My broken finger has cost me $460 so far, and I have insurance.

[SeattleGirl]

Between the co-pays every time I walk into the doctor's office, and the fact that, oh by the way, they aren't going to pay for my visits to physical therapy and the splint they made for me (because none of the ones the doc had fit), I've already paid $450 out of pocket, and this is with insurance.

It sucks when you DO have insurance, and you still get taken to the cleaners.

And yes, before anyone yells at me, I know that it would suck far worse if I didn't have any.

[brentspeak]

1. I have friends in other countries who pay around that much for a surgical operation

And a quality surgical operation, too. Things that go for around 200K here in the U.S (knee replacements, etc.). A broken finger would probably cost them $10 tops to get fixed up.

We live in a twisted nation.

[SeattleGirl]

7. I've read and heard stories like that. WTF is wrong with us anyway?

As a country, we've become so enamored of profits that we would throw our own mothers under the bus just to make a buck.

Well, not US, of course, but that is the overall meme in this country: Profits Before People.

Just sickens me.

[Amonester]

48. I live in Canada and I once broke my right hand's pinky ...

in a 'moderately slammed' car door (just one half a second distraction and... ouch! Bad, bad day) :(

The bone broke, the car departed with the nail, and I was in big trouble for a few hours and it was bloody painful.

I rushed to the nearest town's Hospital ER, showed them my free healthcare card, and waited no longer than ten minutes.

Total bill for me was $0.00 when I left after a specialist 'rebuilt' the finger tip and a small cast surrounded it.

These cool dudes and dudettes also GAVE me all the painkillers that were badly needed.

It was a silly accident. I always make sure it won't happen again since then...

[Amonester]

55. I forgot to add: I (we) pay higher taxes on everything, but...

I (we) don't care! (Because, no insurance bills and my (our) higher taxes HELP other people NOW, plus I'll probably need health care services in the future, or any day when needed.)

[SeattleGirl]

57. I don't think I would mind that much either, if I knew that a medical

emergency wouldn't put me in the poor house.

[Lorien]

66. But there's the difference; you LIKE the idea of helping others. Most

Republicans and DLC Dems HATE the idea of helping anyone who they feel is "unworthy" or "not pulling their weight". I know repugs who would rather die than have a dime of their income help a homeless person, a sick black child or an elderly hispanic person. They don't care how much they themselves might suffer, as long as those who they hate suffer more. Of course, even the dirt poor repugs believe with every fiber of their being that they'll win the lotto some day, so that reason enough to fight tooth and nail for the "rights" of the uber rich to keep all of their ill gotten goods and allow next to nothing to "trickle down". A friend of mine even saw a teabagger with a sign that said "SELFISHNESS IS A VIRTUE: READ AYN RAND" :eyes: . A significant portion of our society is beyond redemption.

[TexasObserver]

2. This is the lesson. Health insurance will never be enough.

They're going to pay what they want to pay, refuse to pay what they want to refuse to pay, and leave you holding the bag on the shortfall.

We need a system based upon need for care, not ability to pay for care.

[SeattleGirl]

8. Absolutely.

Insurance Coverage: $YYY.YY (which is always much less than the charge).

Need for care, that IS the way to go.

Wish the insurance companies saw it that way, but they only do in my dreams.

[xchrom]

3. four hundred and fifty dollars?!?! -- sorry -- that hurts just to read about it. nt

[SeattleGirl]

9. Yep. $25 co-oay just to walk in to door at the doc's office, and the

physical therapist's office.

Co-pays alone have been $125.00.

[SammyWinstonJack]

4. K&R

:hug:

[John Q. Citizen]

5. Obama's plan to bribe the criminal scumbag insurance companies is just plain wrong.

If you lived in a modern civilized country you wouldn't be paying coming and going.

[SeattleGirl]

10. I feel that my insurance premiums are used only to line the pockets

of the insurance company CEO, and that's why I have to pay so much out of pocket. Infuriating!

[NYC_SKP]

6. We might have the same plan.

And what I LOVE :sarcasm: is how the MD sends you to PT, and PT has probably no way of knowing what you're plan will cover, but they aren't going to tell you that.

Few people know the fine details of their own plan.

So they say one thing, you figure there's a good chance they know what they're talking about (you'll be wrong) when they say your plan covers 80%, they're pretty sure.

Then you go home and a few weeks later find YOU'RE paying 80%.

Or 100%.

:mad:

[mwooldri]

11. And this wonderful in-network, out-of-network dance...

I'm having this with my psych office. One doc is under my insurance, the other isn't. I see the psych nurse who bills through either one of these doctors. If it goes under Doctor A, I'm in network and have no co-pay. If it goes under doctor B, I have a bill.

Mark.

[SeattleGirl]

13. Oh now, that is just insane!

Two psych's in the same office, and one is covered and one isn't??? :banghead:

[SeattleGirl]

12. Yep. And it's not like the doc sent me to PT just for shits and giggles.

One, they had to make a splint for my finger (as I said, none of the ones the doc had would work).

Two, there was a danger of me losing mobility and flexion in my finger, so they showed me some exercises to do, plus have done some ultrasound to increase mobility.

Apparently, though, the insurance company considers such things frivolous.

[Fire_Medic_Dave]

14. How badly was it broken? PT for a broken finger.

There is no way I would go to PT more than once and probably not at all for a finger.

[SeattleGirl]

18. I sprained it at the same time I broke it, and am still working on

flexibility. I type a lot in my job, and while I am managing right now without using my right pinky, it get frustrating, and it slows my typing down. Plus, I don't want to lose the flexibility in it. It really does make a big difference when you can't use even one finger.

[Fire_Medic_Dave]

23. Hope it heals well.

[SeattleGirl]

25. Thanks.

It is taking awhile, that's for sure.

[mudplanet]

62. I bet I could break your finger in a way such that

you'd eat those words.

[Fire_Medic_Dave]

70. That's funny.

[aint_no_life_nowhere]

15. My cousin had insurance through his work and they still refused to give him treatment

He worked in law offices for years under very high stress circumstances (12 hour days, including week-ends and non-stop phone calls). He developed heart problems but the insurance company doctor refused to send him out for an EKG to establish the illness and the adjuster said even if it was a genuine health problem, it had to be pre-existing. My cousin didn't want to file a work comp claim (he worked in a work comp office and it would have probably resulted in the eventual loss of his job if he had filed it against his employer and stress claims are very heavily litigated and usually denied in the work comp system). He had to go to Mexico for the EKG and then to France for treatment. Stress claims, continuing trauma types of claims, and even mental health related claims are frowned upon by many insurance companies, even when the employee is supposedly fully covered.

[Fire_Medic_Dave]

17. Why didn't he just go to a fire station for an EKG?

What treatment did he get in France?

[aint_no_life_nowhere]

29. Three months of intensive treatment

including every kind of diagnostic test, medication, dietary supervision, hospitalization for a brief time, and therapy. I'm not sure what exact health problem he had, but apparently it was serious. He will be on medication for the rest of his life. Fortunately, he's a dual French/American citizen.

[SeattleGirl]

20. Good grief!

I also work in a field related to worker's comp, but I know my boss wouldn't fire me over filing a claim (that's illegal as all get out, btw). Sorry your cousin had to go through all that.

[aint_no_life_nowhere]

37. It's illegal if it's related to a specific injury or if it occurs right after filing a claim

But with a continuing trauma that is not a specific injury, it's much harder to prove that your employer fired you for any specific reason. The work comp insurer almost always denies continuing stress types of claims and it usually will require well over a year to fight. Work comp administrative judges, even if they agree with the injured worker's medical reports and not those of the insurance company, will usually apportion away a percentage of liabiilty for the continuing trauma claim of this type. And the injured worker's own doctor will usually state that he can't return to work but must be retrained (workers comp vocational rehabilitation is capped at $16,000 in California and usually is a joke because you learn nothing during retraining). That would have resulted in a considerable drop in salary for my cousin in a job in which he had no experience, while his mortgage payments rolled on. And temprorary disability payments while on work comp in California (covered by EDD where the insurer denies the claim) would have been far less than his salary and barely enough to live on. My cousin decided to retire to save his life, sell his house, and move to another state where life is cheaper, after coming back from France.

[SeattleGirl]

39. One thing to keep in mind is that each state's workers comp rules

are different. I have actually worked California claims, and had to learn their rules in order to work the claims.

Here in Washington, it is legal to "medically separate" someone if they have been out for a specific period of time (usually anywhere from 90 days to a year, depending on the company), but it has to be applied equally to all people with worker's comp claims. Now, I have encountered employers who have given their injured workers what turned out to be "make work" jobs that were basically the bottom of the pile, which is also illegal here. I've ratted the employers out for that crap, and they do get in trouble for it.

[aint_no_life_nowhere]

41. You're a workers comp claims adjuster?

I worked in insurance defense for awhile and I also did applicant's work for a law firm many years ago. I know the adjusters are under a lot of pressure. I got to know some of them well. Some are just absolute fire-breathing monsters who want to deny everything but the majority of them are trying to do their jobs while the Claims Supervisors pressure them to keep costs down. To me, the biggest villains in the work comp system (at least in California) are the doctors. It's been many years since I worked in the field, but I could tell stories about how the doctors on both sides milk the system dry. Some of the stories are monumentally outrageous and actually involve criminal behavior, multi-million dollar criminal behavior. The chiropractors are the worst.

[SeattleGirl]

42. Nope, vocational rehab counselor.

I assess an injured worker's ability to work based on effects of their injury, their skills, knowledge, etc.

I don't think I could work as a claims adjuster.

[ThomCat]

79. That should be criminal.

:(

I am very sorry they did that to your cousin. That type of treatment really should be a violation of their contract at the very least, or more honestly it should be a conviction for racketeering and fraud. x(

[SeattleGirl]

81. Hi ThomCat. I agree, and think that insurance and pharmaceutical

companies should be banned from being publicly traded.

Publicly traded companies have an obligation to their stockholders, and with many companies, I have no problem with that. But with companies that are supposed to be about healthcare should not be primarily about profits. They should be about providing medicines and access to healthcare.

The fact that they ARE for-profit companies is, IMHO, immoral and unethical.

[Contrary1]

16. Our insurance company sent out a letter encouraging my husband and I to have a colonoscopy...

"We're here for you, your health is our main concern, blah, blah, blah..."

$1,200. out of pocket.

[SeattleGirl]

21. Bet the $1200 part wasn't in the letter, was it?

Pretty dishonest of them, if they weren't up front about that.

[dflprincess]

59. My friend's insurance company paid for most of her colonoscopy

but they wouldn't pay for the sedation - she wrote a nasty letter to the CEO (Stephen Hemsley, United Health Group) suggesting he have one without any drugs. She never heard back.

One of my coworkers said her husband's insurance paid for only part of his colonoscopy as well. This one paid for sedation & the test, but wouldn't pay for the facility. Apparently he should have had the doctor come to their home or perhaps have met him in the parking lot and had the procedure done in the mini van.

[mwooldri]

19. This insurance malarky just sucks rotten eggs.

And I'm one of the better off ones. Really. Big DJIA component credit card company self-insuring its employees.

You'd have been $460 less out of pocket in the UK of course.

*hugs*

[SeattleGirl]

24. It does suck, that's for sure.

And I find myself thinking more and more fondly of "socialist" places like the UK and Canada.

[AdHocSolver]

22. Instead of paying them insurance premiums, you should have bought insurance company stock. n/t

[SeattleGirl]

26. Hey, there you go! If I had, I could probably retire, AND have

all the money I need for health care for the rest of my life.

Damned toads!

[nadinbrzezinski]

27. That is why I want everybody to have what I got

the most expensive thing was rehab for a bad knee... that whole episode ran us about 100 bucks... and that was physical therapy, and a visit to doc, MRI and the ortho.

Did I mention we have guv'ment run insurance? Oh and the only reason it was THAT MUCH it was the deductibles to the private therapy. These days it would have been a guv'ment facility and no copays.

This is what I want the rest of you to have. A well run medical system that is not for profit.

And you really do not want to know how much we pay either, but we are very lucky to have that socialistic system working for us... but this is exactly what I want everybody in this country to have if that is what they choose to have. Why a STRONG public option (My choice would be single payer) needs to be in the plan.

[SeattleGirl]

31. Exactly what we need!

Yet there are so many misinformed (and devious) people out there railing against it. They piss me off!

[Speck Tater]

28. My ex's cancer has cost her $13,500 so far, with insurance.

At least she's in remission now, thank God.

[SeattleGirl]

32. Thank God, yes. I'm so glad it's in remission.

Holy hell, though, $13,500??? Obscene.

[Catshrink]

30. I had my knee scoped in June.

With the pre-op PT, which was worthless, hospital co-pay, doc co-pays, etc., it cost me $1000 and the insurance picked up the rest.

[SeattleGirl]

33. How's the knee now?

My daughter had to have surgery on both her knees (unfortunate family genetics there), and she is so much better. Hope you are too!

[Catshrink]

43. It's amazing!

Before I was in a lot of pain and had limited movement. Now I'm nearly pain free and just as mobile as ever. No more DIY projects for me!

Thanks for asking. Hope your finger gets better.

[Oeditpus Rex]

34. You shouldn't have broken your finger

— right-wing health-care plan



:loveya:

[SammyWinstonJack]

35. +1 nt

[SeattleGirl]

36. Yeah, I know. Guess I'm just a dumb librul!

Hi Oedi! :loveya:

[handmade34]

38. no yelling at you - just at the insurance companies.

I dropped my health insurance ($1200/mo to BCBS) after the co-pays and refusals to pay piled up. Sorry about your finger and sorry about the bill.

[SeattleGirl]

40. $1200 a month? Was that including family members or just for you?

Either way, that's a huge chunk of change there.

[paulsby]

44. your insurance sucks. ive posted about mine

i just had MAJOR surgery, and that was after an MRI, and x-ray and three office vists (all within 1 1/2 weeks). i've since had physical therapy once. cost out of pocket: ZERO except for drugs, which have run about $30 (three different drugs, refilled one time each).

as long as i don';t have more than 60 physical therapy visits a year, they will remain free.

its an EXCELLENT plan. just like any consumer product, some are better than others.

my employer pays almost 1k per month for this coverage.

it also gives me 60 massages a year and 30 chiro's a year. all free.

the max out of pocket i can be charged in a year is $400 . once you go over that, EVERYTHING is 100% coverage. before that stuff like massage and chiro was 90% coverage. so, a masage cost me about $8. ,once you pay $400 everything is free. it's pretty nice to know you can neverpay more than $400 in a year. many obviously pay much less.

but to have surgery, MRI, Xray, a splint (free) etc. all free. it's great

[handmade34]

I want what you have!

my only comment and I understand what you are saying, but - whenever anybody talks about free, I cringe... I understand no out of pocket, no co-pay, no hospital bill, but we all pay and we all will and that is ok by me. I will gladly pay that $1000. or whatever is deemed necessary, but only when it is not paid to for profit insurance companies and when we all have good health care...

TNSTAAFL

[paulsby]

51. like i said

im for universal healthcare. i also accept that NO govt. plan is going to give me this kind of coverage and benefits. i DO want the option to keep mine

our union fought hard for our benefits. trust me. i KNOW how good we have it. my wife has a pretty good plan, but mine's better. she has double coverage, since she uses mine as secondary. it doesn't cost anything to add any family member to my plan so obviously the single guys subsidize the married with kids. if you asked me would i take an extra 12k per year in pay w/no insurance vs. having this insurance, i'd have to say no. if i was single i might say yes. i also would NOT be a competitive athlete w/o insurance. that would be insane.

[SeattleGirl]

45. Sounds like you have a great plan, paulsby

Mine would be okay if all I ever did was go in once a year for a check-up. Not so good when I break a bone.

[paulsby]

52. i recognize that

and our union busted okole to fight for our plan.

most guys i wokr with don't take advantage of some of the bennies. when i found out i get 60 massages a year, i was like SIGN ME UP. it's very pleasurable, but it's covered because it's also therapeutic. it also greatly increases my recovery ability and sense of well being. sometimes it's pretty friggin' painful, though

[chicago legal pro]

46. The reason your finger has cost $450 so far is because of trial lawyers

Unfortunately most who post on this board support the trial lawyer bar. If they only knew how corrupt our legal system is.

[SeattleGirl]

49. Sorry, but I do believe that is wrong. The costs come from

insurance companies and drug companies who are greedy beyond belief, who put profits above people, and who would gladly throw momma from the train just to get a few more bucks in their pockets.

[chicago legal pro]

93. Everyone puts profits above people

Including trial lawyers. Doctors and their insurers are forced to do meaningless tests and procedures to attempt to avoid slip and fall type suits.

[Missy Vixen]

67. It's no more corrupt than health insurers

Those of us who've had occasion to hire an attorney to get medical bills paid after a car wreck that wasn't our fault are thrilled with the work that trial attorneys do.

Enjoy your stay.

[chicago legal pro]

94. "No more corrupt than health insurers"

That's a real endorsement. Enjoy your stay too.

[Missy Vixen]

100. Hey, CLP

I've been here since 2001. How long have you been here?

In the meantime, I'm betting that trial lawyers have done a hell of a lot more for the average American than health insurers have.

[SeattleGirl]

101. You know it, Missy!

[chicago legal pro]

108. 2004 but just recently posting

Nothing in my posts suggests I support health insurers as you seem to imply. From my experience in the legal world I know that most trial lawyers are corrupt personally.

[SeattleGirl]

111. They are still not the primary cause of high insurance/drug costs.

[B Calm]

88. Malpractice insurance is less than 1% of your doctor's bill!

[chicago legal pro]

92. The cost doesn't come from insurance

It comes from unnecessary tests and procedures from doctors who are afraid of suits.

[rvablue]

106. Uh-huh, RIIGGHHTTT. You do realize that most insurance companies are corporations, right?

They need to make a profit! Lots of it! The more the better! Gotta hand out some nice dividends to stock holders!

And their profits this year hit an all time record.


Hmmm, wonder how they do that? :eyes:

[chicago legal pro]

112. You do realize that trial lawyers work for corporations

All of them. Their profits are also at a all time high. Wonder how they do that?

[rvablue]

104. That's right coporate health care companies and their never ending need to increase

profits have nothing to do with it. Nothing. :sarcasm:

[chicago legal pro]

109. Sorry to let you in on a little fact

But every trial lawyer in the U.S. works for a private company (themselves or others) and those companies have a never ending need to increase profits. Look at their financial sheets sometime.

[OHdem10]

47. This screams for the public option. With real competition the private

insureres will have to be careful about how they treat customers.

[SeattleGirl]

50. Yes, they will, and they will also most likely have to drop their

premium prices too.

[dflprincess]

53. Last year it cost just over $6000 for me to find out

the funny spot on the mammogram wasn't cancer.

Last year my employer still provided decent insurance and my adventure in breast health cost me about $500 out of pocket and insurance picked up the rest (note the $6K tab was the negotiated price, if I didn't have insurance the bill would have been more than double the $6,000 price).

This year my employer has a lousy plan and between the deductible & "coinsurance" I'd be paying nearly $2,000 out of pocket.

Next year we're going to an HSA plan and I'd be looking at a $5,000 out of pocket bill. This is why, in the long run, HSAs cost everyone more money. People don't bother with preventative or routine tests because they won't be able to pay for any treatment they need if the tests come back indicating a need for follow up.

And the public "option" laid out in HR3200 wouldn't help as that allows for out of pocket expenses that increase with your income up to $5,000 for a single person and $10,000 for a family of 4. I imagine those of us who won't qualify for that option (if it stays in the bill) will still get hit with these kinds of costs by the private insurers regardless of income.

[SeattleGirl]

54. It's all so messed up, isn't it.

And we take it in the shorts every freakin' day.

I'm glad your news was good, btw.

[exboyfil]

75. Our employer went to HSAs thrree years ago

Before we had really good insurance with a reasonable copay (our Union folks still have that plan). Now it is $4300 out of pocket before the insuranc company pays dollar one. My employer tells me that between us we pay $12K/yr for this insurance. I have a tough time stomaching that combined we pay $16,300/yr before the insurance company pays dollar one (except for physicals). My employer helps out by putting $1300 into the HSA and overing all but about $100/mo. of the premiums.

Fortunately my family is healthy so we have built a bit of a balance in the HSA (even paying $3500 for my youngest's braces). We usually stay under the $1300/yr my employer puts in for us.

When I hear talk about taxing the health care benefit (which would be at either at a 24% or a 34% tax rate if you include my state taxes), I have to wonder what value the insurance is to us. We will probably be able to get a better plan on our own.

Because of the $1300/yr our HSAs probably have been a good deal for us so far, but I don't like them, and I know at some point we are going to have a major medical event (like the busted finger) that is going to really tear into our HSA.

The interesting thing will be this year's union contract. My employer is going to want them to take up the same insurance as we have. I suspect we are in for a strike.

[SeattleGirl]

76. $4300? That's obscene that they won't pay anything until you pay

that much out.

My husband and I filed for bankruptcy last fall, primarily due to medical bills. We were absolutely buried.

We're lucky in that we still have a roof over our heads, but damn it all. This country needs to move into the 21st century in access to healthcare.

[exboyfil]

77. Alot of raised voices when the plan got rolled out but what

can you do. I like my job, and we live in my wife's home town. I feel fortunate to have this insurance given the alternatives. I just can't understand why it would be $12K/yr (yes I know the answer to the question).

I wonder what a public plan will look like. I just hope it reduces my downside exposure (the $4300/yr) if it expects me to throw more into the kitty.

[SeattleGirl]

78. I wonder the same thing.

I like the idea of increasing the taxes of the very rich. I don't hate people who have more money than me, but I do hate it that they have so many ways to hide their money, and thanks to Dubya, they have a lot of tax breaks.

For me, as well as for many others, when our incomes go up, so do our taxes. Why should the very rich get away with paying a lot less percentage wise than people like you and I?

[JCMach1]

56. I have paid a total of around $20 for the ruptured disk in my neck

that was only for the initial trip to a SPECIALIST without a referral...

That includes 3 more trips and an MRI.

HOWEVER, I had to visit the doctor in the states before I left for the UAE... $129 for the Dr. visit (GP) and around $150 for the meds. Oh, and the diagnosis was wrong!

[SeattleGirl]

58. That sucks that the diagnosis was wrong, but at least it didn't

cost you thousands of dollars, like it would have if all the treatment had been done in the States.

[JCMach1]

84. Exactly... even the UAE has a health care system that works

unlike my home country :(

[Spider Jerusalem]

60. The downside to that...

is that you're in a country where newspapers have publication suspended for printing things that offend the royal family, where the powerful can videotape themselves engaging in torture and the government shrugs it off as something 'that was settled privately'; where political parties are banned; where there's institutional discrimination on the basis of ethnic and national origin...seems kind of hard to square with being a self-identified liberal, at least from here.

[JCMach1]

83. Teaching democracy, peace, argumentation

is that the wrong thing to do then? What part of educating and opening young minds doesn't jell with the liberal mindset and values?



Of course some things are not cool here... lack of unions, labour issues, oligarchy... With that all said the country is slowly moving towards democracy... At least they are moving in the right direction, unlike your home country which is quickly turning into a 24/7 surveillance society. Is that moving in the right direction...? I don't think so.

Yet, somehow, at least they can get health care right here!

Never said it was a perfect place...

[lildreamer316]

89. Well well well

THERE you are.
Haven't seen you in ages, hope you are well. Just had to say that; you suprised me.
:hi:

[Lorien]

I have a insurance and a badly sprained ankle in need of an MRI and surgery

I can't afford to pay for the ambulance ride (which I was forced into by campus security) which was $700.00. I still haven't gotten in all of my bills from the ER. It happened two months ago and it's still really swollen, with little bits of bone floating around above the injury site and odd troughs where my ligaments had been attached before the fall. My deductible is 6k, with a 20% copay after that. I've been unemployed most of this year, so I have no money to pay for anything. They even took away my home equity line. You get squeezed everywhere, in every direction. It's completely insane and totally inhumane.

[SeattleGirl]

63. I am so sorry to hear this, Lorien.

Things like this should NOT be happening!

[Lorien]

68. No, they should not. I hope that you heal soon

I know how hard it is. :hug:

[SeattleGirl]

71. Thanks.

[csziggy]

61. Yeah, for my shoulder surgery with insurance my out of pocket is over $3000 so far

I expected and budgeted for the $2000 deductible, but I did not expect the copays to be as high as they are and the additional bills keep coming in, even though I paid the estimated co-pays and deductible ahead of time for the surgeon and the surgical facility.

The thing that pisses me off is that I did not get told the exact amounts that had to be paid ahead until three days before the surgery and they had to be paid two days before the surgery. So I had to rush in and pay them with little notice - good thing I had budgeted for them!

The other part that gets me is that in 1994 I had much more extensive surgery on my other shoulder - a total reconstruction of the rotator cuff. That was the kind of surgery surgeons write up to share with their colleagues and show the video of at conferences. We had no insurance then and paid out of pocket for everything. The total bill was about $12,000, including physical therapy.

This surgery, which lasted a quarter of the time and was not anywhere near as involved, apparently was billed at more than four times that amount to the insurance company - and I have not done a real total so it may be five times as much. I am stunned at the increase in costs in fifteen years.

Yes, getting surgery without insurance sucks, but it sucks pretty bad WITH insurance!

[SeattleGirl]

64. Only three days notice on what the cost would be?

And having to pay two days ahead of time.....that SUCKS!

[csziggy]

72. No kidding - but like I said I had budgeted for the deductible and some extra

But I never thought the "extra" would be as high as it is getting.

Both the surgeon's office and the surgery facility were nice. I think if I had needed to make arrangements for payment, they would have worked with me. This was the fourth surgery I have had at that facility, the fourth, with that orthopedic practice, and the second with that surgeon so I think they checked past records to see what my ability to pay was. But my memory is that in the past they gave more notice.

It may have been the insurance that caused the late payment request for all I know. :shrug:

[SeattleGirl]

74. It wouldn't surprise me at all if the insurance company was behind

it.

[Ron Green]

65. Last year I had constipation that cost me over $1000,

and that was with Blue Cross/Blue Shield.

Same deal with a kidney stone.

I'll pay higher taxes for single payer.

[keepCAblue]

69. My weekend in the county hospital cost me $11,700.00

I am self-employed and uninsured. At 53 years of age with a pre-existing condition (spinal osteoarthritis), I cannot get health insurance, so when I developed the flu last Thursday, which by Friday had gone into my chest and rapidly developed into pneumonia, I had to go to the county hospital. And although I received excellent care -- much better than the care I received at the for-profit hospitals I've been in on two prior occasions -- my spouse and I make too much money to qualify for any kind of assistance. We live paycheck to paycheck and have no idea how we are going to pay off this bill. Guess I should consider myself lucky in that I was wise enough not to go to a for-profit ER -- the bill would have been 3 times higher, easily.

Four years ago, while employed by a company, I had Blue Cross/Blue Shield, but pre-existing conditions were not covered for the first six months of my employment. During these first six months, my boss came into work horribly sick with influenza virus and infected 2/3 of our 100-member workforce. I was one of the unfortunate. The flu went into my chest and developed into a severe bronchial infection which caused serious breathing difficulties, sending me to the local for-profit hospital's ER. I was there 3 hours and received medication and a breathing treatment to help open up my airways. I went home and, after two weeks, fully recovered from the flu. A month later I received a bill from the hospital for $3,000.00. Blue Cross/Blue Shield refused to pay my ER bill, asserting my condition was pre-existing. I asked them how catching the flu could be "pre-existent." Well, it seems they refused to classify my condition as complications related to influenza and, instead, classed it as an "asthma related". My only "asthma" was as a child some 40 years prior, but this did not matter to BC/BS. They flat out refused to pay my bill. I tried to fight them but got nowhere -- the hospital (O'Connor Hospital in San Jose, CA) immediately sent my bill to collection and hired one of those sleazy credit collection companies that harass you day and night and try to make you feel like your some kind of scum of the earth or a criminal of the worst kind. It took my spouse and I a long time to pay off the hospital bill and the day we did, we celebrated for having finally gotten free of the slimy tentacles of this credit collection agency. They made our lives hell. Fast forward to today: My spouse took all the reams of required paperwork into the county hospital's financial aid office only to be told we make too much to qualify for even one dime of help. (We are barely making it, financially, just keeping our heads above water, so this was a blow.) The aid counselor was sympathetic and apologetic, but there was nothing she could do. She did, however, upon hearing about our experience four years earlier with O'Connor Hospital, offer some good advice for future ER needs, god forbid. She said, since I am uninsured, do not ever go to a for-profit hospital because they will only minimally treat you to stabilize you, then they will ship you off to the county hospital at the first opportunity. So you'd end up having two bills--one from each hospital. The counselor also noted that Blue Cross/Blue Shield is notorious for refusing to pay on legitimate claims, such as on mine in 2005, and disturbingly, they seem to have an especially high rate of claim refusal for O'Connor Hospital patients. Makes me want to go "hmmm..." Seems like the insurance company and hospital have some kind of scam going or something. Bastards, all of them.

[SeattleGirl]

73. You know, I have half a mind to send this thread to the White House,

with copies to all the senators and representatives. There are some awful stories here, people being hit hard, even when they have insurance.

Your story really saddens me. Denying people coverage for some bullshit reason is, to me, immoral and wrong on so many levels.

[keepCAblue]

91. We, the uninsurable, are just one hospital visit away from catastrophic financial ruin.

It will take years to pay this $11,700 bill off -- fortunately the county will allow payment options so we don't have to file for bankruptcy. But had my condition required anything more than a 2-day stay, we'd have been facing a $50,000 or more debt which would have sunk us completely.

Fifteen years ago I blew my L4-L5 disc in a workplace injury. The cost of the 7 day hospital stay and surgery alone was over $100,000 (and that was 15 years ago -- it'd be much more than that now). Both Blue Cross/Blue Shield (my employer's medical insurance carrier) and the worker's comp insurance carrier were refusing to cover my medical costs -- each claiming it was the OTHER insurance carrier's responsibility. It took the best Worker's Comp lawyer in the state (Sen. Barbara Boxer's husband, Stuart Boxer, and FOUR LONG NIGHTMARISH YEARS of legal battle to finally get the worker's comp carrier to pay my medical bills. Hell, it took my doctor nearly a year of my suffering from the blown disc just to get the insurance company to pre-approve the $1,200.00 MRI needed to diagnose my back injury -- had they approved it from the start it may well have saved me a year's suffering AND early diagnosis could have prevented the injury from deteriorating to the point of radical surgery at a cost of $100,000.00!

Edited to add: Another aspect of the whole healthcare insurance scam is in-state/out-of-state coverage. When I blew my disc 15 years ago, I was in Chicago on a biz trip. I was in my hotel room when it happened and the injury was acute and beyond painful--it felt like I'd been shot in the back by a .357 to the spine. I was unable to walk at all and in unimaginable pain for three excruciating days, stuck in a hotel room. The hotel's front desk contacted an emergency clinic for me but they said they wouldn't treat me because of my out-of-state medical insurance -- my company-provided Blue Cross/Blue Shield only covered me in California! It took me a week stuck inside this hotel room to get to the point where I could barely walk well enough to get up the courage to hobble to the airport and get the fuck out of Chicago...

[SeattleGirl]

95. I would love to say "unreal!" in disbelief at your story, but unfortunately,

it is all to real. (And by unreal, I mean it as a statement of disbelief and shock).

These insurance companies don't care that they are dealing with real people. To them, we are numbers on paper, and nothing more.

[ThomCat]

80. I am sorry, both for your broken finger and the cost.

Yes, we all should have universal health care. Universal insurance will not be the solution if the insurance will have such high co-pays and high deductibles and frequently excluded charges that people will be paying huge prices out of pocket.

Getting a broken finger should not cost a weeks wages for a person earning minimum wage. That is a very devastating problem, not the solution to the problem! Yet, for a whole lot of our bought-and-paid-for politicians, this is the solution they are proposing. :(

[SeattleGirl]

82. Yep.

And you know, I'm not done paying for this, as I had to go to the orthopedic doc again today, and also to physical therapy.

[B Calm]

85. I heard about a guy who found out he had high blood pressure

So he went to his family doctor and was prescribed with blood pressure medicines. After he had the prescriptions filled he went home and then left town on a family vacation. The next day he became very ill and went to an urgent care walk in clinic in a strange town. There they did several lab tests only to find out he was allergic to one of the blood pressure medicines. When he turned this in to his insurance company, they refused to pay anything. The insurance company told him the reason why he was denied was because his plan doesn't cover substance abuse. Lab tests, urgent care, etc = $1,382.63!

[SeattleGirl]

96. Substance abuse?

Their minds must consist of dark mazes to come up with something like that.

[B Calm]

115. Yep.. That's what they called it. Amazing how they think up ways to deny payment!

[Enthusiast]

86. This is the untold story.

Even having insurance in this country doesn't protect us from huge prices for pretty ordinary procedures.

[SeattleGirl]

97. You're right, Enthusiast.

Having insurance by no means equates to truly being covered for medical issues.

[Enthusiast]

113. And if nothing is done to

correct this they will become even bolder in pushing inflated costs on to the consumer. Then with their ever increasing profits they can better influence legislation. Great system.

[lillypaddle]

87. I posted this on another thread

So, I'll condense it. I have BC/BS. Broken ankle, $5000 deductible, have paid about $5000 more for surgery, physical therapy, etc. My premiums (single woman, 61 yo) up to $543/mo. It's outrageous. Next year I'll have another $5000 deductible IF something comes up that I need treatment for. I don't have it. I'm one of the lucky ones with insurance.

[SeattleGirl]

98. Bottom line, the healthcare system in this country is criminal.

Absolutely criminal.

[seabeyond]

90. we are paying for our insurance monthly. how would it suck far worse if i didnt have insurance

and least there would be that monthly amount going out and it would easily cover that finger of yours. your position, you are getting the ultimate fuck

[SeattleGirl]

99. I think almost everyone in this country is getting the ultimate fuck

when it comes to healthcare.

It's as if we are being told, "How DARE you get sick/injured? How DARE you?"

I say, "How DARE you not care about the health and wellbeing of the people in this country?"

I know, they would laugh in my face at that.

[seabeyond]

110. ya, i hear ya. a general, feeding off each other, fuck you to all. lacking integrity

and character. what are those anymore.

[alarimer]

102. Insurance companies should be regulated like utilities used to be.

Another area where deregulation hurts us.

Insurance companies should have to go before some sort of commission before they can raise premiums, copayments or deductibles. They should have to cover everything except elective plastic surgery. There should be no pre-existing conditions. And executive pay should be limited to $250K or thereabouts.

Those are the only conditions under which I am willing to consider continuing the private insurance system we have now. In ever single country that uses a public-private mix, the private insurance companies are very tightly regulated.

Our representative (Democrats and Republicans) are all a bunch of corporate whore, with a very few exceptions. I hate them all.

[SeattleGirl]

105. I, too, think they should be regulated.

They are absolutely out of control, and it is literally killing us.

[Hansel]

103. I have 2 pinched nerves in my neck which cost me $2000

in co-pays and I have a so-called "Cadillac Plan". I am done with my co-pays for the year so everything else is free.

I was taken to the hospital in a ambulance ($1,500) because they thought I was having a stroke as I had lost all feeling on the upper right side of my face and body. I had 2 MRIs (one brain and one cervical spine) and spent 4 days in the hospital. Total bill was $29,000 dollars of which I paid about $1500 and the insurance picked up $8000. The hospital had to eat the rest. I have paid another $500 in subsequent doctor visits and PT co-payments.

They are now doing tests to see if I need surgery which will be free this year, but another $2000 if it doesn't flair up again until next year. The condition is degenerative so it will likely get worse.

It's interesting that between the insurance company and me we only paid $9500 of a $29000 bill. If I wasn't insured I would have had to pay the whole $29,000.

[SeattleGirl]

107. I often wonder why the hospitals write off so much of the cost of some

things when insurance in involved, but insist on charging the whole amount when a person has no insurance.

If it's okay with them to charge the lesser amount in some cases, why no in all cases?

Freakin' crazy, is what it is.

And, IMHO, further "punishment" to those among us who have no insurance at all.

[Kingdom1979]

114. Your system is crazy

As a British man I still have no idea how your system works - I mean it is mental.

You pay for medical insurance which essentially does f*ck all in a lot of instances.

What are the justifications insurance companies have for not paying up? Everyone should be entitled to good free quality healthcare - it makes me angry just thinking about a country of your size with all that wealth who will not care for its own citizens.

[Skittles]

116. thanks Kingdom

please let your fellow country folk know that every time they boo hoo over us having cheaper petrol :)