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20 June, 2009

My health care experiences: Update

So, it's been a few weeks now since I last saw my new Bona Fide American Doctor. The prescriptions he ordered for me are working like a treat. It's really amazing how quickly I felt better after putting up with stomach trouble for a verrrry long time. Congrats to the man. I paid $20 for the visit which I suppose is pretty fair in this day and age. That's probably less than it would cost the cable guy to come over and "prescribe" something for my snowy channels and I bet the cable guy has not spent the last 10 years in training. A real eye opener for me was receiving the statement ("this is not an invoice") from the insurance company which let me know how much he wanted from them. $240. The man barely broke a sweat sitting and talking with me and he wants $240?? I've heard reasons such as "the cost of electricity and rent is risssinggg" wail, wail, moan, moan from the AMA but that still seems a little pricey for me because ultimately the cost is not just magically absorbed by insurance companies, but paid for by the healthy (and not just the wealthy). If the health care industry wants to work this way, then fine, I actually don't mind. What I do mind is the "not telling you the price" bit.

I think I've moaned about this before so I'll dispense with the examples but if I came in, sat down and he asked for my issues. Kept a poker face and said "Well, I can give you some prescriptions, tell you what is going on, take a look at your chest, ears, mouth and eyes, but it's going to cost you you $240." Then i'd be happy. I'd probably think "Well, that's a bit pricey but I want to feel better so what the heck." I might even try saying "Well, my ears and chest are fine and I don't need to know the real reason. Can you skip those and I get a discount?". I don't think there is any other industry in which you accept the service without knowing the cost.

My other bit of health care news is that I went for my 2nd refill of my prescription the other day and was shocked when the price had sky-rocketed. First time it was about $6 which I thought was fantastic. I could live with that. 2nd time around, about 20 days later, and it's almost $20. Same drug, same amount of pills. So, I ask the pharmacist (when I got home after prompting from Ms. Allclick who helps keep me in check with these kind of things) and they say something like "Oh, it's your insurance company. They must have adjusted how much they are willing to cover" or some such. I call my insurance company "Oh, it's the pharmacy. They must be paying more for the cost of the drug in the first place. I return back to the pharmacy and they shrug their shoulders. "Yer, the price went up and so it's just fluctuations really. Next month it could be less." Apparently I'm at the whim of the drug companies now. Sigh.


Evil Twin's Wife said...

Our insurance changed in July - and didn't bother to tell me (the person who handles the insurance stuff around here) that now there's a deductible plus a 20% coinsurance on all services. I won't be seeing any more specialists.

Neurotic Atty said...

"Oh, it's a racket." Plain and simple. I only have one prescription. After I meet my deductible each year, it's only $15 a month, which still feels like a lot, but I can live with it since it's only one prescription. Anyway, when I first got this prescription, the pre-deductible price was somewhere around $45, so I'd pay $45 in July and then around $30 in August, and then it would be $15/month. (My deductible was $75.) Last year, July rolled around, and it was $72!!! And in August, it was $72!!! Turns out the price on the drug went up, as did my deductible! I'm not looking forward to next month...

All Click said...

ETW: Sorry to hear about that. I thought America prides itself on it's specialists :-(

Atty: Wow $72?? And doesn't it make it worse that there is no warning? At least the evil electricity and cable companies give you a heads up about rate increases.

MountainLaurel said...

Welcome to health care, US-style. Your coverage can change with the drop of a hat. The big reason that it costs so much is that we need to pay for the insurance. Insurance companies hire folks to deny (and theoretically approve) claims. Medical professionals hire billing specialists to code things correctly so that the myriad insurance companies will pay. And every insurance company has its own set of rules. These costs are passed along to the patient.

And you can still see specialists. You'll just have to pay for it yourself. And make sure that you have time to wait as often medical professionals will bump someone with no coverage in favor of someone with coverage because there's a higher likelihood that they'll be paid by the insurance. There are more self-pay folks that default and those costs are also passed along to everyone else.

It's a huge mess, for the patient as well as the health care profession. Something will change; I just hope it's for the better.