Email a Friend
Print Article
The Doctor will See You Now, Insurance or Not
There are so many different types of insurance out there (by different, creative names), that it is becoming silly. My wife bought a bug-zapper a few years ago for $15 dollars and they sold her an "extended warranty" (another name for insurance) for another five dollars. She bought it. It broke after one season, but I have no idea where she put the receipt and I wasn't about to go through the HUNDREDS she keeps stuffed in her purse. I wrote it off as a bad decision. You buy a cheap product, don't expect it to last. Buy a better one next time, or better yet, just swat the bugs with a rolled up newspaper.
If you have terrible health insurance, stop complaining about the high co-payments, high deductibles, or limited drug formularies to your medical provider. You get what you (or your cost-conscious employer) pay for. The innocent front desk person who must collect your $40 co-pay, the pharmacist that tells you the medication is not covered, and the medical provider that has already provided the care, have absolutely no control on the quality or your choice of health insurance.My refrigerator bit the big one yesterday, so I had to go out and get another one. I did not have refrigerator insurance. This fridge has been a real stinker and I am tired of putting repair money into this lemon. After buying the new appliance, the salesman immediately tried to sell me some repair insurance...preying on fears that I would have to shell out huge amounts of money to repair this new refrigerator future. I refused. He persisted. I refused again. I strongly believe in health, car, life, and house insurance, but I am not a big fan of extended warranties. I take my chances in this department. I think I can get by without refrigerator insurance.
I have worked with my medical assistant for about six years. During this time, she has gone through about four cars. She wrecks 'em and abandons them. Why? She does not carry the mandatory car insurance. Many of those vehicles were financed, so those bills keep coming in and those creditors keep calling (even at work). Feeling sorry for her situation, a philanthropic person gave her a nice car, free and clear. After a few months, she traded this free car in for another, more expensive one that she financed. She wrecked this one, too. She told me that she was late for her insurance premium by a month or so, and for some reason, they did not cover the accident. She doesn't have a car now and has to find other ways to get to work.
My automobile mechanic charges $100 per hour for labor (not including parts) - more than I charge for private-paying patients in my office for a routine visit. Knowing this, I did buy the extended warranty on my truck. Recently, the latch on the back seat broke so I had to get it repaired. I was told it was covered on my extended warranty with a $50 deductible. That was great. Of course, the entire bill was $58 dollars. So far, I saved eight bucks on a $1200 policy.
Sometimes, I would rather give away free medical care than hassle with insurance. As a matter of fact, that often happens when insurers fail to pay because we didn't put down the proper code, or didn't dot an "i" or cross a "t". Many medical offices simply write it off, rather than go to the time and expense of resubmitting those bills to the insurance companies. The loss of revenue to some medical practices is staggering. And, the cost of trained personnel just to do the billing for hundreds of different insurance companies helps raise the rates to those that pay cash or have decent, doctor-friendly insurance polices. I wish that medical providers didn't have to deal with insurance, but of course, I also wish that it rained during the dry season. Neither one will happen.
Americans feel they are entitled to free medical care from the government or their employers, but no one expects free car repair, free food, free gasoline, or free electricity. We do not want our often-inefficient government to mess with our troubled health care system, so our representatives routine vote against universal health coverage. Many say they are jealous of the Canadians with their national health insurance, but we often bump into them at the border when they are heading south to pay cash for needed and delayed medical services.
Illegal aliens and uninsured Americans know that they can go to any ER, get high-tech care, and just walk away without paying...ever. ERs can't turn you down for emergency care, nor can they track you down and haul off your furniture or vehicles for payment. The result is that billions of dollars are spent on "indigent" care, and the state or federal government picks up much of the tag. Overburdened taxpayers eventually get hit with some of those unpaid bills, and some hospitals eventually go bankrupt.
Nearly every week, on the ENT board, someone is asking me to diagnose and treat them via the Internet because they do not have health insurance. As much as I would like to help them, there is really no way that I could adequately take a complete medical history or reach out through cyberspace and diagnose their problem. Trying to evaluate someone's hearing loss or tinnitus on WebMD is not the same as those medical sites where you can get prescription Viagra by answering a "few, simple questions from a licensed medical practitioner".
I am really not sure that people know they can get medical care by paying cash or credit card. Many do not realize that the costs of some medical visits are less than you would pay to get your car or refrigerator fixed. Sometimes, you just have to use your creative resources to get the things that you need. Charge your visit on a credit card and pay in installments if you must. Borrow some money from a friend or relative. Negotiate a lesser price with a compassionate medical provider (Always inform your medical provider at the visit about your lack of insurance). Or, find a free clinic. Do what you must to take care of your medical needs. If you have an arrow stuck in the top of your head, please go the ER. Worry about paying for it later.
I know that many people get miffed when I inform them that I cannot (a) diagnose them, (b) e-mail them a prescription, or (c) perform surgery on them via the Internet. As much as I try to be compassionate since I know medical care is expensive when you don't have insurance, there is really little that a medical provider can do via the Internet, other than some sound advice and education.
Many health message boards (like WebMD's) are open boards. Any board member can offer comments and advice. It is up to you to decide if the advice is sound, or provided by someone that is medically trained. I am often surprised that people will take medical advice from just about anyone. There are a lot of people in health food stores practicing medicine out there.
I read a cartoon many years ago (Born Loser) that showed a man tripping on a sidewalk.
"I think I broke my leg!" He cried.
An old dog walks by, looks down at his leg, and said, "No, it's not broken. It's only a sprain."
Startled by this talking dog, the excited man hops down the road and sees a local street-person (aka, bum). "Did you hear that? That dog over there talked! He told me that I didn't have a broken leg."
The bum replied. "Don't listen to that dog. He doesn't know squat about orthopedics."
So, if someone answers your posting on the Ear, Nose, or Throat board, make sure that they offer some common sense advice, or at least know something about otolaryngology. Insurance or not, we do try to help everyone.
Related Topics:
- WebMD Video: Physician Assistants: Filling a Void in Health Care
- WebMD Video: The Doctor is Always In -- For a Fee
12 Comments:
that was excellent!
My experience with auto repair is that you take your vehicle in, they diagnose it, give you an estimate. You get the opportunity to decide if the repair is worth the money and if the bill is going to be 10% more than estimated once the tech starts working, they call you and tell you the situation. You get a one year guarentee on the repair and if it doesn't work as promised, they work on the vehicle again for no cost.
I have never been given an estimate for health care nor any guarentee regarding the quality of care. I have been misdiagnosed twice and I still was responsible for paying those medical bills. I also had the responsiblity to pay for additional medical care to deal with the damage from the misdiagnoses.
My car runs great. I am broken.
"Americans feel they are entitled to free medical care from the government or their employers."
-I must disagree with this statement. In no way do I feel entitled to "free" healthcare; rather, I just want a fair plan that I can afford. Right now, as private citizens we are being ripped off by the health insurance companies, when compared to those who pay group rates. ...All I want is to pay the same amount as everyone else.
You also said, "You get what you pay for," and I would have to disagree there as well. I am paying exorbitant amounts for my health care, which covers next to nothing; basically, as long as I don't go to the hospital, everything comes from my own pocket (prescriptions, medical visits, etc.). To me, I'm clearly not getting what I'm paying for, yet I have no other choice.
What a beautifully written article! I enjoyed it very much -- my credentials include a UCBerkeley doctorate, and many years of teaching writing in French and (now) English. I'm also a Ramsay-Hunt person (on permanent rehab, since there's no actual cure for nerve damage).
Your article is uplifting and encouraging, even for someone like me who's ten years down the line from a disastrous misdiagnosis, when I could have been helped only within the first 72 hours or so... The doctor in E.R. told me to "wait 7 days and then see a neurologist." He said, "oh, you have three things wrong with your ear, all unrelated. You have Bell's Palsy, impetigo (referring to the ear-rash), and a severe ear infection affecting your balance." Weeks later, just before my second appointment with the neurologist, I talked to an ENT (fru=iend of the family)from Loma Linda who diagnosed it over the phone. When I told the Neurologist, he wnet into another room for a few minutes. On returning, he said, "Oh, classic case. Ramsay-Hunt Syndrome. You don't need a Spinal tap, but you do need this course of antivirals."
Too late, really, to help. Goodbye, smile.
As an ENT, you can help educate other doctors about the connection betwen Ramsay-Hunt and Bell's -- both closely correlated with recurrence of childhood chicken pox.
Well, good luck to you. My big, broad smile is gone, but yours doesn't have to disappear.
Amy
I wanted to comment on the part where you basically say not to take it out on the innocent desk worker who has to take our co-pay. I have a $50 copay which I don't have a problem with at all, but every time I have an appointment the "innocent" desk worker who has to take my payment makes a big deal about how high it is and sometimes goes on and on. I end up feeling embarrassed... This is not isolated to one doctor's office either.
Say what you want,believe what you
want.My experience is as long you
have the insurance or funds to pay you phsician. Everything is fine. But for someone with no coverage
and cant work,is pretty much screwed! I awaiting on medicare because of deteriorating rhuematoid
arthritis and mental disorders including bipolar.Then when you run into a money problem,what do they say.We cant treat you anymore
and your dismissed. Emotional not thinking your dr treats you this way;You ask what do I do now?
Ther response is look in the yellow pages !!!!!!!
THATS REALITY,SO DOCTORS REALLY CARE ABOUT THE ALLMIGHTY $$$$$$$
Speaking the truth, like it or not
shirley
Both my kids have had alot of health problems connected to Peutz Jeghers disease.They were well taken care of as children because my husband and I both worked and had good insurance. Now they are 26 and 29 with poor health and mental problems. They struggle to keep good jobs and insurance. My 26 year old is trying to find an individual policy, but is being turned down because of her passed medical history. I fear for them both because they need regular preventative care and just can't afford it. Lack of insurance can become a matter of life and death. You comparing a person to a car is ridiculous.
I had cancer at the age of 23 and didn't have insurance. I am still having to pay for the meds I am on and will for the rest of my life out of my pocket. I know what it is like to try to find insurance with a pre-existing condition. What do you do when you can't pay and your credit is ruined? Go to the next one in the phone book.
He wasn't comparing a person to a car. He was comparing a bill with a bill. Don't attack the doctor who didn't even charge you for his two cents.
I say right on and kudos.
"Sometimes, I would rather give away free medical care than hassle with insurance. As a matter of fact, that often happens when insurers fail to pay because we didn't put down the proper code, or didn't dot an "i" or cross a "t". Many medical offices simply write it off, rather than go to the time and expense of resubmitting those bills to the insurance companies."
Yeah, or they just foot the bill BACK to the patient and try to pretend like it's supposed to be that way. Nice system, indeed.
Worrying about the health of your car or your house is not the same, and should never be the same, as worrying about your own health or the health of your children.
I DO feel health care should be a right, and not an affordable privilege. This country is far too rich on the whole to excuse itself from taking care of its citizens' health. Could it be abused by people? Of course. But that doesn't mean we should just throw the whole idea out. How very capitalistic has our own healthcare become. It's disgusting.
I will agree, however, that insurance only seems to make the situation worse, promising to be there to help, but then "nickel and dime"-ing you to death, along with the doctor's office or hospital and their 5 different bills for one procedure.
It really does make one consider not paying them, or paying the bare minimum on them and truck along with life as if they weren't there. After all, when you finally die from the infected splinter in your thumb you couldn't afford to have removed and treated, you probably won't give a damn.
I've worked in the medical field for over 30 years so I see things from the doctor's perspective. However, I also see it from the other side. My 26-year-old daughter is bipolar and is getting worse by the day. She has been to the emergency room at our county hospital twice on her own and once by ambulance when she was in terrible crisis. I was out of town and it took 2 hours for me to return. What help did she receive from them? NOTHING. They kept her for hours and then handed her some papers with phone numbers for the "free" clinic the county runs - along with a HUGH bill. Not one second of help. She had already called and made an appointment with the "free" clinic months before. She had gone down there and even though she had an 8AM appointment, she still sat for over 6 hours!!! She was first to arrive that day and at 2PM, when ALL the other people who arrived after her had been seen and the staff closed the windows to leave for the day, she gave up and left! She had repeatedly asked why she had been passed over and they kept saying she would be next. The thing about bipolar people is that they do not all have the capacity to go down to a clinic and sit like that!!! That experience took EVERY hope she ever had of finding help and threw it all in the garbage. I tried to pay for her doctors out of pocket but when the first appointment ran $845.00, and wiped out my savings, (and she still didn’t get any help) I realized that I can be of no help here!
My daughter is bright and friendly and helpful and thoughtful and so full of life when she's "normal" but that is less and less often. The other times she is suicidal and has become terribly hateful to her family and friends. She is going to college full time and is doing well there but cannot work on top of that. Now she’s saying she’s not going back to college because she’s not capable of working anyway!
Social Security Disability? She would have to have documentation that she’s incapable of working. EXCEPT SHE CAN’T GET A DOCTOR TO SEE HER WITHOUT INSURANCE!!!!!!
Even when she worked and had insurance it wouldn’t pay for mental help and she couldn’t take off work often enough to go to a doctor once or twice a week!
So, the frustration has now exploded into furry that there is NO ONE (and I’ve contacted every group and society in this very large city we live in) NO ONE is willing to help her.
I live everyday knowing that I may get a call that she’s dead.
To all you doctors out there… I hope you all sleep well tonight.
Using the car analogy, what would you do if the mechanic didn't fix (or even seem to address) what you asked him to? Do you still have to pay the bill? I'm going through a situation right now where the doctor didn't address the problem I came into the office for, but instead put me through a bunch of tests and then told me I was a candidate for a surgery I didn't ask for (it was a plastic surgery to correct my lazy eye that had been brought on by retinal dettachment when i was younger, but I was there for an injury that had caused swelling under my eye that persisted for several months, and actually, I still have it!).
I don't have insurance. I came to him through a doctor that had seen me for free and thought I needed to see a specialist.
What are our rights? I'll admit I didn't pay the bill at first and when the office pressed me for it, I wrote the doctor a letter explaining why. He wrote back that he had treated me professionally and I owe him the money. I've searched and searched but have found nothing online about how to deal with this situation. What rights do I have as a patient?
I'm afraid maybe I just have to pay because I didn't speak up at the office. I did tell him, after he told me I was a candidate for this "correct my lazy eye" surgery, that I wanted to know about the swelling. He told me it should just go away and if it doesn't to come back. I was too stunned that I had sat through all tests for something I didn't ask for to really say anything else.
Any advice?
I have been insured, uninsured for twelve years and insured again. I have been on both sides of the coin and know the difficulties from the uninsured side. You are not treated near as well. My husband and I have three beautiful children and have been blessed that they are fairly healthy, I however am not so healthy. I deeply sympathize with those who don't have and struggle to make it and pay the doctor bills too. I agree that the system is broken and needs some fixing. We,at this point, am looking at possibly losing ou health insurance in the next few months and it a pretty scarey thing. My husband and I own a small business that has had its ups and downs and last year my husband nearly cut off half of his hand (not at work) and was very blessed to get a truly gifted surgeon who with two surgeries has given him a mostly functional hand. I am extremely grateful for the insurance that allowed this to happen, but I also know that without it, my husband would have lost three of his fingers and been quite possibly unable to work for the rest of his life (his injuries were that bad). We ended up with a lot of out of pocket expenses, even with insurance, probably right around $20,000.00 that I am still trying to pay on. I am also of the mind that everyone should be provided with basic medical care at a "reasonable price" while we live in supposedly the wealthiest country in the world. There is way too much waste in our country to turn a blind eye to the most basic of things that we all need. I do believe that our
Doctor's need to be paid a good wage for the work they provide for us, however, things at this point are ridiculous all the way around. I think it is high time we do more than think about health care reform and do something about it; because in my mind everyone, docotors and patients, need to be treated fairly but also need to have more respect for one another. Patients need to be thankful that there are people willing to put the work into becoming doctors to treat us and some doctors need to look at us patients as more than a way to get rich. To sum it up both sides need to more tolerant of each other and try to look at the bright side, seems both sides could stop complaining so much and do something about it; think of all the places in the world that we all certainly wouldn't want to live because it would be a sure death sentence and be thankful for what we do have, flawed as it is. And please be more compassionate to those who don't have, because not everyone has the opportunity to "get what they pay for"; they can barely afford to feed their families with the high costs of today. I have also been on both sides of this pay scale...it can happen to anyone, even a doctor. I guarantee that doctor who thinks I am full of crap right now, wouldn't think so then.
Post a Comment