department zed | ramblings from the great white north

A while ago, I wrote a post about SCHIP and Health Insurance. This was a general reaction to something Paul Krugman wrote, whom I respect and admire—but whose information (like pretty much everything else out there) I don’t take for granted.

Let me tell you a story.

In the previous post, I mentioned that I finally took employment with my company (SitePen) partially because of the idea of benefits, the main one of which was health insurance. Now, I make a pretty good salary (and thank you again, SitePen) and so if I’d wanted to go with a private plan, outside of my employer, I probably could (unlike the majority of the people out there). But since part of the way America provides health care is via an employer, I don’t.

I should also mention at this point that I’m pretty healthy (regardless of what I do to myself), and rarely go to a doctor. In fact, I can’t stand the idea most of the time—mostly because every time I do, it results in a lot of headaches, paperwork, and general bullshit. So…back to the story.

About a year and a half ago, I decided that since I hadn’t been to a doctor since 2004 or so, I should probably go and at least get a physical. Our insurance is provided by The Principal, and if you hit that link you’ll see that they provide “a number of different services”, including 401K plans.

First thing to notice: the full name is “The Principal Financial Group“. Remember that. The insurance plan provided to our company (full of JavaScript gurus) is a financial group.

(Disclaimer here: this is not through bad decisions on the part of SitePen. When I first started, we were with Blue Cross/Blue Shield, who (through their “largess”) had a tendency to raise the rates on their group plans somewhere around 33% a year. 33%. Think about that for a minute, and then move on to the rest of the post.)

OK, so…having not seen a doctor in 5 years or so, I decided that now was a pretty good time (last summer, actually). So, being the good industrious person I am, I hit the Principal web site looking for an office which was part of their “network”. I made sure (looking closely at the insurance card provided) that I was looking in the right group, made very careful choices in their search, and found an office within walking distance that I thought I could trust.

So I made an appointment.

Said office was very helpful, very efficient, and had me in within a week. The nurse they set me up with (and wtf was up with that? I’m there for a physical; why am I being set up with a nurse—as nice and as efficient as she was—as opposed to someone with an actual M.D.?) was great. She did everything she needed, made some recommendations, and assured me that I’m not dying of cancer (or something else similar).

While I was there, I casually asked about what was available for helping me stop smoking; she gave some advice and prescribed the most common drug today (I won’t get into that, suffice it to say that the drug’s side effects were much worse than actually smoking, and I’m still dealing with some of those today).

Great. America’s health care in action, and since I’m one of the lucky ones, all is good.

Or so it seemed.

Fast forward to three months later. I get a bill for close to $400 for my visit to the nurse—something like $240 for the physical itself, and the rest for “consult on tobacco cessation services”. My first reaction was “are you kidding me? $240 for a fucking physical???”…second reaction was “wait a minute. Asking about quitting smoking was about a 3 minute conversation. $160 for a 3 minute conversation??? Plus the $140 or so for the drug that entirely fucked me up for a couple of months, which I had to stop for fear of committing suicide? Are you serious?”

What I found out was that the Principal (see link above, not doing it again) had decided that said office was “out of network” and therefore was not liable for any of the fees charged. Even though I’d found said office through a careful search via their own website.

Several calls and complaints to both the office in question and the Principal resulted in a lot of “um, I don’t know you’ll need to call X” and a lot of other bullshit that most of you reading this is probably very familiar with. In the end, I paid the bill and said fuck it—against the wishes of the people around me.

Let me remind you all again: this was all over a fucking 10 minute physical.

How many of you can either relate or top that experience? I bet you it’s a lot of you…and god forbid you have children.

…now, I don’t begrudge most of the medical staff a salary. They worked just as hard (if not harder) for their education than I did, and they have the disagreeable task of making a diagnosis that affects lives in a very succinct way. But like me and a lot of the people I work with, I’d guess that they don’t really know, in the entirety, what is being charged in their name; I’d imagine that their thought process works something like this:

• Why is this person here?
• Ok, we’ll check.
• Oh, there’s additional questions outside of the normal “why is this person here” routine?
• Ok, answered and duly noted.
• Have a nice day! Maybe you should hit our lab and get that cholesterol test too.

Actual fees involved? Likely to be at least aware but without knowing details.

Deep breath.

So why am I ranting? I think you, gentle reader, know the answer to this question but I’ll say it anyways: because a lot of interests in this country want you to think this a good thing. To which I say: really? Strangling our businesses with double-digit rate increases per year, and then fucking over people anyways is a good thing? Really?

To those participating in the current lobbyist strategy of shouting down anyone with half-a-brain, I say to you: shut the fuck up. The current situation is untenable. General Motors, in many ways, went down because of prohibitive health care costs. This is a problem that needs to be addressed now.

(And don’t get me started on whoever is paying people on Medicare to say “keep your government hands off my Medicare”. The irony there is ridiculous in so many ways.)