This is what is wrong with healthcare in America

For the past few days, I’ve been feeling a little under the weather.  My throat is sore, my voice is hoarse, I’m coughing and spitting up some pretty thick and nasty flem.   All this and it’s midterms.  So I did what any American with insurance does, I called the doctor’s office and made an appointment so he (or she) could diagnose me and send me on my merry way.  By the time I had finished the appointment, the nurse practitioner who saw me (no people, not even a doctor) suggested I rest and drink lots of fluids.  Thank you for that information, I had no idea.  She called it an upper respiratory viral infection and for that diagnosis, a mere 82 dollars.  WHAT?!  I’m a student, and this is my student insurance and I can’t believe you people are charging me this much to see a nurse who told me to get some rest!

Apparently I hadn’t met my deductible yet. Ya, that basically means I need to rack up a bunch of useless visits and charge them so that I meet the deductible so that I don’t have to pay the $82.

I have been talking about starting this blog for a long time.  So be it that this visit finally fueled the beginning of this blog which will be dedicated to health.  Health care, national health reform, health policy, healthy lifestyles etc. So here we go…Enjoy

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5 Comments

Filed under health reform

5 responses to “This is what is wrong with healthcare in America

  1. I’m interested… what would you like changed in regards to this situation?

    • I would like for them to tell me that I have not met my deductible before I go in to see the nurse practitioner. For them to say, “Ms. Michel, if you go in there to see the nurse practitioner, we will have to charge you a staggering $82 dollars.” I actually overheard the administrative staff woman on the phone saying something like, “oh she hasn’t met her deductible? So she will have to pay the full amount out of pocket?” I thought they were talking about another patient, but now I’m sure they were talking about me-and this was as I was sitting in the waiting room!

      Ultimately, making things more transparent overall, like telling people how much the visit will cost before a sick person makes the trek to the Doctor’s office only to be seen by a nurse practitioner who recommends rest and fluid and then charging a student, who is already paying for health insurance in their tuition fees, $82 dollars is unacceptable.

      • How would you solve that problem?

        My insurance company sends me updates after each medical claim to let me know about which claims qualify for discounts and how much I have left before meeting my deductible. Since I keep track of it, I know beforehand whether or not I will have to pay out of pocket and I ask before the appointment how much it costs. I also ask my doctor about the cost of prescriptions, etc, to make sure that he/she is prescribing the best/cheapest option.

        With the baby delivery, I will sit down w/ the hospital, and my doctor’s office so that I can know roughly what I will be charged. Granted this is extra work, but it is not impossible to know the costs beforehand.

        I do wish that costs were more standard across the board. However, if the medical provider was expected to sit down with every single patient and sort through all of their insurance plans in order to tell them information that they could easily learn for themselves before each visit, then administrative costs would skyrocket. It just makes more sense that this would be the responsibility of the patient.

      • This is fun. Okay, so you think you will have a roundabout number of how much the baby will cost. How bout I get you to guest blog on this. “Having a Baby in America: Texas Style.” You can blog about what you have encountered, through the insurance side, hospital side, patient side, every or any side you see fit. We’ll see if your forecasted costs end up being close to the final tally of what you pay, and if you are happy with the hospital’s performance etc. also, when i talk about transparency it doesn’t mean sitting down with people and having them give you an estimate. There are hospitals and healthcare providers who have interactive websites where you can basically choose, “to have a baby” in one hospital and see the cost of that versus in another hospital. there’s also something called bundled payment which would be great for your situation. So instead of paying the OBGYN for the delivery, the hospital for your stay, and anyone else for the care you receive specifically from them, you would just say you were having a baby and everything that entails would be bundled into one direct payment.

        want to do the guest blogging? It will be fun!!!!

        love!

  2. Sameena

    Hi Sarah,

    Being in the US for just over 2 years, I’ve learnt my lessons the hard way. The American Health Sector sucks, at least for the patient, if not for the docs and the insurance companies. Every time me and my husband go to the doc, we make our savior call to the insurance guys, no matter what. It is so complicated that they will trick you into some thing or the other.

    My husband stayed in the ER for a few hours on one night. He paid the co-pay and came home thinking that his insurance will take care of the rest. And here we are. A bill of $6000. Guess why?
    Because the insurance company denied it. It seems that since my husband changed his job and the insurance company no longer caters to the old employer, they wouldn’t pay for it. We’ve faced similar problems before. Now our plan is to complain to the state insurance authority and they will take care of the rest. It really leaves you exhausted emotionally. Moral of the story: do not fall ill, and if you do try avoiding the doc or think of grandma’s home remedies. Or else, act smart and take every step carefully.I know it’s sad. I would rank my ‘developing’ home country much much higher in these terms.

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