Friday, August 21, 2009

Insurance Hell Update

Good news! Regence has evaluated R.'s
"special circumstances" and determined that they
were indeed special, and will pay what they are
required to pay. This is a good thing.
But I shouldn't have had to pursue this.
And why someone should be required to have
a referral for an emergency hospitalization
defies logic.

And consider the following:
The total bill (for 2 days) was $35k.
Because R. has insurance, the bill was knocked
down to $18k. Aha! A bonus from the generous
insurance industry and/or hospital!
Goodie! Woo Hoo! Feelin' lucky!

But my question is: what is the actual cost?
If R. wasn't insured, would his actual cost be $35k?
But because he is insured, it actually only cost $18k?
Huh? Is what I am buying when I buy insurance,
in effect, a discount program?

Don't get me wrong -- I don't object to paying for
insurance. I just want to get what I've paid for.
When I go into a deli and order and pay for a pound
of salami, I can reasonably expect a pound of salami
to be in my bag when I walk out of the store.
When I pay my monthly insurance premium
(waaaaaay more costly per pound than salami!),
I expect to get in return what I have purchased,
what the company very clearly presents in their
myriad graphs and charts.

I know, this is not a new argument. It's one we're all
sick to death of. I admit to having been in a bit of a
la-la state these past seven weeks, with no television
and no American news headlines glaring at me
everywhere I turn. So it's been somewhat of an adjustment
to come back home to the raging health-care debate
AND my own personal health insurance hell.
(And since R. is still recovering, and not working,
Mom is paying the bills.)

Paying for medical insurance is a little like buying
a lottery ticket -- if you're really lucky, you'll get
that million-dollar payout. If you're like the rest
of us Americans, you're going to have to make do
with that $2 return on your investment.


  1. This comment has been removed by a blog administrator.

  2. I think it's a similar scam as all the supermarkets use now. If you agree to give them all your personal info so they can do market research on you, then you get "discounts," whereas for everyone else the prices are half again as much. So, what's the "real" price of the food? Clearly even the "low" price I pay for milk guarantees a healthy profit for the store, so that means everyone else is REALLY getting ripped off.
    If I (or my employer)pays $100K to the insurance company over several years, that doesn't entitle me to that much payment if my medicals bills were to hit that level, nor does it even guarantee me a "discount" -- but even more woe be to the "under-insured"!
    How do insurers sleep at night? (On feather beds, probably.)

  3. Blogalot -- it's insidious, isn't it? And because R. has a "catastrophic" plan, his plan is not "portable", meaning that if he changes to another plan (ie, one that has rx coverage), he has to wait 9 months for coverage of any kind on any pre-existing condition. The "catastrophic" plans are the "affordable" plans, meaning, once again, those who can't afford boutique insurance plans are screwed.'s a wonderful life, isn't it?

  4. I'm glad to see that you're safely homw from Ireland and I'm so sorry that you've come home to insurance woes.

    It's maddening that just because one pays for coverage- you get a 'discount'. I, too, have wondered why and am glad that, right now and with my high premiums, I get the discount. But, I remember years without insurance when I paid the full amount and had no other recourse. A very bad and mixed up system. I'm trying to hang on to any hope that I can find that we will make progress in health care this year. But, some days, it's hard to find any glimmr of hope.