Suddeny Last Summer

[mia]

The following health care story was posted today on a conservative, investment oriented website. The comments following Allena's story are remarkable in that they are largely supportive of the single payer option.



Exactly one year ago this morning, I found myself strapped into a rescue helicopter en route to UCLA Medical Center. It had been a little over an hour since a predatory black bear attempted to make a lunch of me, and I was determined to make it to the emergency room before I passed out–maybe for the last time. Both my father and my sister had gone to medical school at UCLA, and I knew that there I would be given top-notch care in a top-notch facility, with the help of the best technology in the history of the planet. But I also knew that should I somehow survive, I was in for years of hassle with the insurance companies that control the medical field– and I wasn’t entirely certain I wanted to face that....


Comment by drumminj
2009-07-22 09:37:10
ahansen (unless someone else on this blog had a battle with a bear as well)…

After reading your linked story about your troubles with insurance companies, I’m curious to ask -are you still fighting with the insurance companies, or are you ending up paying for a lot of this out of pocket? Are you racking up bills with the surgeons? Or are you simply foregoing care at the moment?

Sorry to hear it’s been such a difficult battle. One would hope that surviving the bear attack would be the hardest part. It would appear that’s not the case…

Reply to this comment
Comment by ahansen
2009-07-22 10:23:31
Out-of-pocket expenses so far are in the mid-five figures, and I’ve a couple more years to go in my reassembly. My individual Blue Cross policy (which I’ve paid religiously for 30 years,) has a $2500 deductible which resets every January 1. (Do-able, right?) After the deductible has been satisfied, the policy supposedly covers 70% of “reasonable and customary medically necessary expenses” excluding dental, ophthalmic, and cosmetic surgery–all of which I need. There is no coverage for drugs. Such things as X-rays and anesthesia are not deemed “medically necessary.”

Unfortunately, “reasonable and customary” does not mean the same thing to Blue Cross as it does to medical providers. So that $2500 deductible turns out to be more in the order of $7500 out-of-pocket before ANYTHING is covered. Then the 70% Blue Cross DOES cover is conditional upon whether or not THAT is a “covered expense,” “reasonable and customary,” etc. etc. They even tried to charge me $1700 co-pays for each of the five rabies vaccinations I had to have–which the public health hospital got for free from CDC! And on top of that are the monthly premiums....



http://thehousingbubbleblog.com/?p=5542

[mia]

1. More comments...

PRIVATE INSURERS are bankrupting households with medical expenses - premiums, deductibles, copays…..

Medicare (over 65 or permanently disabled and qualified for SOc Sec Disability but not those solely on SSI) was created BECAUSE private insurers would not - not ever, not at any cost - sell coverage to the elderly population.

Medicaid (below 150% Federal Poverty Level with kids or below 150% Federal Poverty Level and disabled but not qualified for Medicare) was created BECAUSE private insurers would not or could not sell coverage (premiums, deductibles, copays) that was affordable to lower income households.

The median household income is $50,000. The average cost of a non-group plan for a family is $12,000 in premiums alone with usually a $2500 -5000 deductible and 30% copays. Do the math.

PRIVATE insurers take an extra 10% of every premium $ for profits. They use another 20-25% of every premium dollar for advertising and finding ways to refuse to pay. Medicare spends 3-5% on administration as compared to private insurers 20-25%.

Medicine for profit to shareholders as practiced by PRIVATE insurers and for-profit medical centers is driving costs through the roof.