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Fri May 13, 2016, 10:04 AM

My unintended experiance with being "uninsured"

My wife and I both came down with what her doctor diagnosed as bronchitis. No problem: her Cadillac health care plan after 28 years with the CIA covered everything for her. I'm on VA health care and because I used to get bronchitis almost every year and because neither of us could take the 50 mile drive to my primary care physician in Austin or 80 miles to Temple Medical center I decided to hunker down: rest, push fluids and shelter in place.

That was Monday.

Thursday, neither of us were any better and were decidedly worse, in fact.

I called VA to get authorization to use the local hospital emergency room.

At Scott and White I got incredibly good and quick service. Second only to the care I get at VA.

What I had was type B influenza. You know, the one not covered by this flu season's inoculation.

What I also got was $250+ in prescriptions and a bill I haven't seen yet that I am confident will be more than a $1000.

This is the sort of thing that will make some people miss rent, a car payment, a weeks work, lose a job, become homeless. We've all heard that the average American is four or so paychecks from the streets.

The biggest thing I learned? We need single-payer now more than ever. ACA was a good start, lets get to the next logical and better step. Oh, and regulating the vampire pharmaceutical industry is a necessity, also. For the price of the codeine cough syrup alone I could have bought a good bindle of smack on the street. Something is very wrong.

Meanwhile: back to my sick bed.

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Response to marble falls (Original post)

Fri May 13, 2016, 10:10 AM

1. Thank you for telling the story. We need single-payer now, no doubt.

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Response to marble falls (Original post)

Fri May 13, 2016, 10:40 AM

2. Get well soon, marble falls.

I agree about single payer too.

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Response to marble falls (Original post)

Fri May 13, 2016, 12:20 PM

3. My supplemental insurance feels like a shell game.

The coverage changes each year and if I don't pay attention I could wind up paying hundreds of extra dollars because last year's plan isn't the same as this year's. It's ridiculous.
Thanks for the post.

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Response to marble falls (Original post)

Fri May 13, 2016, 12:22 PM

4. I hope you feel better soon

Don't mess with the flu! Get better.

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Response to marble falls (Original post)

Fri May 13, 2016, 01:08 PM

5. Single payer? But that will hurt the very rich! We can't have that in an oligarchy!



Hope you get better. Single payer NOW!

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Response to marble falls (Original post)

Fri May 13, 2016, 08:44 PM

6. $1000- I bet it is at least

 

5 times higher than that. Ten years ago I got a nasty cut on a finger. I got four stitches, they bandaged it (didn't send me home with extra material), and a tetanus shot. I paid $50 copay (ER copay now 200), and they billed my insurance company $5k. Medical billing in this country is out of control.

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Response to marble falls (Original post)

Fri May 13, 2016, 08:52 PM

7. Sp will have to be a step AWAY from the ACA.

 

The ACA probably set healthcare back by a generation or so. Especially since Mrs Clinton has made "No single payer healthcare in the US, ever" part of her campaign. But calling Obamacare a good first step is denying the problem we have

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Response to Doctor_J (Reply #7)

Fri May 13, 2016, 09:02 PM

8. As long as we move away from ACA, I'm willing to pretend it was a good program. The compromises...

made to get it into law screwed it up.

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Response to marble falls (Original post)

Fri May 13, 2016, 09:17 PM

9. Here's the secret.

 

We poor...when we're uninsured, we simply don't pay. We know the cost is bullshit and that it's inflated as a 'game' between the insurance companies and the hospital companies. Well, when two people are playing a game at your expense there's only one possible alternative: DON'T PLAY.

And we don't.

If having insurance changed that, it might be worth pursuing. It doesn't (because the costs never go down to a reasonable amount, they only pick up from where the theft has already occurred), so it isn't. Eventually they will go out of business, but that's kind of the intent anyway. It will be unfortunate, but no one felt it was important enough to actually bother fixing instead of just slapping a few bandages on (okay, so the reality is that they knew it was important, and that's WHY they didn't fix it, but let's pretend our government actually works for us).

Only the wealthy are to be allowed medical care. We're just in the transitory period now. Heck, they even try to scare people off by posting police in a permanent desk in some waiting rooms now.

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Response to Shandris (Reply #9)

Fri May 13, 2016, 09:19 PM

10. Its a good point: when more money becomes available to pay the debt, the prices go up....

The cop in the ER certainly put me off, too.

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Response to marble falls (Original post)

Fri May 13, 2016, 09:38 PM

11. I hope you are feeling better soon.

I just had a similar situation but mine was pneumonia and I was able to go to an urgent care place in my insurance network. As I recall the codeine syrup was pretty cheap. But I'm on a high deductible plan so will be paying the bills out of my HSA.

Still ... it sounds like your bills are much higher, and I think they would be if you went to an emergency room. In case it happens again, you may want to locate the nearest urgent care center. If VA was willing to authorize an emergency room visit they should have no problem with urgent care. It's a heckuva lot cheaper. In my case it was better than the emergency room would have been, too.

But all that aside, what is important now is that you both get better!

And you are right about single payer, of course.

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Response to MH1 (Reply #11)

Fri May 13, 2016, 09:54 PM

13. I'm fortunate. Very fortunate. I am in one of the highest rated VA systems in the US and ...

Scott and White and Temple VA are partnered up. VA will pay my bills.

My primary care physician in Austin (also a very highly rated facility) has done all sorts of things for my health that my former cadillac plan might do if I had kept at them and if I could wait for my medical board to assess and weigh my needs, in days on her authority. Thank g*d for my Muslim woman doctor. She's ALWAYS returns my calls, usually personally and and always in a day.

VA because of its size would be a very good model for a national health care system. But single payer with a private hospital component as in France would be very good, too.

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Response to marble falls (Original post)

Fri May 13, 2016, 09:52 PM

12. My husband who is in stage 4 liver failure

had to have ER care 6 months ago for fluid in his lungs. I was out for a business conference when he called and told me that his PCP ordered him to go to the nearest ER.

He went to the closest hospital which was St. David's south. He was cared for in the ER and later admitted for three days to deal with his issue.

One month later I received a bill in the mail for 23,000.00 because his insurance didn't cover at St. Davids. He needed to go to a Seton facility.

I am still fighting this bill! I do not have 23,000.00 to just hand over! It's ridiculous! He has an Insurance Plan that we pay a pretty penny for every month!

He is on the liver transplant list and the only place that his insurance covers ( and the only place close to Austin ) is In San Antonio. We have to travel 75 miles each way for him to get his care. It's been a nightmare!

Single payer!!! Now!!!

On Edit: I hope you get to feeling better soon!

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Response to Texasgal (Reply #12)

Fri May 13, 2016, 09:59 PM

14. What a nightmare. I bet they were very calm and so sorry about your "misunderstanding"....

I had a similar experience Humana in Phoenix in '85. They told me to go the emergency room and then refused to pay for it. My bill was only for around $2,000.

My prayers are with your husband and you.

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Response to marble falls (Reply #14)

Fri May 13, 2016, 10:16 PM

15. Thank you..

It's been a huge back and forth issue between Humana and St. Davids. My issue is that when you need emergency care how the hell are you supposed to know where to go?

I refuse to pay this bill. It's currently in collections and our credit is being dinged every month. I do not care. Humana should pay this bill or part of it period. I will NOT work out a payment plan until the insurance company pays up. I can negotiate the rest. Until then they can BITE ME!

Along with all the other health issues we are dealing with this is the last damn thing I need. I stopped answering the phone last month...only unless we get the "the call" for an organ and believe me we are desperate right now.

Thank you for your thoughts and kindness. I hope Marble Falls and surrounding areas get more medical facilities as well! Seriuosly How awful is that that you have to travel that far for the flu? ARG!!!

Please take care, and get well!

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Response to Texasgal (Reply #15)

Fri May 13, 2016, 10:40 PM

16. I have one more Humana story for you:

My daughter was a high risk birth, but Humana made my wife stay in their ER for several hours until the nurse finally realized my daughter's heart beat was starting to fail: my wife would not efface.


That birth was $10,000 in '86. My share was around $3,000 because she was born at Dessert Samaritan where they were VERY skilled at this kind of situation.

When I went to pay it with a check the billing was for two patients: my wife and Emily. Say $1500 each.

A month later someone from dessert Sam called and asked about my delinquent account. When she heard my side of it she saw on her computer that the $3000 was applied to my wife with a $1500 credit and a $1500 debit for Emily. She said no problem and said she could fix it easily.

Next month and for four more months months, same thing, still very polite.

Finally I get the nasty call from a truly committed jerk using words like 'deadbeat', 'liar', 'jail', 'police' .... When he finally shut up I asked to speak to his manager as I had taped the whole conversation when it got ugly.

He thought he had put me on hold when he actually put me on conference and I heard him tell the operator what an "asshole" I was and she should let me hang on hold forever. I told him that I may be an asshole but that I at least knew how to use a phone system and that he had no redeeming qualities whatsoever. The operator had his manager on line in record time and he fixed their mistake finally, saying he was going to do something about his collector.

I know my problems are pittances next to what you're going through, but I hope there's at least a chuckle in it for you.

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Response to marble falls (Reply #16)

Fri May 13, 2016, 11:07 PM

17. LOL!

Goodness! That's nuts!

I just decided that I was not going to deal with this injustice. We have about 50,000.00 in medical dept since this has all started. I have no more blood in my turnip!

You asshole!

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