Comments | Recommended Print
RSS
Yahoo! Buzz
Steve Blow
Archive | Bio
E-mail
Only hope for our ailing health care system is real reform
12:00 AM CDT on Sunday, July 19, 2009
I'm pained to confess that I got my first demand letter from a debt-collection agency.
It's painful because I'm old fashioned enough to see such a thing as a stain on your character and reputation.
It's also painful because I don't think any of this past-due payment mess is my fault.
I blame the U.S. health care system.
To make a long story short, my wife left my group health insurance plan this year and went on her employer's plan. We could save some money on premiums that way.
But let me tell you, the additional cost in hassle and aggravation has been enormous.
Lori had a couple of medical tests shortly after the first of the year. And we started getting notices that insurance wasn't paying because they were deemed "pre-existing medical conditions."
Lori protested that these were tests, not treatment for anything. Her new insurance company launched an investigation into her medical history and sent a packet of forms for her to fill out.
She had to provide information on every doctor she has seen.
"Should I list the dentist?" she asked me one evening as she filled out the form.
"No!" I scoffed. "They don't need your dentist."
"It says every doctor," Lori-the-rule-follower replied, as of course she put down the dentist's name.
So this thing drags on and on. We keep getting bills from doctors and labs and so forth.
When Lori would call them, some clerk would tell her not to worry about it, that it's just the usual insurance snag, etc., etc.
This went on for months. Lori finally called her insurance carrier and was told that things were in limbo.
"Your dentist hasn't responded yet," the phone clerk said.
Arghhh.
Lori's disputed tests had been a colonoscopy and a breast screen.
No teeth involved!
On and on, it dragged. Each day the mail brought more bewildering statements. I couldn't tell if I was supposed to be paying, waiting or crying.
After the snotty letter from the collection agency arrived, I called the insurance carrier last week to see if I could sort through this mess.
Only after we had talked awhile did the phone clerk say something like, "Oh! So your wife was on your policy last year? Well, then the pre-existing condition limits don't apply."
Say what?
Yep. Just by faxing a certificate from my insurance company showing that Lori was previously covered, she was suddenly exempt from the rigmarole and the steep limitations on pre-existing conditions.
Well, that was a happy outcome for us. But wait. Consider the absurdity of this!
If Lori had been one of the millions of unfortunate Texans without health insurance last year, her new policy would pay only a pittance for any existing medical problem she might have.
Cancer? Bad heart? Sorry, she's out of luck.
But because she was among the lucky ones with insurance, jackpot! Everything is covered!
Yes, the rich get richer, and the poor do get poorer.
We're in the midst of a great debate over reforming our health care system. And I know that change is scary.
But frankly, I'm not that big a fan of what we've got now.
This whole system of depending on employers to provide health insurance is outdated and dying. And letting private, profit-motivated insurance companies dictate medical decisions is just scary.
Let's not let fear of change condemn us to more of the same.
Count me as ready to experiment with some real reform.