Medical Care American Style

At the risk of coming off like Lenny Bruce obsessively reading from his trial transcripts, as his legal ordeal continued and his heroin use spiked, I have one more, hopefully quick, take on the crisis in American health care.  Tying health insurance to a full-time job with a reasonable wage (and creating as many loopholes as needed to avoid offering health insurance at all) is part of American Exceptionalism, like the wonderfully acronymed COBRA that can be purchased by those fired from jobs to continue to have full-priced health insurance.  Tying health insurance to full-time work guarantees America a fairly docile work force since, if you lose your job you can’t afford COBRA and you’d better not have any health problems.  It also allows the nation’s largest private employer, Walmart, to employ a vast non full-time workforce it does not have to offer health insurance to.  Luckily for those employees, many are so minimally paid they qualify for Medicaid, a government plan for poor people paid for by all other taxpayers.  

While the zealots of the majority Freedom and Liberty party vote on party lines to gang bang and strangle Obamacare, with a much better, if very hastily drawn, plan that ensures the rich will get richer and the weak, ill and lazy will no longer be able to exploit the Kenyan Muslim’s overly generous health care plan, I am beginning to try to straighten out hospital bills for a brief mid-November stay, bills I began receiving between Christmas and New Years.  As the bills came in I was still wrestling with the giant anaconda of the New York State of Health Marketplace and its mandate to reapply for insurance between the week before Christmas and two weeks after New Years.  If you have never experienced that ‘marketplace’, God bless you, and be extra nice to your boss.

Last summer my new Obamacare doctor flexed his muscles to show me what a healthy heart muscle was like and then let his arms droop to show me what my dilated left atrium, one of the four chambers of my heart, was like.   He promised to refer me to the cardiologist who was to set up a practice in his office in the next few weeks and told me not to worry as long as I had no chest pain or shortness of breath.  Not long after that I had chest pains while riding the bike up a hill and decided to wait to see the cardiologist before staying in shape with biking.  

In fairness to my doctor, I only followed up about the new cardiologist a handful of times over the next few months so he is not 100% to blame for the escalating untreated concern about my heart that I was having.  Following Sekhnet’s alarm and this doctor’s advice, one November night I checked into the nearest Emergency Room with enough symptoms and risk factors that they admitted me to the hospital.  

Of course, because the ACA allows doctors, hospitals and insurance companies to opt in and out of the plan, the hospital I went to, and the doctors I saw there, were under no obligation to accept my insurance.  As far I knew, under the PPACA, Emergency Room visits were covered, then again, my fully covered colonoscopy a few years earlier had left me with hundreds of dollars in medical bills– lab fees, they insisted, were not covered, nor the almost $200 for the mandated pre-visit to the provider who performed the colonoscopy, according to the lawyers letters I received.  

After a brief overnight hospital stay and a stress test the following afternoon I was cleared for strenuous exercise and have been working myself back into some kind of cardio health so I can do the 40 mile Bike NY ride with friends in May.  

My follow-up with the cardiologist on December 15th was abruptly cancelled mid-exam.  There was some question, the unethical cardiologist explained, about his getting paid by my insurance carrier for the visit.  Walking back home on that frigid day I stopped by the hospital to let them photocopy front and back of my insurance card.  I wanted to be sure they had the current insurance information correctly in their system, since I’d been obliged to change insurance, and doctors, multiple times in recent years.   I followed up with the hospital’s offsite billing department and was told there were no charges pending.   A week later a blizzard of bills began arriving.    

I’d estimate there are now more than two dozen bills, some explaining what they are charging for, others less exact, others threatening me with legal action for unheeded second and third notices.   I finally called yesterday about a bill for $810, the cost of the stress test.  At the bottom of the bill was printed BCBS Health Plus, the name of my insurance carrier and plan.  The woman at billing asked for my ID number in that plan, a plan I no longer have.  I read it to her.  

She checked her computer and told me no bill had ever been submitted to the plan typed at the bottom of the bill I was holding.  She told me she had just submitted it and that it would take four to six weeks to hear back from the insurance company.  She also informed me that her office did not deal with Emergency Room or other hospital bills, only physician’s services, and gave me the number for another office.   In the meantime there was nothing she could do to keep the automatically generated doctor’s bills from being sent to me.   She suggested I just ignore them until I heard what BCBS had to say.  

I will do that, as I will ignore the letters from the hospital’s lawyers informing me of their collection efforts.

While I wait to see what these lock-stepping bullies in Congress decide to do to give the very best health insurance to our nation’s most vulnerable citizens.

God bless these exceptional United States!  God bless us a lot.


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