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In Which I Remember to Hate Our Health Care System
We had a number of people from Asia and Europe at Rebooting the Web of Trust, and they seem pretty universally aghast at our "health care" system here in the United States. One asked what I paid for healthcare, and I explained that I had recently switched plans to drop my premium from $800 to $500. A month!?, he goggled. He said, so a family with a child would have paid $2400!? No, I said, the premiums would probably be cheaper for the child.
I didn't hear the specifics of a few other peoples' complaints, but they're pretty obvious.
For-profit health insurance is a travesty. Not treating healthcare as a basic human right is an aberration. ObamaCare definitely made things better, because it guaranteed coverage, because it removed life-time limits, because it outlawed yearly plans and other scams (where you weren't covered for problems from previous years), and because it limited profits. But if you're not working at a company large enough (and moral enough) to afford healthcare for its employee, you're probably hanging on by your fingernails.
If you think I'm complaining about my travails with Kaiser and my kidney stone right now, I'm not. I did have stress in getting ahold of some folks to make appointments, when I was out of town. And the almost three-week wait for an ultrasound was totally unacceptable. If Kaiser screwed up the appointment for my ESWL this Friday, I'm going to be more than furious.
But without minimizing those problems, and without condoning them, I also have to say they're just the sort of thing that happens in bureaucracies. The three-week wait for ultrasounds is the only one where I feel like there's a notable structural problem that should be resolved — but it's a very distinct issue at Kaiser, different from x-rays (20 to 45 minute wait) or CT scans (1 day wait).
(I've be able to compare and contrast scheduling for the whole set in the last few weeks, though the CT scan was actually without contrast.)
And there's a lot that Kaiser does right. When I had my night of kidney stone pain, I was able to get in to see my doctor almost immediately. I ended up making my final appointment in the middle of the night with about 8 hours lead time. I never even had to make an appointment with a urologist: she just called me. Similarly, when we agreed to the ESWL they called me to (hopefully) schedule. Even beyond not having to worry about American stupidity like referrals, Kaiser does a lot of things efficiently, with minimal pain for the patients.
No, instead I'm complaining about Kimberly's insurance today. She has literally been fighting with our local hospital Alta Bates (and our insurance companies) for more than four months over an inaccurate bill.
The stupidest thing is that it's for hospital care where only the very first segment of care has been unpaid. No problem with the identical rest of it, but that first segment got misbilled or incorrectly declined or who knows what and so Alta Bates keeps trying to come after us for the $2,000. Even though our insurance company says that Alta Bates is violating the terms of their contract with said large insurance company by doing so.
So in February, Kimberly finally got her insurance company's grievance folks involved after (literally) 30-40 calls to various folks, starting way back on November 1. They contacted Alta Bates and got them to agree to resubmit the bills. They then sent Kimberly a letter telling her it was in process and to definitely not pay the bill.
Problem solved, yes?
No.
The ass****s at Alta Bates apparently decided to spit right in the eye of this whole grievance process and passed the bill off to a collection agency. Which means they've escalated from sending a fraudulent bill to threatening our credit rating. And there's a good chance that we're going buying new property in the next 2-4 years, after we move to Hawaii, and we may want a mortgage. So that's a borderline existential threat. It could cost us a mortgage or just a few hundred dollars every month due to worse interest rates. And it's based purely on the incompetence of Alta Bates (and/or the insurance companies, but they've at least claimed to be on our side and kept saying the right thing about us owing no money).
So today — after an exhausting five days of Rebooting the Web of Trust, before a Sunday of having to take our limping cat to the vet, before a busy next week of catch-up, medicals tests, and (if I'm a very good boy) a painful but hopefully helpful medical procedure — I got to spend my entire afternoon working with Kimberly to write an official letter to these debt collectors saying their debt was invalid, finding all the people to Cc: it to, and also taking the next step, of filing a complaint with the California Department of Managed Healthcare.
We made sure the letter was very sharp, we made it obvious that we believed that Alta Bates was acting very badly and that we had precise documents of the last three and a half months, and we suggested that Alta Bates might be incurring liability through their actions.
Fun times.
Also, this is not the first time that Alta Bates has screwed with us like this. I got a couple of CT scans two years ago, when we originally spotted my well-loved kidney stone. Alta Bates tried to bill me a few thousand dollars for the second, and it turned out to be because they'd never correctly sent the data about the test to my insurance company, and then ignored the requests for it. I also vaguely recall a $5,000 or so bill that Alta Bates incorrectly sent us 12 or so years ago, but at least that time Kimberly didn't get the run around to a half-dozen different people.
A more cynical person might say that Alta Bates collecting unwarranted debts from patients is a feature, not a bug.
I didn't hear the specifics of a few other peoples' complaints, but they're pretty obvious.
For-profit health insurance is a travesty. Not treating healthcare as a basic human right is an aberration. ObamaCare definitely made things better, because it guaranteed coverage, because it removed life-time limits, because it outlawed yearly plans and other scams (where you weren't covered for problems from previous years), and because it limited profits. But if you're not working at a company large enough (and moral enough) to afford healthcare for its employee, you're probably hanging on by your fingernails.
If you think I'm complaining about my travails with Kaiser and my kidney stone right now, I'm not. I did have stress in getting ahold of some folks to make appointments, when I was out of town. And the almost three-week wait for an ultrasound was totally unacceptable. If Kaiser screwed up the appointment for my ESWL this Friday, I'm going to be more than furious.
But without minimizing those problems, and without condoning them, I also have to say they're just the sort of thing that happens in bureaucracies. The three-week wait for ultrasounds is the only one where I feel like there's a notable structural problem that should be resolved — but it's a very distinct issue at Kaiser, different from x-rays (20 to 45 minute wait) or CT scans (1 day wait).
(I've be able to compare and contrast scheduling for the whole set in the last few weeks, though the CT scan was actually without contrast.)
And there's a lot that Kaiser does right. When I had my night of kidney stone pain, I was able to get in to see my doctor almost immediately. I ended up making my final appointment in the middle of the night with about 8 hours lead time. I never even had to make an appointment with a urologist: she just called me. Similarly, when we agreed to the ESWL they called me to (hopefully) schedule. Even beyond not having to worry about American stupidity like referrals, Kaiser does a lot of things efficiently, with minimal pain for the patients.
No, instead I'm complaining about Kimberly's insurance today. She has literally been fighting with our local hospital Alta Bates (and our insurance companies) for more than four months over an inaccurate bill.
The stupidest thing is that it's for hospital care where only the very first segment of care has been unpaid. No problem with the identical rest of it, but that first segment got misbilled or incorrectly declined or who knows what and so Alta Bates keeps trying to come after us for the $2,000. Even though our insurance company says that Alta Bates is violating the terms of their contract with said large insurance company by doing so.
So in February, Kimberly finally got her insurance company's grievance folks involved after (literally) 30-40 calls to various folks, starting way back on November 1. They contacted Alta Bates and got them to agree to resubmit the bills. They then sent Kimberly a letter telling her it was in process and to definitely not pay the bill.
Problem solved, yes?
No.
The ass****s at Alta Bates apparently decided to spit right in the eye of this whole grievance process and passed the bill off to a collection agency. Which means they've escalated from sending a fraudulent bill to threatening our credit rating. And there's a good chance that we're going buying new property in the next 2-4 years, after we move to Hawaii, and we may want a mortgage. So that's a borderline existential threat. It could cost us a mortgage or just a few hundred dollars every month due to worse interest rates. And it's based purely on the incompetence of Alta Bates (and/or the insurance companies, but they've at least claimed to be on our side and kept saying the right thing about us owing no money).
So today — after an exhausting five days of Rebooting the Web of Trust, before a Sunday of having to take our limping cat to the vet, before a busy next week of catch-up, medicals tests, and (if I'm a very good boy) a painful but hopefully helpful medical procedure — I got to spend my entire afternoon working with Kimberly to write an official letter to these debt collectors saying their debt was invalid, finding all the people to Cc: it to, and also taking the next step, of filing a complaint with the California Department of Managed Healthcare.
We made sure the letter was very sharp, we made it obvious that we believed that Alta Bates was acting very badly and that we had precise documents of the last three and a half months, and we suggested that Alta Bates might be incurring liability through their actions.
Fun times.
Also, this is not the first time that Alta Bates has screwed with us like this. I got a couple of CT scans two years ago, when we originally spotted my well-loved kidney stone. Alta Bates tried to bill me a few thousand dollars for the second, and it turned out to be because they'd never correctly sent the data about the test to my insurance company, and then ignored the requests for it. I also vaguely recall a $5,000 or so bill that Alta Bates incorrectly sent us 12 or so years ago, but at least that time Kimberly didn't get the run around to a half-dozen different people.
A more cynical person might say that Alta Bates collecting unwarranted debts from patients is a feature, not a bug.
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