Health Care in America
Posted: Wednesday, July 23, 2008
by Missing Link
Kaiser is a good example of what's wrong with American health care. I am an average "Joe" in America and here is my little trip down the health care path over the past nine months or so. I applied Kaiser Permanente for a medical insurance policy and I was accepted back in December of 2007.
Now first of all it is an amazing thing that I was accepted at all since the last time I applied for health insurance I was denied because I have had melanoma. The cancer appeared back in 1995 and was cured with a couple of relatively simple surgeries. No radiation and no chemo, it was a shallow tumor and it was discovered and treated early.
I came back into the same government agency in a less than full time job some years later and learned that costs had gone up since I left. I was now required to pay $180 per month, plus higher co-pays and only had 80% coverage up to a certain deductible. The drop in the quality of my insurance under this agency had nothing to do with my employment and everything to do with the rapidly rising cost of medical care.
So fast forward now to 2007 and after some years without any coverage at all Kaiser accepts my application and I am foolishly relieved by this. The coverage begins costing me $177 per month with a $2,700 annual deductible. This means that the first $2,700 comes out of my pocket for any medical care. After the deductible is paid, there is a $30 co-pay for each visit and 30% of all costs are mine to pay after the deductible is met.
So I decide, OK, I am going to have a physical and get the blood work done and see a dermatologist to make sure that melanoma hasn't reappeared. I immediately learn that there is a charge just to get in the door. I think it was the thirty dollar co-pay which I thought was only to be paid after the deductible since the brochure says, "After the deductible", but I was mistaken in my interpretation of the written English. So I paid the woman with a swipe of my credit card and had my physical.
A week or so later I received a bill for the doctor visit of $172, this was the residual I owed from the total bill of $385 minus the KP Plan Benefit Payment of $75 and the Contractual Adjustments of $43 and $95 respectively. Not sure what that meant but it was all good because it meant my final bill was somewhat lower. So my brief visit with this doctor, the blood pressure check, heart rate, temperature, ears, eyes, turn and cough and bend over and "it's my finger" cost a total of $385. My part to pay for all of this was the $177 monthly fee, plus $30 co-pay, plus $172 residual, a total of $379 out of my pocket.
I am sent for blood work at a different facility some weeks later. The blood work costs me nothing walking in the door. I am cynically certain that I'll pay for it somewhere else so I don't make plans for the savings. The charges for assessing the health of these two vials of my blood are $245 for "General Laboratory"; $250 for "Chemistry"; and $120 for "Hematology" for a grand total of $615 for blood work. I ended up with a bill of $51 for this service.
Next I go to the dermatologist, at another building in another city. This visit is so short it barely registered on the nuclear clock as the man looked at my skin for less than five minutes, said about three sentences to me before he left the room. I sniffed my pits after he left to see if I was offensive. This visit cost $170 of which I paid $30 walking in the door and another $45 billed after I walked out the door.
Now I kept this insurance through the end of May so I paid the $177 for six months having paid a total of $1,062. This monthly fee is to have the "privilege" of walking in the door at Kaiser. The Kaiser card which I gleefully shredded enabled me to pay walk in fees and to be charged even higher fees on the way out the door.
I paid a total of $60 in walk in fees and $268 in walk out fees. So my grand total out of pocket for a simple physical, blood work and for a nano-exam by a dermatologist with a badly frayed shirt was $1,390. Kaiser claims to have contributed $902 to my health care from my "policy benefits" so the combined total for my six months of health care was $2,292.
In this time I was actually in the presence of a medical person for a total of maybe fifteen minutes altogether. I had one blood test. No procedures, no medications, no medical equipment, no nothing. Nada, Nada, NADA.
Now I don't know how it works in the rest of the world, but our health care system is broken. I dropped the Kaiser insurance because it doesn't pay for anything. I ended up paying for everything anyway. I figure that if I get really sick, I won't be able to afford the monthly payment and the 30% co-payments because I won't be able to work. So what's the point of having the insurance if they are going to cancel it when I need it and if they are going to charge me a lot more than I can get the same service for at an urgent care facility. I'll just pay as I go and if there's something I can't afford to have done, it won't get done.
That's health care in America.
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Top-level comments on this article: (1 total)Great article at a timely moment. Opinions based by experience and fact and come Monday my article will be int he hands of the State of Florida. Joint Commission a facade, doctors, above us all, leave the word "care" out following health and use money. Case management, what? People, well they pay the bills. Let anyone and I do mean anyone come and talk to me about care. Yes there are many but then again today and in my opinion it is more about "a job". Best wishes from a totally abused family.Thanks for your comment Robert. Hope that you and your family find some peace!
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