Not with all our running and our cunning…!!! 8-)
Peter,
Wow. What you said.
We just all want to feel a part of something.
Right?
Jane has made a place for us here.
(((Jane))).
Peterr @ 86
Amen, Father…!!! *G*
kirk murphy @ 94
Kirk! Whattdid I say?
But, thanks.
Bwahahaha!
do-si-do @ 79
Well, if you want to laugh, you may want to check this out. Courtesy of Newspaperbrat.
Yes, demi. Give me the details via email!
Loo Hoo. @ 101
demi @ 99
Indeed she has. Part of her magic!
sexy babe!
actually i just want to say Thank You a million times for blogging the ‘Truth’ and ‘The Right Thing’ despite your ongoing illness!
Alicia @ 95
The Gary Bauer/William Bennett/Grover Norquist/George Bush pop-up paraphrase picture edition of the New International Version more likely
Jane has Magic.
Power to the MagicJane, right on.
Check out what Kraft food owns. They own Koolaid too. Who needs bombs:
http://en.wikipedia.org/wiki/Kraft_Foods
Loo Hoo. @ 102
Going there.
hackworth @ 93
In the SF Bay Area, Black Sheep Farm is my absolute fave.
Further afield (tee-hee), eatwild can help you find local pasture-based farmers.
Blub @ 108
With the words of Jesus crossed out.
ccmask @ 79
Fair Debt Collection Practices Act explains the “personal business” thing. Collectors are not allowed to tell third parties the nature of the call, or to let anyone else know that *somebody* hasn’t paid a bill.
When I was working at the family business, we had a couple who kept getting collection calls at work. If I happened to answer the phone, as soon as I heard “personal business”, I stopped them right there and demanded that a supervisor be put on the line. I would then tell the supervisor that I considered the calls to be harassing, and a disturbance to the business, and told them where to check in the FDCPA to verify that I had the right to make the calls stop. Always got firm promises and apologies, and about a two week break before the whole process started all over again. sigh.
Folks, I received a FB letter from Petrocelli this morn, I thought I should pass it on…
“No chance, the Huns won’t let me near Wifi, except when we come into town for supplies(Beer), and only to check my mails (30 minutes maximum !!!
At least the cretins are providing Beer (my choice), a pool table,
a huge TV (nature is so much better assimilated with a 1080p Plasma *g*) and lots of time to write my book.
I will be back at the lake Tuesday or Wednesday nite … I really miss the gang and TRex sledging the buffoons … he must be having a field day with Senator Craig … *g*
How much in denial is that guy … he is NOT gay … just as the surge is NOT failing and Nixon was NOT a criminal … new Republican slogan … “The Republican Party … we’re against reality …”, oh wait, that was their motto all along … *g*
Love to all of you !!!
P.”
Well, at least they allow him beer…!!! ;-)
Loo Hoo. @ 103
OMG ROFLMAO. I saw this once before and my kids fell down laughing too.
I admit sometimes I laugh because I’m insane?.
Woo-hoo, A no hitter for Buchholz and the Cardiac Sox…!!! Snoopy Dance…!!! 8-)
CTuttle @ 116
Thanks Tuttle!
The problem is not the insurance “system” per se. The problem is the initial, fundamental greed of doctors, hospitals, and drug makers. That’s why your bill is so huge. There should be caps on all charges. No surgeries should cost most than $1,000.00, maybe $3,000.00. No drug should cost more than $50.00 for one week’s supply. No day in a hospital bed should cost more than $750.00. No use of a surgery facility should be more than $500.00-$2,000.00. And those figures are all at what should be the high end of expenses.
A piece of equipment that costs $100,000.00 should not be a license to mint money. A medical education that costs $200,000.00 should not entitle you to earn $200,000.00-$1,000,000.00 a year for the rest of your life.
Three years ago, I had a mammogram, which required a follow up biopsy, which was negative. It cost more than my deductible which was $2500. I went into debt to pay it, and then I cancelled my insurance and went bare for a year and 1/2 until I reached Medicare age because I was so angry that my insurance was useless. I still can’t afford to go to the doctor or to get sick, as I have no more savings to pay for the balance. If I get sick, I die. It’s as simple as that, and I am reconciled to it. I am blessed with good health, so far, but I have no optimism about my chances in the future. Hillary won’t get it for me. John Edwards might. He’s my only hope for compassion for those of us who deserve, as human beings, to receive care when we are sick. Our government doesn’t care about us.
Bless you Jane and all the best in your recovery.
A medical education that costs $200,000.00 should not entitle you to earn $200,000.00-$1,000,000.00 a year for the rest of your life.
Just a question: Why not?
Alicia @ 113
OK, whenever I hear the words “moral clarity” and “fight evil” and “God told me to” and crap like that, I remember this passage:
Genesis 18:26
No I’m not a chapter and verse person. I went to a handy online tool to find the exact place and quote. But I know the story and the point. I guess George was home sick when they covered this in bible study.
I want to spit everytime I hear someone say we’re making progress.
Good evening Jane.
As if it’s not bad enough to deal with cancer or injury or illness …. then we have to deal with the financial end. I am nearly certain that healing is impeded by the stress of insurance companies, HMO’s and struggling to find the money to pay the bills.
Jonathan @ 122
English and Canadian Doctors live a comfortable living for their efforts…!!!
what horrible bastards.
I got so lucky when my son (an infant at the time) needed surgery, because my pediatrician was past retirement age and didn’t care what an insurance company would or would not cover, or what pre-approval process they had. It was an HMO at the time, so the whole thing was covered. I have no doubt that my son would have gone without treatment if it were happening today.
Thanks again, Dr Shipper of Santa Monica. You were a prince.
Buchholz rocks!
An awesome outing!
I don’t begrudge the doctors their salaries, but I’d love to know that the nurses and nursing assistants are being paid well and that the insurance company executives make less that 300x the nurse’s salary.
I have a tale to tell about my son who was diagnosed with kidney cancer last November. He had no health insurance but had to have a kidney out immediately. I offered to pay all of the medical bills and since he would not be able to work for awhile he had no choice but to agree.
It broke my heart to hear him telling the nurses as they wheeled him into surgery that he didn’t want any unnecessary tests or procedures or medications because he didn’t want me to have to pay for them. Afterwards he questioned everything they gave him, every procedure to make sure each was absolutely necessary. And he wanted to go home as soon as they would allow it.
It shouldn’t have to be like that. He had enough on his plate.
Blub @ 98
CalGeorge @ 127
Hey, Cal-Bears are doing an admirable job against the UT Vols…!!! ;-)
Jane,
If you were in a preferred facility and treated by a non-preferred assistant surgeon, the managed care plans I am familiar with will pick up any amount that you are “balance billed” by that non-preferred doc that you had no control over being there. Maybe this is not your situation, but it could be and you just didn’t know….
This is true for in-hospital treatment by radiologists, pathologists and anesthesiologists, as well. And ER doctors. You had no control- you picked the facility and the admitting surgeon only. All others are OFTEN non preferred because they have no incentive to contract. But the policy will still often pick up their balance bill. You may need to ask BCBS customer service directly.
Contact me if you want- I work for a major health insurance company.
Vanlassie
And the 25-40% of premium dollars Big Insurance takes as profits and “costs” isn’t greed, is it?
And the fact that the industrialized democracies that actually provide universal coverage don’t allow transnational megacorps to siphon 25-40% off the top of health resources is just irrelevant, right?
Anon @ 117
BTW – lots of docs are greed heads (though not the majority I’ve met) – I look forward to single-payer driving them off.
kirk murphy @ 132: You’re quite right. The insurance industry is a big part of the problem, drives the cost way up. We need single payer, among other things.
Why can’t people just send monthly payments to the hospital in their county, I always wondered? Then, you would be covered in any hospital.
I had emergency surgery 7 or 8 yrs ago. I was admitted to the hospital, met the anesthesiologist etc. and they then postponed the surgery for a few hours until some test results came back. By the time they actually did the surgery, it was a different anesthesiologist who was not on my insurance plan. But do you think THAT is what I asked him when he put the mask over my face?
kirk murphy @ 133
What gets my goat about big Pharma is their Lobbying and Advertising budgets dwarf the R&D budget, seriously misplaced priorities…!!!
ccmask @ 134
They could, if we had a decent system. The problem (see Jane @ 67) is how to make it happen.
Jonathan @ 122
because you have arrived at the position of skill you possess via the historical efforts of those who built
the system(not withstanding your personal effort)
and to not pass the benefits of that system forward is the action of a leech and degrades that system.
every system can shrug off a certain amount of parasitical behaviour,
however,there comes a tipping point and once that tipping point is reached,the system collapses.
Ok. I’m just a bit tired and have to get offline here.
Coupla things before I go:
Even healthy people have health issues from time to time. I would be extremely healthy for the work I do to maintain it. But I went through menopause and impacted wisdome teeth without coverage. Do you know what happens if you don’t get those teeth fixed? They push sideways. After all my side teeth cracked and shifted from the pressure, I still had no way to fix the problem. I did have a pair of pliers, though. I wouldn’t wish that pain on anyone. I have arthritis and other minor complaints that I just live with.
Aside from the Lion’s club providing me an appointment with an optometrist and a new pair of glasses, I haven’t seen a doctor or a dentist in years. I’ve pretty much decided that my chances of getting any kind of coverage before I’m 65 are non-existent. If I should find myself with a catastrophic illness before then, it will only be treated when it’s too late to fix it, so why bother?
Goodnight folks.
Oh PS: If you want to talk about soc’al’sm, try misspelling it. I think soshullism would work just fine.
may @ 139
Ooh, well said…!!!
do-si-do, my daughter made me play it for her five times!
Great to hear that Petrocelli is doing okay and keeping up on all of the *important* news!
IIRC, Eve calls it “Murder by spreadsheet.”
Not really. Their priority is profit, not healthcare.
Two articles from yesterday on prospects for California healthcare reform
http://www.sfgate.com/cgi-bin/…..4RRM9R.DTL
http://afp.google.com/article/…..dyW3cejd9Q
If Arnie can do this, I might even switch from being utterly contemptuous of him to being merely sceptical
Audrey, do you qualify for medicaid? Are there any free or sliding scale clinics near you?
wigwam @ 143
woops, you’re right.
Alicia @ 73
To me, it’s strange to see the worst aspects of the both Calvinism and evangelism come together in a single philosophy, but, that’s what it is, I think.
Next thing you know, we’ll be stuffing work houses with cancer patients who couldn’t pay their bills….
Loo Hoo. @ 6
Make no mistake, people. We are all potentially cases in point for Sicko. I know I am…It’s barely September but I just fell into the donut hole. That means from now until January I either have to beg for drugs, buy drugs (if I bought them all, it would cost over $500 at Walmart or more than $800 at Walgreens), or do without drugs. My spec*al*sts are a $35 copay (I have a cardiologist and a pulmonary doctor; both want to see me about every two months) and some of the testing costs money (I think they will bill me $125 for the MRI I just took and $25 for some xrays.) My rent is $718 and my income is about $1,367/mo. Yet I am lucky. I could have Jane’s bills and her medical problems. Good luck with that, Jane. Hope you can straighten them out. Actually, have you used Michael Moore’s name? I’m serious. He mentioned that on a show I watched.
~~~ModNote: Edited for content to clear filters.~~~
Vanlassie @ 132
I will check. The doctor in the bill above was not the admitting surgeon, that was somebody else (my portion of his fee was a mere $7000).
{{{GM FORD}}}
I had surgery for breast cancer three years ago — much less advanced than yours, Jane. My insurance paid what was not written off under contract — after my deductible and out of pocket were pif — around $5000 in my case. I used caregivers under my PPO.
But what shocked me was, the hospital billed me over $13,000 — about three times what the insurance company paid them — for an overnight hospital stay. I was insured, so when I submitted that bill to insurance, the insurance company paid and the hospital wrote off the balance. Was the hospital spiking its bill to the insurance company? Were they shifting payments to the uninsured? What? If I had been uninsured, would they have expected me to pay that whole bill????
So, if you don’t have insurance, you not only pay the full amount — but you pay the full amount — times 3??? How can that be? Uggh!
Good luck with your appeal.
GMFORD @ 129
Oh how sad. How is he doing now?
So, is going bare and not forking over premiums to BCBS an answer? It just might be. Forty-seven million people without health insurance now, you know it will become 100 million soon enough, the trends being what they are. What if, by not buying crappy “insurance” we all self-insured? Yes of course our life savings could be wiped out, and our medical access denied, and we could die. Like Ghandi’s millions of salt-miners. Like Tom Paine’s patriots who risked “our lives, our fortunes, and our sacred honor.”
I’m seriously considering it. My COBRA runs out in November, and I’m 60. I could get “good” insurance for 900/month, or crappy 5000 deductible for 250. I’m healthy so far, but What If Something Happens? I might not even bother with the 250/month, and just bet on myself. I’ll add myself to the 47 million, and maybe by the time it’s 100 million, then 150 million, some President will have the strength to get universal single-payer health care done.
What about that?
Anon @ 120
Very few doctors make anything like that amount. In fact, doctors are becoming a force in the single-payer movement.
Some hospitals are just plain greedy. But even those that are not deal with a strange American refusal to deal with reality. How much did it cost to keep Terri Schiavo “alive” all those years? And yet large numbers of people wanted to call removing her feeding tube “murder”. Triage is a fact of life. People need to deal with it (and deal with the opposite problem too – it’s not “collateral damage” when a the military kills civilians while in pursuit of the enemy. It’s at least manslaughter.)
On a more mundane level, hospitals spend absolutely primo dollars on every piece of equipment. On many items, they are being had by manufacturers who know damn well these are people who will pay 2x as much if the failure rate is 0.1% less.
I’m not going to try to defend big pharma, and I absolutely loathe insurance companies.
How does the privatization of hospitals fit into all this?
PeterK @ 144
The one place where there is some Federal support is R&D. NIH makes approximately $18 billion in biomedical research grants each year. Now, mind you, pharma and the medical-industrial complex ultimately do profit from that work.
PeterK @ 144
Heh, no Hippocratic oath for them…!!!
TexBetsy @ 146
Ha! Caught me just before logging off. :)
No and no. Believe me I’ve explored the possibilities. There isn’t even a local hospital anymore. They closed last year, I think.
Thanks for asking though.
montag @ 148
Wow! You nailed it!
Some of Jonathan Gruber’s (MIT economist whose research was used to shape MA’s universal health insurance system) work appears to suggest that outright nationalization (or state takeover)of large portions of the insurance system would be preferable and more cost effective than employer-premium-subsidies and other half measures. I don’t think he outright comes out and says this, but that’s a pretty common interpretation of his conclusions and his numbers.
nuncamas @ 153
Don’t take it. Talk to other people in the same situation. Organize around a good candidate. Fight it. It.is.not.inevitable. There are other ways.
GMFORD @ 129
That is heartbreaking.
Blub @ 145
I’ll stay with contempt.
The repeat sexual batterer, Arnold the Guv, stated he would veto SB 840, Sheila Kuehl’s single-payer plan.
Arnie’s plan is the same neoliberal crap as in Mass.
The plan uses Statte power to force citizens to purchase megacorp’s product lines.
The megacorps (Big Ins) will have a State-enforced compulsory market for their private business, and make a fortune.
You think California auto insurance is a racket?
Arnie knows exactly what he is doing – so does the ambitious Democratic shit Fabio Nunez.
Pretending to give us health coverage when they are actually giving Big Insurance big sloppy Craig jobs.
And Arnie and Fabio aren’t squeamish about picking up the paper Big Insurance drops on the stall floor.
They call it contributions.
nuncamas @ 153
I’d pay the $250.
nuncamas @ 152
Lotta people out there who are under continuous care and medication for whom such a decision, in this system, is a death sentence.
And, what will happen, over time, is that as pools shrink, the costs for the remaining insured will go up and the geniuses in Congress will simply add to the debt trying to subsidize the increased costs, rather than addressing the core problem.
Things will then go from bad to worse without fixing the system, I’m afraid.
Jane, I’m skimming on dinosaur dialup and all I can add is Yes! We have the “good” insurance and still get swamped with charges for coverages denied by the insurance carrier. BCBS-ND. The last state in the union where a C-leg is considered “experimental” and not covered. Even Idaho, the other last hold-out, we’ve heard, now covers it thru their BCBS group.
But the ND-BCBS exec director was busted after a home-invasion “under the influence”–kind of a Larry Craig moment, which came as a bit of a surprise to the wife in the bed….quickly hushed up after a brief flurry in the media.
Gotta love the Repervlicans and their devotion to their closets and their Big-K Streeters.
TexBetsy @ 156
Well, when this administration sends in helicopters to airlift out patients after a natural disaster, public hopitals need not apply.
denise k @ 151
“Market forces”–yep, that’s the way they do business. Edwards nails it when he talks about two Americas. The rich-insureds and the rest of us–”insured,” underinsured and uninsured.
Demand better.
Prairie Sunshine @ 167
I still haven’t heard anything about the three federal prosecutors who meet untimely demises in Texas… Hmmmm…………..!!!
Employers want to be rid of the burden of paying health insurance as any. Why not form a coalition of the unwilling to pay private insurance any more? It seems like the right move to make right now.
“meagacorps’ profit lines” not “megacorp’s profit lines”
proofread, proofread, proofread.
jeebus.
OT – PeterK: didn’t mean to give you a hard time last night. My neighbor is from Bangor, moved down here and got married around 60. He says ‘ayuh’ (and can’t say my name at all, comes out “gaahden”). The local accent, though, is a bit crisper.
denise k @ 169
Because the employers don’t want to pay the percentage for single-payer, either. Who screams the loudest about raising the cap on SS/Medicare wages, every time? Employers’ associations.
Jane Hamsher @ 163
Yes, it is. Actually didn’t know why he was being so picky at the time. I though he was just kind of out of it from medication. His wife told me later it was because he was worried about the cost.
I am with a school system insurance plan and pay more than double what I used to for medications. Just the copay.
My wife had a breast cancer two years ago and, thanks to my union health benefits, she is now free of it and we’re not living in our car.
We had total coverage at the start, but, midway through the treatment, our coverage changed and, suddenly, we had to pony up 10 percent.
Doesn’t sound like much, but opening that first bill under the new terms was heart-stopping.
I strongly advise everyone that if they get sick, do it in January, in case your health benfits change on the new year.
Ours changes Sept 1.
PeterK @ 144
And therein lies the problem.
Regular reader, seldom commenter here, this is a subject I have watched devolve with sadness over a career in healthcare. I have worked in cancer research where my patients who have stage 4 cancers continue to work to maintain their healthcare insurance so they can be treated for their disease. Recently I found was trying to solve Hospice needs problem for a man with no insurance, no money and trying to find a hospice who would meet his needs. AT one point in discussion with his friends and family, his mother (also a nurse) asked me what normally happens in these circumstances. I had no answer for her. Personally I am a diabetic currently without insurance my monthly drug bill would run about $1750 without insurance, I need to work in a less stressful job but can not leave the one I have because of the costs of my meds and the wide variability of Health Care Plans out there.
There is only one word for this..SHAMEFUL.
Jonathan @ 122
Peruse this and get back to us:
Wealth Creates Poverty
annonurse @ 180
Yes it is.
Gee, where’s punaise? I wanted to ask him how to say, “Zoot alors! Those Americains are fuckin’ idiots.”
All of Western Europe must think we’ve become brain-damaged by all the crap in the water, or something.
It’s just mind-boggling how this fundamental societal issue hasn’t been solved, ages ago (of course, yes, I do remember the fights in Congress over Medicare and Medicaid).
As others have pointed out, the “Health Insurance” industry is not in the business of health; but in the business of making money. I have “good” health insurance, but a Jane’s story point out, it may not make any difference. The insurance companies reading of the fine print, a denial, and you can be 100k in debt over night. A few months ago I had emergency eye surgery; at night, out the door in Am, $15.5k hospital bill, insurance paid $575. I just keep my fingers crossed until I can get Medi-Care.
Single payer is the only way to go..but it is going to take a huge turnover of Congress and public pressure to get it done. The public is so brain washed that when single payer is mentioned; the response is “I don’t want socialized medicine”.
TexBetsy @ 178
Most change on the advent of Jan 1st, but there are many more that have picked July 1st as a turnover date as well. Big Insurance basically changes things over every 6 months if they can get away with it. Copays go up without notice, and you get sneaky deductables too. You’re lucky if they manage to send you legally required notice about those changes in advance too.
Not a good thing, and they get away with it–constantly.
Here’s a combination of two monstrosities:
Katrina victims saddled with hundred-thousand-dollar medical bills from poisoning by FEMA’s toxic trailers, in which tens of thousands still live.
http://www.sctimes.com/apps/pb…..10033/1009
injury to insult.
Blub @ 186
Yep. Working out great for them.
My wife is Costa Rican. If she needs something major done she can get it done there at a fraction of our cost and the government covers it in the national hospital system. If you go to a private faciltiy it will cost more but still be much cheaper than here. She is under my State of Arizona insurance here.
175
GMFORD says:
September 1st, 2007 at 7:46 pm
And well he should be. I once got a bill for more than $5 Grand for about 5 hours in the Emergency room for a bad case of Bronchitis. (Of course, I also have COPD, but I don’t know if that’s what made it so exhorbitant.) Luckily, the State has a program that will pay the hospital if you cannot afford to pay such an extraordinary bill. This was good because at the time I had no insurance for a period of like three years although it was the first time in my adult life I found myself without insurance.
OT, but, is this Marcy reacting to Michigan’s loss to Appalachian State today?
Mauimom @ 190
I know she not happy with the biggest shock in Big Blue’s history…!!!
boing – flying forward one-and-a-half somersaults, pike, no splash*
g’evening everyone
*no matter what that %@&$* bulgarian judge says
Hi Blub -
Slow typist here…I was writing my 164 when your 161 came out.
Hope my displeasure with the MA health plan didn’t seem directed towards you. If so, I very much apologize.
Suzanne @ 192
Bonne Soir, Ma Cheri!!!
Hi Jane,
FWIW, I think that healthcare is the ultimate battering-ram issue for progressives. It is the place where the conservative creed of private-sector competence and efficiency is emperically discredited by what’s happening in the rest of the industrialized world. The current generation of Americans has been raised on that nonsense. They buy it in their gut without realizing what they are doing.
Paul Krugman has been excellent on this stuff. NYCeve has been right on top of it. So has Gerard Anderson of Johns Hopkins http://content.healthaffairs.o…..ct/22/3/89
kirk murphy @ 193
no problem.. I think it’s a minimum threshold.. inadequate, but a start. And, given the complexities to which Jane alluded, perhaps the best we can hope for in the short term. At the end of the day, I agree that I don’t think the current system is fixable, but politically, I don’t think Americans are ready to deal with that. From what I understand, even Gruber would probably agree with that assessment. These plans are a band-aid on a stop-gap, and they’ll probably increase costs in the near-term.
The one thing that gives me hope is that more and more of the Boomer generation, through caring for aging parents or their own health, see it for what it is, an utter shameless mess. But, almost all believe that change is hopeless. I desperately want to work to change that perception. I had a discussion with a republican at a gathering about health care he kept using the “soc*al*zed medicine ” although he had some experiences that had enlightened him to the need. Finally I just told hime to remove the word “socialized” since it seemed to make him anxious and substitute single-payor. Interestingly the linguistic shift helped the discussion.It seemed I was able to make some headway in his understanding that profit has no place in health care. One at a time, minds must be turned.
~~~ModNote: Edited for content to clear filters.~~~
Hmmm…
Wish I had Lexis-Nexis…
somewhere I’ve read current studies that the majority of Americans currently WANTS single-payer.
Big Insurance’s vehement opposition is intended to convince us we’re alone and losing.
Progressive ideas are strong – and the majority of the population supports this one.
We’re the majority – and we’re winning.
Our timorous pro-corporate “leaders” lag far behind – most of them.
shiny new thread upstairs, pups!
CTuttle @ 118
It was his second–he pitched one in high school. A much needed up for Soxpups.
The insurance companies and Big Pharma could live with something that would be called ‘universal health care’. The key is that it be ‘single-payer’.
A good single-payer advocacy group is Healthcare-Now!
http://www.healthcare-now.org/…..ctors.html
Anon @ 120
That would be nice, but it isn’t going to happen. As a rule, I tend to dislike surgeons, but there’s a reason surgery is so expensive. For starters, you need two doctors (a board-certified surgeon, and a board-certified anesthesiologist), a minimum of two nurses (one who is in the sterile field assisting the surgeon, and one who is outside the field dealing with anything that needs to be taken care of), a sterile operating room with sterile instruments and equipment (think $20 for a pair of gloves), and access to things like ICUs and blood banks if anything goes horribly wrong. None of that is cheap.
As for hospital beds, they aren’t hotel rooms. Most hospital beds have a medical resident covering them 24/7. That means that someone who just spent $200,000 on an education is there in the hospital at 3AM just in case something happens. There’s also a highly-skilled nurse taking care of you, and that person is presumably being compensated for working a graveyard shift.
As for whether or not a $200,000 education entitles you to a $200,000-$1,000,000 salary, I’ll agree with you: I doesn’t ENTITLE you. But if you have $200,000 in student loans, you’re probably going to look for a job that pays six figures. And if those jobs don’t exist, there probably aren’t going to be many people willing to pay $200,000 for an education.
Then there are people like me: I went to both medical school and graduate school (8 years of school) for free under a federally-funded Medical Scientist Training Program. After 8 years of school. I worked for a pediatrics resident for 3 years in New York City, making less that $50,000 a year (but the hospital subsidized my studio apartment). Then I did another 3 years in Houston as a genetics resident, now making between $48,000 and $55,000. Now, after 8 years of school and 6 years of post-graduate training, I have a job making $70,000 a year that allows me to see patients one half-day a week and spend the rest of my time doing medical research, which is want I wanted to do the whole time. The only problem is that the NIH, which is the main funder of medical research in this country, is going through a budget crunch, so the last two grant applications I’ve sent them have been rejected. So please don’t try to tell me that the root of the problem is “greedy” doctors.
kirk murphy @ 94
Kirk, I don’t think many people should strike, you, emergency personnel, or a person how can’t sacrifice their minimum wage for that day to feed their family. Many others can’t. But many can.
What I’m interested in is seeing some dialog about it, or maybe some other action besides waiting for Democrats to quit being toadies to the system that owns them. It ain’t gonna happen folks, even if you talk yourselves blue in the face.
Ya, in my house we always referred to Blue Cross as ‘Double Cross’.
Wow, Jane. This SUCKS.
thanks Frank.
Hope NIH gets the funds it needs – and your grants are funded.
GMFORD @ 129
This is beyond sad. I hope your son has recovered. This should not be.
Love the chair . . . I love modern chairs
I have an interesting chair, from the 60’s maybe, always wondering how to research it.
These resources may be helpful…
http://www.kff.org/consumerguide/7350.cfm
has a map with links to state insurance departments (which regulate fully insured plans, based on situs of contract) for consumer assistance and complaints and
http://www.patientadvocate.org/
free volunteer advocates; can help w/ financial problems, negotiating rates…always ask the facility and the provider to work out a deal for non covered amounts; sometimes they will accept the “par physician” reimbursement rate even if you are out of network; they won’t normally offer it but asking sometimes works; especially with the doc’s.
Frank Probst @ 202
If it’s a priority, making the education cheap/free (as they do in Cuba) then requiring 5 to 10 years of work at a reasonable salary (not comission) is an obvious fix. Putting doctors on comission was always an awful idea.
kirk murphy @ 198
Hi Kirk. I’ve read that too, and I’m almost certain that it was in a Paul Krugman op-ed from NYT. Truthout.org has a pretty complete archive of them. I think that mgpaquin.wordpress.com also has a good archive of Krugman’s stuff.
Ian Welsh @ 210
it’s particularly absurd given that the pay is tied to the procedure and not to the diagnosis or the outcome. I’m convinced that there is a lot of unnecessary surgery that wouldn’t occur in a rational system.
I am 34 have no health insurance and have had heart trouble since I was 28. last year things got so bad that I had to have surgery, so by losing just about everything I owned, and through the generosity of my quite small and hardly well to do family, I was able afford the surgery. Well 10 full months after the surgery I recieve a bill from Oscar at Grant&Weber stating that I owe Huntington Hospital $2500.00. These Hospital Corporations are running a huge and obvious racket and there just HAS to be a way to bust them!
wigwam @ 212
The US has a ton more surgery per capita than any other country I’m aware of. But it doesn’t have better results. That’s… suggestive.
Well, you got PPO coverage there, pussycat, and had out-of-netwok care. So..umm…sorry, but you owe the money.
You shoulda stayed in-network, where it’s cheaper for the insurance company to keep their money through back-door deals designed to rape you of your cash while being under anesthesia.
Oh yeah, and I highly doubt Doc was that upset over $1,000. Especially after he gets to hop into his goddamned BMW after he’d done slicing & dicing you all day.
Here’s the solution. Let’s get a hold of that prick Tony Snow’s medical insurance claim forms and see what he’s paid so far compared to his income.
BobbyG @ 43
Bobby, same here. My mom just spent 5 days in the hospital, no surgery, no broken bones, just unexplained lethargy which made the nursing home nervous so they sent her to the hospital to get checked out, and the tab came to $22k. Medicare did cover all of it.
Usually, going to the hospital from the nursing home after you’ve run out of your Medicare days benefits is a good thing so long as the hospital keeps you three days. When you get back to “rehab” at the nursing home, Medicare kicks in for up to another 100 days, including all sorts of therapy, everything from occupational, to physical and speech. After medicare runs out, you’re on you’re own at the nursing home/rehab, which where we are runs $6k a month for the nursing home and $10k a month for rehab. Secondary insurance covers none of it except the drugs. (Many secondary insurance policies cover far more than medicare so there’s no reason to sign up for medicare’s drug policy.)
I’ve been so inundated with paperwork from doctors, the nursing home, medicare, secondary insurance, her long-term care insurance and the pharmacies, that as long as the amount isn’t outrageous, I pay it. But who checks to see that the patient isn’t getting price-gouged in the first instance? That the services on the bill were necessary to provide and legitimately priced?
One of the reasons I have no desire to live to past age 80 is the time I spend in the nursing home watching these folks. None of them seem to have any quality of life to speak of. On the few occasions when I get a smile or a laugh from my mother, or a coherent sentence, or she gets pleasure from a long ago memory, I get all excited and happy. The next one might be three weeks later.
There has to be a better way of helping the elderly in this country. We’re all going to be there someday.
Every few months I get the urge to start an aging blog, I’ve already bought the domain, Aging Right.com…now if I only had time to write it and share the lessons that Bobby G, me and countless others learn the hard way, from scratch, so that others would have a frame of reference when they suddenly face these problems, I would start it.
If there’s anyone here that would be interested in an elder care blog (and in writing it from a personal experience point of view, let me know.
Jane, you need to get them to forego the remainder of your bill. Let it be a fight between the doctors and the insurance co. Your contribution should be zero.
Someone should remind me the next time this topic comes up to mention medicaid. My occasional housekeeper of the past 28 years, who has no assets or private health insurance, has had two bouts of breast cancer, one of cancer of the uterine wall and one of lung cancer. She gets all the surgery and followup she needs with Medicaid. Her first cancer was 15 years ago, her last bout of chemo ended six weeks ago, and she’s already back cleaning a few hours a week. She just turned 69. In a great sense of “family duty”, her daughters are now “sitters” with my mom at the nursing home 3x a week, which means I only have to go twice a week. Point being: This is going to be the largest crisis we’ve ever had in that it will target all Americans over 60 at some point and none of us except perhaps the Leona Hemsleys of the world are equipped to deal with it.
We not only need single-payer, BUT also elect decent and sane Congresspeople. I guess I always think ahead. If … IF … we get single payer, a few years after, if a GOPer gets in, you can see them F*ing it all up, just as they (try to do) to Social Security today.
They never stop. Those who say this is a life-long battle are correct.
Think FDR was popular? He was, but the GOPigs never stopped working. They always come back.
So — politics must always be on your plate — in 2008, in 2025, in 2050. Forever. Don’t be like my mother and say, “There’s more to life than politics.” Politics IS life.
Jane, I’m living the nightmare with my parents.
Stop the war.
Stop faith-based initiatives.
Fund health care for every single American.
We’ve been going through this shit with Esten too, being harassed by collections agencies because of wrongly-filed claims. Regardless of those, and despite keeping up the premiums and meeting our out-of-pocket expenditures, we still have to make a $40 co-pay for every new insurance claim.
So far, this year alone, there have been 200 claims.
In the 11 months since he was diagnosed, we’ve spent around $20,000 on treating my son’s illness. And we have insurance.
My surgeon charged one fee to cut me open, and a second fee to sew me up. How droll.
My wife went through four hospitalizations for End Stage Renal Disease, eight months of dialysis, and now a kidney transplant. She had Medicare/Medigap
(costing a total of about $250 a month) and the only bill she ever had was for the phone in her hospital room. I never had to call Medicare to question a claim, because nothing was denied. We should aspire to this for all.
I am going to send a contribution to the FDL address to help Jane get out from under this.
Jane, we have just gone through the same thing in our family. I highly recommend you pick up a copy of the book:
http://www.theinsurancewarrior.com/
Best of luck, our thoughts are with you.
All the Blue Crosses play this game of denying big bills as not medically necessary and hoping you don’t appeal. After stringing you along for a while, if you show tenacity, they cave and pay the bill.
My infant daughter had a seizure two years ago while my mother in law was watching her. My MIL had no idea what had happened, other than the baby had lost consciousness and turned grey. She called 911, they sent an ambulance. The EMT guys rushed her to the hospital. At the hospital, they diagnosed her with a febrile seizure, which can be serious, but considering the possible outcomes, was one of the least bad outcomes.
Then the insurance company refused to pay the bill for the ambulance ride, the emts and the emergency room visit as “not medically necessary” because a febrile seizure can be treated with outpatient monitoring.
I pointed out to them that the doctors disagreed, but even more significantly, that we didn’t get that diagnoses until about 5 hours into the thing, Our pushback went nowhere until we completed our appeal, and made a call to the state insurance commissioner. Then they caved. In the meanwhile, I had bill collectors leaving messages for my 1 year old daughter on the answering machine for about 8 months.
D @ 215
Hey smartass, call someone else pussycat. Having dealt with this situation for 14 years I’m well aware of what my coverage is, so patronize someone else. And as a matter of fact, I don’t owe the money. I paid it all in January and the Blue Cross “claim form” was addressing how much they were going to reimburse me for. Not how much I owe.
When I need someone to come in and “explain” things for me, I’ll let you know.
Daniel Fox @ 213
Your experience is very common. A year and a half after my last I got an enormous $30,000 bill from the hospital because Blue Cross said they had filed it too late and had denied it; the hospital decided they should go after me for it. I called Blue Cross who said I didn’t owe it, so I called the hospital and told them to stop biling me. They finally settled it with Blue Cross but not without giving me a heart attack and forcing me to make a series of bureaucratic phone calls I should not have had to.
Jane, you were a lot more gentle with that D character than I would have been.
I admit I skipped a few of the more recent comments, so if this has been addressed, please ignore.
The insurance companies have got the healthcare industry by the dangly-bits on both ends. What we the patients seem to forget a lot of the time is that the MALPRACTICE INSURANCE rates are so unbelievably astronomical that many doctors are forced to abandon their practices. Here in Illinois there is a severe deficit of OB/GYN care, due primarily to this very expense.
Until we get the LAWYERS out of health care, the INSURANCE vultures will be free to keep raising the doctor/hospital care fees to meet their malpractice premiums, thus upping our “health insurance” premiums and giving us less coverage – which means more people will be tempted to sue for malpractice… vicious snowball?
Dick Durata @ 203
What good is harming my employer by refusing to work going to do? My employer is kind and honest and good – and he pays for the majority of my health insurance, such as it is. It certainly is not HIS fault that the insurance companies have raised their rates to where he is limited in the choices he can offer us.
Why would I want to punish my employer because our government doesn’t care about us except at election time?
I don’t think the kids in the heart surgery ward in Russia will understand the political point if I go on strike for a day.
Let’s work, ok? And let’s work to get this band of criminals out of office.
welcome to my world.
Don’t pay it. It’s marked “not a bill.” It’s not unusual to get those and when you receive the actual bill, it may be lower. That was true in my case.
However…I had emergency surgery to remove my gall bladder and, a year later, emergency surgery on both my knees following an accident. I am self-employed and have maintained the best insurance possible with Kaiser for many years. My deductibles were only $500. So, I’m grateful for that — although I spend $600 a month for the damn coverage.
Nonetheless, all kinds of other copayments, especially on rehab, combined with a huge slowdown in my work to recover, landed me in bankruptcy court.
Oh, and, as it happens, the surgeon botched my knee surgery — ON BOTH KNEES — and I have to have it again!
A friend of mine broke his knee up in the mountains last spring. He managed to get to the nearest hut, got hold of a helicopter which transported him to a hospital. Cost: 0.
He then had multiple x-rays, an operation where they fixed the knee properly, rehab 3 times per week with a professional, for basically 6 months, and a large amount of painkillers. Cost: 6$ per night while hospitalized, about 150-200 $ total before he hit the ceiling for medical costs/year.
No that was not the US,it was Sweden and we have universal healthcare.
Greup @ 232
Yep. I’ve landed in ERs in France and Switzerland and my bills were nominal.
The solution to the impact of astronomical malpractice insurance rates on health care is two-fold:
1) deal with doctors who are repeatedly or recklessly negligent through loss of license and criminal penalties rather than through the tort system; and
2) provide health care, home care, and occupational support for all of our disabled, not just for those who are ‘lucky’ enough to be injured by someone with a deep pocket.
Jane and all
You should check out Leroy Sievers blog at npr. Go to NPR.org and click on My Cancer. There is a wonderful support group in those who post to the comments.
It’s time for Universal Health Care.
This is insane!
Jesus, Jane! I think I’d’ve had a major coronary upon opening that flaming piece of tripe! {{{{{Jane}}}}}
Are you on tap for Michael Moore’s sequel to SiCKO? Not that he’s doing one to my knowledge, but if he is, your case should be in it.
My mother is undergoing treatment for breast cancer. 6 chemotherapy sessions, 25 radiak treatment sessions,lots of tests, medicines, and meetings with doctors. Her total bill will this year 130 dolllars for medication and 250 dolars for doctors. She has to travel by car 120 km to the hospital for which she is payed a certain amount of cash to cover the gas. Since she lost her hair she even gets a vig.
Once again its not in the US but in Sweden. Yes we pay a bit more taxes but on the other hand we get this back when we need it.
I know what you’re talking about, Jane. I had Blue Cross in 2001, as an individual. $2,500 deductible. Then my chest started hurting. It took me a while until I faced the facts and called 911. They came. $600. They were right out of Rescue 911, firemen, and very pro. But then they asked me, what hospital? I said, sweating, what’s closest? They took me to Hospital B. Bzzt! Wrong answer. My bill for the heart attack was $28,000. They decided they’d pick up $14,000. Double deductible because it was a non-participating hospital. And then the co-pays and god knows what else. So the hospital started calling me twice every day, asking when they’d get the $14,000 I owed them. My chest still felt like somebody jumped on it. I came up with about $8,000, and they decided that would be enough. Then assorted specialists, and the firemen, dunned another couple of thousand out of me in pieces.
It’s like the medical system is being run by the Three Stooges. It’s got to stop.