Monday, August 16, 2010

Healthcare is Broken

Someone needs to call 911 because our healthcare system is definitely in a state of emergency. Although I feel I am somewhat intelligent and I know that healthcare costs have been rising for the last several years, it's not until it has directly affected my family that I have found out just how truly screwed up our healthcare system is. And a quick memo to all of you who think that Obamacare is the answer: it most certainly is not. It is the anti-answer. And yes, I made that word up.

This is a long story that I will try to make short by using bullet points as the highlights:

- Kate is now 10 months old and has had her left eardrum burst three times and her right eardrum burst twice. Needless to say, she has some ear problems and thinks that the cold pink stuff is a yummy snack to accompany all meals. She has had at least eight ear infections that we know of.

- Kate was seen by an otolaryngologist (I did not make that one up) and we were advised to have tubes put in her ears.

- Because of the rising costs of my previous healthcare policy, I have an individual policy through Blue Cross with a high deductible, not astronomical, but not $250. Before taking Kate to the ENT, we hadn't touched that deductible.

- We scheduled the relatively minor procedure for Kate with the doctor and were told we would be going to Phoenix Children's Hospital. It took them a little over a month to fit us in.

- Two days before the procedure, I was called by the pre-registration experts at PCH and told that I would have to PRE-PAY for the procedure because we hadn't met the deductible. Grand total $1,973. Ten minute procedure - two grand. Two days before the procedure. I wouldn't have been all that bothered by this except for what I learned next:

- Uninsured patients have a cash payment option for the EXACT SAME PROCEDURE - $1,020. Upon learning this, I said, "I'll take that option". I was informed it was unavailable for me because I am insured. Let me repeat, I was unable to have the cheaper cash payment option BECAUSE I HAVE INSURANCE. They are required by contract to bill my insurance company. I was floored. I thought it must have been a mistake.

- Anyone who knows me knows that if I think I am right, you are just not going to win an argument with me. I simply will not let it happen. I will talk to whoever it takes, whether it be insurance company management (his name was Vincent), or PCH Registration management (a tool named Linda) the surgical scheduler (Amanda) or the Financial Management Director at PCH (Irma) until I get the right answer.

- For three days, I could not get anybody to give me the answer to this question: "How is it rational that I pay double the cost that an UNINSURED patient pays FOR THE EXACT SAME PROCEDURE????" I must have asked that question 500 times. The answer I got most frequently was: "I don't have a good answer for that. It's just our policy."

- Kate had the procedure, she is a completely different baby now that she can actually hear and Michelle and I are very grateful parents. PCH was an unbelievable facility and the nurses and staff could not have been nicer or more professional.

The point is, I finally did win my argument. Irma, the aforementioned financial director at PCH who was the only professional who I felt was on my side, agreed to bill my insurance and then adjust the amount down to the cash payment option of $1,020. However, I have spent the better part of four days on the phone arguing, name-calling, fighting, complaining and pleading with complete strangers who seem to have more control over my daughter's healthcare than I do. It was the single most frustrating experience that I can remember.

Healthcare is broken. It was broken before Obama took office and it is still broken after Obamacare, probably even more so.

Tuesday, August 10, 2010

The Good Samaritan

There is nothing worse than losing stuff that's important and hard to replace, like your wallet. I lost my wallet at a Diamondbacks game a few years ago - I prefer to say it was stolen just to make myself feel less irresponsible, but that's probably not the case. It was an awful experience, new credit cards, new driver's license, insurance cards, temple recommend and most importantly, my various collections of frequent dining cards. You would think that I would be worried about losing my cash, but I don't ever have any, so it's never a problem.

With that in mind, fast forward two years to yesterday afternoon. I had just finished my Monday afternoon ritual of working out at the gym and getting the kids out of the childcare while Michelle teaches her Monday night muscle and bootcamp classes. I was carrying Kate and holding the keys to the car, my wallet and an empty bottle that Kate had just finished and trying to make sure that my other three kids didn't get hit by a car in the parking lot. Needless to say, my hands were full.

We got to the car and I unlocked the door using the actual key and not a remote because I didn't have one, and I put the bottle and my wallet and the keys on top of the car so I could strap Kate into her carseat. For a split second, I remember thinking to myself, "don't leave that bottle on top of the car, Michelle would be so mad at you." Really? Anyway, because it was 150 degrees inside the car, it took a little longer than normal to get Kate strapped in. I grabbed the bottle, smiling to myself thinking, "You are such a good husband and what a wonderful memory you have", and I got in the car and drove home.

We had been home for about 20 minutes when there was a knock on our front door. I opened the door to find a man who I had never seen before but who I won't soon forget. He didn't say much except that he found my wallet in the middle of the street and found my address from my driver's license. He also said that he didn't know how many credit cards I had but that he hoped he had found them all. Apparently, he spent some time in the street searching for my cards and putting them all back in my wallet before bringing it to my doorstep. Most surprisingly, all $68 that were in my wallet before I left it on the roof of my car were still in my wallet.

He didn't leave his name, he wouldn't let me give him any money (believe me, I tried) and he was very quiet and unassuming. All he said as he left was, "I have lost a wallet before, and I would have loved if someone would have brought it back to me with everything still in it." I wish I knew his name and address so I could do something for him.

In a world that is becoming more and more depressing as the days go by and where there is a severe shortage of good, honest people, it was refreshing to be reminded that there are still some good people out there. Of all the people that could have driven by after my wallet fell off my car, I certainly am grateful that it was that particular man who decided to be a good samaritan. I hope somebody does something real nice for him today.