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Guest Voice: Health Insurance House of Mirrors

Posted by DR. CLARISSA PINKOLA ESTÉS, Deputy Managing Editor, Columnist in Economy, Education, Health, Politics, Society.
Oct 15th, 2009 | Comments

Hello there, Dr. Estés here w/ a tale of being mix-mastered in the house of mirrors passing for health insurance– or not. The cadeusus w/ sword and serpent once meant instinctive balance of mind/spirit, (serpent considered helping messenger between heaven & earth) w/strong dose of protectiveness toward body via symbol of flaming sword, to fight afflictions. Nowadays, seems more like poke in eye with a sharp stick– no wise snake in sight. But let famed storyteller Ron Beasley, TMV Guest Voice, tell you true…
Dateline: October 15, 2009

Adventures In Health Care
By Ron Beasley

You may have noticed that I haven’t been around the last few days. The reason is I had a medical adventure. Yes, it involved an ambulance and a hospital and since I have no insurance the second part of the adventure is still to come. What happened to me could have happened to anyone and what happened to me could have been fatal. I am 63 years old and in pretty good health. I had never been in an ambulance or admitted to a hospital prior to last weekend. My age was a pre-existing condition and made it impossible for me to get an individual policy. We will look at how that will impact this adventure in a latter post when I have more information.

This Could Happen To You!

Last Thursday I woke up with a head cold. It was your run of the mill head cold – sneezing, runny nose and throbbing sinuses. It continued through Friday. I woke up Saturday morning and my head has cleared – good news and sooner than I anticipated. About noon on Saturday I had the first indication that my head cold may have move to my chest – coughing and wheezing. It continued to get worse as the day went on. About 7:30 I decided to go to bed. I woke up at 1:30 Sunday morning and I was unable to breath and called 911. When the ambulance arrived the wonderful EMT’s checked oxygen saturation and it was at 80, 90 is considered the minimum. They put me on oxygen at once and they were very helpful in helping me take care of some things before taking me to the hospital.

Once I arrived at the hospital they took X-Rays and ran some other tests. They determined it was not the flu or pneumonia but a virulent bacterial infection in my lungs. They started anti-biotics, steroids for my lungs and bronchial treatments and I was breathing fairly well and my oxygen saturation was in the 90s within a couple of hours. I was admitted to the hospital and had continued bronchial treatments until about three Sunday afternoon at which point I was given prescriptions for tetracycline and a bronchial inhaler and allowed to go home. Except for the havoc the tetracycline has caused to my gastro-intestinal system recovery has been rapid.

Since I have no insurance I will be faced with an ambulance bill, a hospital bill and bills from two doctors. In fact I received the ambulance bill today and at $731 was a little less than I had anticipated. They will allow may to make payments of $35 a month. Ironically by the time I have it payed off I will be on Medicare. I have not received a bill from the hospital as yet but I have talked to them and they too are willing to come up with a payment plan and will give me a discount because I am uninsured.

Before I turned 60 I was able to get an individual policy. It was $1,200 a month and would at most payed about half . Bottom line – This adventure will cost the equivalent of two or three months of insurance premiums and would have payed half the bill.

_________
CODA
Be Well RB, very well.

Crossposted to RB’s Website, Newshoggers, here.

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Father_Time

Very Interesting. I am curious as to out how this works out.

As I have stated many times here and elsewhere, the current healthcare legislation is not addressing the problem. The problem is the extraordinary, and, unnecessary, high cost of healthcare. Virtually all of the “ideas” being batted around are merely an attempt at “covering“, cost not reduce it. Only Socialized Medicine will reduce costs. I see trouble ahead regarding this issue.

Leonidas

Hope for a speedy recovery. Sounds like the Hospital and ambulance were willing to go quite a bit to help you to afford your treatment, good for them. Perhaps in the future your fortunes will hit an upswing and you can pay off your debt more quickly and have it out of the way.

This story reminded me of that told by Governnor Bobby Jindal, whose father had to make similar arrangements to cover the cost Bobby's birth. When there is a will, there is usually a way and people like you and Bobby Jindal's dad will find it. Mother Neceesity is a significant part of our American culture..

ordinarysparrow

Ron not being able to breathe in the middle of the night is one scary place to be. . . glad you are out of the hospital and feeling better. . . sorry you, like so many others, found yourself between the rock and the hard place concerning medical coverage. . . take good care and be well. . .

That tattoo is really interesting. . .

Ron Beasley

First I want to thank my friend Dr. E. for cross posting this. I have never had a better friend . But I also want to make it clear that the response to my medical emergency was all if not more than anyone could ask for. But I have some questions that I think I know the answers to. The response was quick and no questions were asked but is that because I live in a relatively affluent neighborhood? I suspect the answer is yes. While the event was life threatening the treatment was cheap - would they have started asking questions earlier if the treatment had involved major medical intervention? I suspect the answer is once again yes. Just something to think about.

archangel

I think Big R, that some, like me, were thinking too close a call in another way... sky high usury for policy for one person -you- at $1.2k per month, measured against a tiny disturbance of matrix with no cover... Ok, can handle. But a different 'if but for' that is, a serious serious matter (i.e. $$$$$) and no ins, outcome can be unpredictable depending... to x degree re how others might perceive your ability to pay up. I believe I've seen services rationed when perception by service provider is latter.

Still, we are all glad you are Aok. We have to get you to stop, however, going on archeological digs in your own garage without wearing your superduper well sealed chem mask.

dr.e

Leonidas

The response was quick and no questions were asked but is that because I live in a relatively affluent neighborhood? I suspect the answer is yes.

Well I don't know about where you live but I know where I live ambulances don't care where you live, they get there ASAP regardless. Good caring people work in these services around here, they are there for one reason, to save lives. I hope its just your cynicism suggesting that wealth is something that ambulance drivers and doctors consider in your area and not the truth,

spirasol

It seems to be the trend to publish one horror story after another, with potentially life and death nearby. I hope it helps and I wonder if the right people are listening. I hope so.

I remember 18 years ago when I lived on 25th Street and 1st ave in NYC very near to NYU hospital and Bellevue Hospital. The patient type was very different in these hospitals. The latter was a public hospital, and famous for its emergent care department. NYU would reject patients who found their way to their doors but didn't have the right credentials. I recall reading a story of a man coming to NYU by helicopter and the delays caused by cockpit discussions about insurance coverage and refusal to treat actually resulted in death or irreversible injury.

Myself, without health insurance but with an attack of stomach spasms found myself at the Bellevue emerency room with at least a hundred others. There was no one at the desk so I sat down for a time and waited. When the pain became unbearable I went up to the desk and started making pain noises until someone came out. I was placed on a gurney and left in a hallway next to more emergent gunshot victims. An hour later relief came when they drained my stomach contents through a tube. When the student docs said they had to cut me open to find out what was wrong, I signed out AMA. I went back a couple of days later on my Nurse sister's advice to ask for outpatient care. They insisted I be signed back in. Three days later I was discharged, but then when I went back to get the results, a kindly intern told me apologetically that the lab results had all been lost. All was paid by medicaid, and since I felt better I just moved on.............

JSpencer

Maybe all those folks down in Washington who have been playing with our healthcare futures would take it more seriously if they didn't have socialized medicine themselves, and instead had to face the day to day serious decisions some of us out here in the world have to make. I miss the days when I was young, invulnerable, and relatively ignorant and happy. I fear this "reform" coming isn't going to address the real problems, but will be little more than a political "victory". Best of luck to you Ron, glad you are still here! There are lots of us sharing that same boat...

D. E.Rodriguez

Ron. Glad that everything turned out OK, although you haven't received the entire set of medical bills yet.

One of the things that I glean from your story is the outrageoulsy high medical insurance premiums you were faced with ($1,200 a month). I don't know how many "regular" Americans could afford those kind of premiums. Call me a bleeding heart, but you are one of the reasons that I fiercely support health care reform, that will give you and millions of Americans decent, affordable health care insurance and bristle at specious and callous arguments against it.

shannonlee

Glad you are back in good shape Ron, scary stuff.

I just came across this and had to post it somewhere...

At a meeting last April with corporate lobbyists, aides to President Barack Obama and Sen. Max Baucus (D-Mont.) helped set in motion a multimillion-dollar advertising campaign, primarily financed by industry groups, that has played a key role in bolstering public support for health care reform.

The role Baucus’s chief of staff, Jon Selib, and deputy White House chief of staff Jim Messina played in launching the groups was part of a successful effort by Democrats to enlist traditional enemies of health care reform to their side. No quid pro quo was involved, they insist, as do the lobbyists themselves.

Say hello to the new boss. Same as the old boss. This feels so very BushAdmin...

Ron Beasley

What we are seeing here is that we no longer have a Democracy but a Corporatocracy. That's why the new boss looks a lot like the old boss.

tidbits

Best in your continued recovery Ron.

dduck12

Any responsible adults out there. You buy insurance early on and use it to protect yourself and your family from costly medical bills. You don't buy fire and auto insurance after a fire or car accident. It also sounds like your bills were subsidized (becoming a dirty word, these days) by people with insurance. Hope you get to Medicare age as soon as possible, so you can be covered like an adult. Ok, I'm braced for the hate responses.

archangel

dduck. No one's going to give you 'hate responses.'

Ron is a friend to most all here, and we are just glad he is ok.

On your note about insured / not insured, etc. My personal experience and that of many who read tmv (most do not leave comments), is that when you work daily down at the base of people who dont have health insurance, you see there are literally thousands of reasons why any one individual doesnt. For some, it's literally food and (non-covered) medicine versus monthly insurance payment out of reach. FOr others, its the monthly payment on their parents' assisted living care. For others, it's being out of work and COBRA being usurous. For some, they dont realize how many twists of fate can occur and leave a person stranded. For some, they spend hours and hours daily just trying to get the insurance they do have to pay without having one more time 'lost' the info, call something 'uncovered' and forcing appeals.

We dont know anyone's situation with your idea of someone's bills supposedly 'being subsidized by people with insurance.' But, I'd say, from first hand witness-- although there are as I said, literally of reasons and factors in why/ how of insurances... the actual individuals who are subsidized by people who carry insurance, and the government which subsidizes the subsidizers... are private doctors, private practitioners, mental health workers in private practice, private nurse practitioners, ortho clinics that are private, rehab faculty and administrators.

Often 80% of their billed fees are paid by insurance, with the user paying the balance. That's among the 'subsidized' insured. 80% subsidized to user, and that same 80% subsidized directly to service provider.

Health workerss, by taking this subsidy, could be seen like farmers taking subsidies. A drag on the economy, causing food prices to remain high... and no farmer, no matter how bad a farmer, no matter how screwed up or inflating his /her prices, would ever go out of business because their business is artificially propped up by subsidies.

Talking about subsidies can be useful, I think, but not particularly focusing with regard to patients who are second or third tier to it all. Rather, with regards to the final payee; the provider, who often charges huge inflationary prices for aspirin, let alone anything else. Who often couldnt make it on his/her own without the props.

Competition for the medical market either in intervention or pharms is not keen. Why? Subsidies to the practitioners and administrators. Seen an overnight hospital bill lately? I have. Researched hospital administrators' salaries lately? I have. Insurance CEO/CFO/SVP's salaries? Same. Cost of simple equipment... mostly mfg off shore? I have.

I'd like to see not opinions but the grit truth of facts about subsidies, instead of the pap people make up in media and in their armchairs. I think they are the hole in the bucket through which huge numbers of dollars are washed narrowly downstream.

anyway, I thought your thought about the word subsidies was interesting.

dr.e

dduck12

Lets start with subsidies. They are fine when properly used. When they are coming out of someones (taxpayer, hospital, ambulance provider, etc.) then perhaps clearer terms could be used. One mans subsidy is another man's tax.
Non-insureds. You say you have seen a bunch of things, above. Well, if you were in the insurance business and seen and heard people, not the ones you site, of means say they don't need health, disability, long-term care, life, not because they can't afford the premiums, but because they admit they will gamble and worry later. And, I've heard this when they have children.

Ron Beasley

dduck
You are so wrong here in so many ways. I had health insurance through my employer until I was in my late 50's and my company and my job were shipped to China. I paid for COBRA until it ran out. Being between 60 and 65 an individual plan is not an option - no company will write one at any price. As for those "subsidies" - I will still being paying 40+ percent more than an insurance company would pay for the same service. I will be subsidizing those who have insurance.
I find your claim that I have not been responsible to be offensive and slanderous.

dduck12

Coincidence: I was fired after thirteen years at a company, at age 55. The insurance company offering the COBRA tried to charge inflated prices and even stalled so I almost missed the due date. Yes I complained to the NYS Insurance department. I then went and got a policy on my own. Your situation may be different, but I was railing against those that choose to gamble by not having insurance. I'm sure many of that type would choose not to have auto insurance absent the legal requirement. I have no quarrel with responsible adults. Believe me there are plenty of people gaming the system. Oh, and before you blast me, I am for health care reform, just not a big gov. type. (The laid off and fired folks are a great case for mandatory coverage of some kind.)

Father_Time

I take exception to the very idea that “being responsible” means that I have to supply profit to a private company……for any reason.

It’s simply anti-American.

spirasol

My sense, similar to what others have said, is that the focus is misleading when we look at healthcare from the point of view of finances alone. At least in part, to a large degree in my opinion, that is why we have as large a problem as we do today. By now we have heard from many an expert and insiders (whistle blowers) who tell us what happens when medical decisions are made based on money/payment/profit. People die, or get sicker, who didn't really have to. It boils down to haves and have nots. why would someone who has good insurance want to change it? It would take an act of collective conscience to see and care about one's neighbors and fellow citizens to make that choice.

dduck12

"Answer for your own actions. Don't make excuses or blame others for what you do. When you take responsibility for your actions you are saying "I am the one who's in charge of my life."
from: http://www.goodcharacter.com/YCC/BeingResponsib...

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