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What Health Insurance Crisis?

Parapalegic Man Dumped in L.A. Gutter Sues Hospital

Gabino Olvera, 42, sued the Hollywood Presbyterian Medical Center for negligence after it discharged him in February 2007, took him across town in a van and left him in a soiled hospital gown without a wheelchair in the heart of the city’s homeless area.

Witnesses who came to Olvera’s aid said they saw him dragging himself on the ground with hospital papers and documents clenched in his teeth while the driver sat in her van and applied makeup before driving off.

The incident was captured by security cameras at a nearby homeless shelter.

Not only does this infuriate me on a basic level, it also brings to mind a recent incident of my own.

Last month I had my yearly GYN exam. My insurance card is generally in my purse, and I always bring my checkbook for my co-pay, a holdover from when doctor’s office didn’t take debit/credit cards. When I checked in, they asked for my card, which mysteriously wasn’t in my wallet (I suspect I was looking up something on the insurance company’s website, which would require my ID number). When I revealed I didn’t have the precious little piece of plastic, the receptionist immediately kicked in to panic mode – I could see it in her eyes.

“The information is the same as last year.” I said, trying to be helpful.

“But you haven’t been here in a year.”

Bear in mind that my state of mind has been highly fragmented since about – oh – Thanksgiving due to family emergencies, being the owner of an ecommerce biz (can we say holiday retail shopping season??), Folly’s cancer, a 1968 blue toilet sitting in my guest bedroom, etc., but this struck me as one of the most absurd statements I’d heard in my life. Of COURSE it has been a year…..

“That would be because I only have to be here once a year.” I said.

She muttered agreement but I could tell her thoughts were decidedly elsewhere. Gone was her sense of customer service, replaced by this frantic scrambling; I’m certain I’m not the only person who’s ever shown up without their insurance card, so what is the problem? Plus, I’ve been seeing this same doctor for ten years; it’s not as if they don’t know where I live.

“Well, you’re going to have to leave some sort of payment.” she said.

“All right.”

“Or you can reschedule.”

“It takes me six weeks to get in here for my annual exam. I’m not rescheduling.”

“And you need to get us a copy of your card. Can you bring it over or fax it to us?”

“I can fax it to you.”

“Okay, today? Tomorrow? Cuz we need to have it.”

Oh my God.

“I will get it to you.”

While waiting to be called in, I filled out a questionaire regarding ovarian and breast cancer in my family. They’ve discovered a nifty gene that greatly predisposes women to either affliction and identifying that gene allows women to make certain decisions regarding their health care. A local hospital is testing women and gathering all relevant data related to the matter.

Naturally, the test is about $3000. Even more expectedly, insurance companies don’t cover it. Frankly, it’s not in their best interest to know if you’re suseptible to breast or ovarian cancer, and they don’t care if preventative double masectomies might save a woman’s life. It’s far more profitable for them if you get the disease and they provide you with their maximum 10 grand a year in treatment. If you die, so what? That just really isn’t their – or their stockholders’ – problem.

Yes, I qualified for inclusion in the study.

Here’s the TMI portion of the program – I have a tipped uterus. Basically this means that my doctor has a helluva time checking for all the bits and pieces and she’s inclined to send me to get a fucking ultrasound. Last year I blew her off, so this year she gave me a bit of flack for it and made me promise to go. I was too tired to argue, so I made the appt.

Did I mention that my fucking insurance doesn’t pay for the ultrasounds either? (see my post last April on my $300 deductible)

Checking out, I informed the woman about the missing insurance card.

“I have a check,” I say, fully prepared to leave my co-pay, as usual.

“How about a credit card, so that when we get your insurance card, we can just charge your co-pay?”

Yeah sure, whatever. So I give her my debit card and tell her how much my co-pay is.

That night I tell my S.O. how irritating it was to be treated like I was going to scam them out of their money because I forgot my insurance card.

The next day I fax them a copy of my insurance card.

Then the weekend passes.

On Monday morning, I attempt to call and ensure they actually RECEIVED the fax. But typical of contemporary medical practices, my doctor is in but one office of their organization, so the number goes to a phone tree then hits a woman at the administrative portion of the company who has no idea what I’m talking about. She transfers me to the ‘woman who deals with the faxes’ who then hims and haws, puts me on hold, then shuffles more paper around and finally tells me she can’t find my file, so she’ll have to call me back, maybe tomorrow.

Okay.

I hang up and head up to the shower. When I emerge from the shower, clean, pink and barely toweled off, I’m beseiged by a very pissed off S.O. who is demanding to know WHY my doctor’s office has charged us $125.

I don’t know about you, but I do not have an extra $125 laying about in my checking account, so this was potentially a disaster. He happened to log in to the online banking and see the charge; otherwise I can guarantee we would’ve had things bouncing around like jack russell terriers on cocaine and incurring untold hundreds in overdraft fees ($32 per, you know. Fucking banks). Apparently before my S.O. decided to take his exasperation out on me, he called the aforementioned number and eventually got some woman in billing who told him that it’d be 30 to 45 days before the charge would be reversed.

Infuriated (at him and them), I throw on some clothes and drive over to the doctor’s office; wet hair, sub-freezing temperatures and all. I find the ‘check-out’ woman (different than when I was there the prior week, and not the same woman who ‘couldn’t find my file’ on the phone), who calmly tells me she never got the fax. I give her a copy of the damned card, and she IMMEDIATELY reverses the charges. What the hell was so difficult that the chick on the phone wouldn’t provide that as an option?

Here’s the tie-in:

1. This homeless gentleman received the treatment he did because he had no insurance. If you think this is an isolated incident or that it can’t happen to you, see above. The moment I couldn’t display my insurance card, I was treated like a grifter who had wandered in off the streets to con the doctor’s office out of a hundred bucks worth of medical procedure. Imagine how much this guy’s ER visit cost, so they’re even less happy to see his indigent ass.

2. My doctor belongs to a practice (and in this case, they’re a microcosm of EVERY practice out there) that encompasses multiple offices and specialties. They’ve grown so big that the people who deal with the adminstrative portion of the business have NO contact with the actual patients (aka consumers) other than a number on a file or maybe a disembodied voice on the phone. In other words, they don’t CARE. You’re not human, you’re just an account.

3. It was easier for the woman at the desk to charge my debit card $125 than it was for to pick up the phone and inquire about the faxed insurance card. Picking up the phone would’ve meant a little more time out of her day, whereas charging my card ‘solves’ the problem for her. She can close the file, send it off to Admin and move on to another task. Calling me might actually require keeping my file open until she received the fax, la la la, and the most important thing is not customer service, but making her job easier.

A simple resolution to the task at hand – I’m sure that’s all the woman driving the van from Hollywood Presbyterian wanted. It’s not her fault the guy’s homeless, a parapalegic, or that he has no insurance, right? Her job was simply to get him out of the hospital’s sight. What he does from there?

Well, that’s his problem.

2 replies on “What Health Insurance Crisis?”

When I read that she asked for your credit card I had a feeling they were going to do that too you.
Healthcare is out of control. As Jan rolled around our Cobra coverage went up to $1149.00 per month and this made us drop dental coverage.
Currently we are also batteling the ins company because they didn’t pay for my Chiro treatement.
John tried checking for other coverage but they told him since he is insulin dependant diabetic they will not insure him.
I’m sorry you had to go through all of that. Its just crazy that the man and you had to go through all of this.

I so feel you. A couple of years ago, I had a past due bill of LESS THAN $100 (I think it was $65)at the kids’ pediatrician’s office. The way our insurance works is you submit the bill and hope they pay for most or all of it. in this case, they hadn’t, but I didn’t know this. The bill was considered past due even though i had only gotten one notice for it. Nice, huh? I had been seeing this woman since my son was born (about 7 years by that time)and now also my daughter. I knew the bill was past due, but had an appointment with my daughter in a few weeks, and figured I’d pay it along with her copay. Mind you, up until a couple years ago, our insurance didn’t pay for preventive vaccinations at all, unless you called them while you were pregnant to tell them – to get ready for it, I guess. I had my own insurance when both my kids were born, and it was GREAT – cost me the $10 copay from when they verified I was pregnant and that was IT. (Gone are those days, by the way)So you can understand why I didn’t call my hubby’s insurance when I was pregnant. I didn’t see the need. Because of that, up until 2006, we paid for all vaccinations in full. So, I’m imagining that the $65 was for some sort of vaccination, and as I said, I was due to see the doctor anyway. When I arrived, I was told that the bill had gone to collections, that I was no longer welcome at the practice, and that my kids were “suspended” from seeing anyone there. WTF?? If I paid the collection agency (it was out of their hands now, you know)I could then write a letter basically begging them to allow my kids back into their practice. So, I did all they asked, and I had some nasty b at the office tell me every day that they never received payment. I sent them a verification from the collection agancy, my bank statement showing the charge to my debit card, and they would not budge. The only thing they would accept is the fact that THEY showed no record of it being paid. When I asked about how they did that, they explained that they get a long list of people who have made good on their debt and then they input them into their accounts. So I called the agency, who informed me that they sent my name weeks ago clearing me of the debt. I called back; the “lady” got nasty and said that if they had sent it, it would be noted. So I said, “Hey, I’ll tell you what. You get your accounting together, call the agency, get the verification from them – I’m sure you have a super-secret number that you call that I’m not privy to, and then when you work all this out, let me know.” I was then told that it was my reponsibilty to prove that they made an error. Wasn’t that what I had been doind???? I said as nicely as possible that they could kiss my ass, and I now have a great new pediatrician.

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