Dear Madame L,
Perhaps this is more of a vent than a question, but I ask you, why do I even pay for insurance? Let me explain. Recently I went to a health fair put on by the local University to have my blood drawn by lab technician students. For only $35 they did a number of blood tests. When I got my results back they indicated that my thyroid was off so I scheduled a visit to my family doctor. I brought my results and had a nice little chat with him. He looked over my results then decided that he should check my thyroid himself, and of course those results came back exactly as expected. Well, shortly after my visit to the doctor I got an explanation of benefits from my insurance stating that they were not going to cover the blood work my doctor ordered and I would be paying $156.80 for a simple little thyroid test. I was under the impression my insurance did pay for a thyroid test but when I called them to ask they said they only do if it's billed under a yearly wellness exam (which it wasn't). I then called my Dr.'s office to ask if they could bill it like that and they said they could not because it was not a wellness exam, but a visit to talk to the doctor about my thyroid. But here's the catch. If I would have known my insurance would not have covered the thyroid test I could have paid the doctor's office out of pocket and it would have cost around $15. But since I didn't pay out of pocket, they sent the bill through the hospital who demands over 150 bucks from the insurance for a stupid little thyroid test that was completely unnecessary for the Dr. to even order! In other words, if I didn't pay $250 a month for my crappy insurance policy and rather just paid out of pocket for this little visit to the doctor it would have cost me a total of $115 for the visit. But since I do pay $250 a month for crappy insurance then I get to pay $180 (including my $30 copay) for this lovely visit to the doctor. Tell me Madame L, does this make any sense? And this is not the first time something like this has happened! It seems to happen almost every time a member of my family or I visits the doctor. You would think I would have learned my lesson by now, but they are just so darn tricky about everything! I feel like a silly little pawn caught in the middle of a stupid game between the medical industry and insurance company. Should I just cancel my insurance policy and save the $250 a month just in case something catastrophic happens? Your input would be greatly appreciated.
Unsure about being Insured
Madame L thanks you for venting, she she definitely feels your pain! What happened to you did NOT make any sense, unless it were to be explained by greed, lack of care for patients, and/or incompetence.
Madame L absolutely empathizes with your description of being a "silly little pawn caught in the middle" of this game between the greedy health insurance and health care industries. Madame L knows it doesn't have to be this way, and looks to the examples of other countries (England, Canada, Australia, France, Germany, Japan, and most every other country in the developed world) which have much more sensible and reasonable health-care systems for their citizens.
Madame L realizes, though, that there are still many Americans who are protesting what they call "Obamacare," really the Affordable Care Act of 2010, the health-care insurance package passed by Congress last year which didn't even include the elements that would have made it half as good as those of every other industrialized country. The government's website, HealthCare.gov, explains the law.
Madame L hopes that you, Dear Unsure, are writing to your representatives in Congress to insist that health care be improved in the U.S. Repealing our current law, which has great promise for helping you and Madame L and millions of other Americans, would not do it, of course. However, carrying it farther in the direction it started would be a huge help.
Madame L suggests some reading for you on health insurance. These articles, backed by your personal experiences, will make the "arguments" become clear and unarguable for your members of Congress.
1. HealthCare.gov has links for health care insurance by state, age group, family situation, etc.
2. Here's the White House's own explanation of the act's provisions.
3. The Christian Science Monitor last year provided a very helpful explanation of the aspects of the law and dates for each segment to be rolled out.
4. The Huffington Post also provided an interesting explanation last year.
5. Here is the actual bill that was passed by Congress and signed by Pres. Obama.
You may wonder why Madame L has not posted here any of the arguments against the health care law. Here is why: Madame L has never been interested in arguing with people or listening/reading the kinds of arguments that have been presented against this law. She is more interested in helping people go forward with the materials at hand.
And that is why she encourages you to write to your representatives to ask them to go forward in helping you and millions of others who need meaningful health insurance.
Again, your informed letters and phone calls and email messages will alert your representatives to the needs of the people they should be representing. Madame L knows from personal experience that sometimes it seems that these messages have little effect, but she trusts that your representatives' desires to be re-elected in 2012 will encourage them to take positions that will help their constituents.
Best of luck, and best of health,