The Economy

A few years back, my father had quintuple (supposed to be quadruple) bypass surgery. His recovery was slow. A week passed, and the hospital sent him to a rehab center, where he was feeling worse. Another week passed, he ended up in the ER. His levels were all messed up.

A doctor gave him some sort of “sugar water”, and a few seconds later, my Dad started having a seizure. My Mom and I pointed that out to the doctor, who first blew us off, then saw what my Dad was doing and called in for help. About 20’or so doctors, nurses, EMTs and a firefighter or two who happened to be around came by. They stabilized my Dad, told us they were taking him back to the cardiac ward, and that they would come get us in the cardiac ward waiting room once he was admitted.

Long story short, we later found out they needed to use the paddles to zap him; the surgeon in charge of the entire department wasn’t quite sure what was wrong with him, told us he was very sick, that they needed to do a CT scan, and if it wasn’t clear what was wrong, that would be a huge problem.

So Mom and I are in the waiting room at 5:30 in the morning, and the surgeon comes back with another guy, who it turns out was the anesthesiologist. The surgeon actually was smiling in relief, said the CT scan told them Dad had fluid around his heart (1 in 50 have this problem), and that they would operate to drain the fluid.

They gave my Mom a bunch of papers to sign, and Mom and I just start laughing because what the hell else were we going to do? Not sign and have my Dad die, or sign and possibly get hit with a mortgage-like medical bill. She signed.

He woke up a day later, found out it was Sunday and that it was 8:00. He asked to put the Super Bowl on and was told it was 8 a.m. We watched the first half together, and it’s still one of my favorite games that I’ve watched.

 

Well, that's another ridiculous truth about our system.

 

99% or more would sign those papers, and that's not a secret from the hospitals. They know that they'll be writing off some part of virtually every bill, because no insurance company pays what they bill for in full. Hell, the big companies, the Blue Crosses and equivalent, often pay significantly less due to their bargaining power. You know who are expected to pay in full? The uninsured, the people least able to do so. I used to see it all the time when patients would come in with a bill, trying to figure out why they got one. Often it was an error in a diagnosis code and could be easily fixed. I saw bills for a couple of hundred dollars for tests that I *knew* BC/BS was paying $65 or so for.

It's not that I don't understand where Ragu is coming from, it's more of a "What did you expect people to do when they're confronted with a health crisis? Do without when someone's life or longterm health outcome is on the line?" There are an awful lot of people who are a couple of missed paychecks or a major car repair away from being homeless.

Predatory pricing is also involved. I had a colonoscopy during full bore Covid. The hospital where it was done required a Covid test by their lab before the procedure. I had no problem with that, but I did have one with the $200 I was charged for it when I had a dozen such tests in my bathroom cabinet.

 

I just got back from my drug store. I just happen to be walking by when I heard the pharmacists on the phone tell someone, "It'll a thousand dollars."
Now I don't know what they were discussing, but I'm sure it was a drug someone needed.

 

Absolutely true. Working in the doctor's office, when the doc ordered a test on a patient with no insurance, it was like pulling teeth to get a straight answer from the lab performing the test how much it would cost. Trying to comparison shop hospitals for MRI's or something is even worse.

The uninsured get screwed without any lube in sight.

 

The nutty thing was, they did get hit with a big $100K bill from the hospital for his original bypass because they billed the wrong insurance.

My dad hurt his back at work a few years before the heart surgery, had back surgery and Worker’s Comp took care of it. He had the heart surgery at the same hospital, gave his insurance card, told them that it had nothing to do with Worker’s Comp, and the hospital ended up billing them anyways. My Mom got it fixed.

The entire system is one fucked up mess.

 

When my dad had his stroke and had to go into a rehab place for a couple of weeks - which is the time the VA recommended and would pay for - the facility paper pusher had the balls to ask my mom, "I see you own multiple properties. Would you be willing to sell one to cover expenses?"
These people prey on folks in a tight spot. It might be the only time in her life my mother told a complete stranger to fuck off.

 

Well, first off, if you ever get hit with a bill like that, stall. Call and ask questions. If you have any question about the validity of the bill, or whether the diagnosis and paperwork is correct, don't pay until you're answered. If you pay it you'll never get it back. People also get freaked out when an explanation of benefits comes in and has all sorts of charges on it. It's marked "not a bill" but I've seen folks lose their minds thinking it was something they had to pay. Especially happens with old people who are accustomed to paying their bills when they come in. Sometimes you'll get a medical bill which has already been paid by insurance in the amount agreed in the contract between them, but they throw a bill at the patient and hope that they make up the difference out of ignorance. Again the elderly get taken this way entirely too often.

 

Yep, good advice. I have sleep apnea, and get C-Pap machine supplies from Apria. There’s no charge as long as I use the machine for four hours a night for 70 percent of the supplies.

I just got a bill from Apria for $140-something for supplies. The date on the bill was four days after the date of service for the supplies and I got the bill in the mail two weeks after the bill was generated,

Four days is no time at all for a provider to send a claim to the insurance, the insurance to do the claim and issue the Explanation of Benefits. I looked at my insurance online and the statement hasn’t officially been generated yet, but the claim showed that I owed nothing. Needless to say, I ain’t paying.

 

I don’t go to the doctor anymore because I can’t afford it.

 

Which is all well and good till you gotta. I'd also refer you to Warren Zevon's last appearance on Letterman. I know you're talking money, but -

"I might have made a tactical error not going to a physician for twenty years. It was one of those phobias that didn't pay off." ~ Zevon

 

I actually went to the doctor today. I started feeling poorly Saturday evening. Sunday I felt like I had a bobcat in my chest and corks stuck up my nose. I slept most of the day (and drank a pint of whiskey). This morning I wasn't any better off and called to get seen. Before I left work, more than one person asked if I was OK because I didn't look good. I got some sort of shot in the butt - hurt like hell - but am on the mend.
Multiple younger people I work with are also sick. "Hack. Hack. Cough. Cough. I'll be better in a week or 10 days."
Been there, done that. I'm too old for that John Wayne shit. There is no glory in being sick.