July 05, 2005

Our Local Hospital Can Shove It

Back in Hamburg, Shelby had to go to the emergency room one night, victim of mysterious abdominal pains. She rode there in an ambulance. Once there, she got a CT scan. She was examined by the ER doc on duty. She got IV fluids and various drugs. A few hours later, they sent us home with a prescription.

I sweated out the next few weeks until the bill came; we'd just recieved emergency health care from a medical system whose inner workings were totally opaque and alien to us. Our (still-American-based) health insurance required us to pay any bills up front; they'd then get around to reimbursing us at their leisure.

Our total bill for the whole experience? 67 Euro (or, at the time, about $85 in American money). Why had I worried? I didn't even bother forwarding the bill to the insurance company.

Back to the present: an insurance-related item in today's mail led me to wonder if any claims for Shelby's recent hospital adventure had been filed with the insurance company yet. As it turns out, there were a few:

This goes on for about ten more lines.
$3,182 for "Incidentals"?
That's right three claims have come in so far, and they're asking for a total of $23,464.48 for the first night of Shelby's hospital stay. Remember, I didn't call 911 until around 7:30 PM on the night of the 20th, so these charges are for about four hours of hospital time.

But those four hours were jam-packed with dedicated physicians performing life-saving feats of derring-do, right? Maybe an emergency open-heart surgery or two? Nope. I think that Shelby got an EKG, an X-ray, and some pain medicine, but most of that first night was spent waiting for on-call doctors to finally call back.

While Shelby was in the hospital, we felt like the internist who was coordinating her care was padding things out, adding not-strictly-necessary tests because we had good insurance. One of the people who came in to do one of those tests even said as much! If this is what they do to everybody who has "good insurance", how much longer will it be before nobody has "good insurance"?

The beloved employer made a big push during the last open-enrollment period to get us to move into a "Health Fund" instead of a traditional insurance plan -- one of those "market-based" systems where us "consumers" are supposed to become more aware of what our health care really costs. Our conventional plan costs more and more each year; the health-fund documents make the new plan sound like carnival rides, puppies, and ice cream on a hot summer's day, and I'd been considering switching the next time around but an experience like this makes me think twice. Thrice, even.

Note that the claims are still "in progress", so they have yet to go through that hospital-versus-insurance company magic whereupon the hospital agrees that a $10.50 payment is a pretty good reimbursement for a $950 charge. And we're pretty close to our insurance plan's out-of-pocket ceilings for the year, so we're not looking at paying too much on our own. But still, this is just insane, people.

Forget good insurance what about those people who have no insurance? How much longer and how many more medical bills like this have to arrive nationwide before the country decides to ignore the GOP and Heritage Foundation shills telling us why "Hillarycare" is bad for us, and rises up in bloody socialist revolution?

Posted by Kevin at July 5, 2005 05:37 PM