Medical Bills - How to Deal With

I've no special expertise, but this is how I have dealt with them lately.

1. Wait at least two months for all the bills and insurance statements to come through. (Generally there's no penalty so long as you pay within 90 days, but check and make sure.)

2. Take the time to figure out, as much as you can, exactly what the bills and statements say. This can be nearly impossible.

   All the people you will talk to are reasonable people trying to do their jobs to the best of their ability. Treat them well. Their job is confusing and difficult and you need their help. Document all conversations including the name of each person you contact and the time of the call. Remember that they are doing their best but their job is to maximize payment to the hospital or minimize expenses for the insurer.

3. Call the hospital and confirm that you understand what the bills say.

4. Call the insurance company and confirm that you understand what they are willing to pay.

5. Study your insurance plan documents. Keep in mind that the summary which you may have is not an official document. You may have to get the original. You will probably have to contact the insurance company to get clarification. Their interpretation will favor them as much as possible, but it isn't necessarily correct.

6. If it makes sense at this point, go ahead and pay the remainder. If it doesn't make sense, get on the phone again and ask them to explain. Be respectful and as nice as you can, but be insistent. Don't get put in the position of relaying information from the provider to the insurance company. Insist that they contact each other. Provide the names of the people you have talked to so they can talk to the same people. If the people you talk to aren't forthcoming or reasonable, ask to speak to their supervisors.

7. If it makes sense now, pay the remainder. If it doesn't make sense, go to the person who negotiated the policy with the insurance company. That will usually be the benefits person at your employer or the person who sold you the policy. Ask for their help in understanding the situation and ask them to advocate for you with their contacts. Be nice but insistent all the way through the process. Document everything.

I've had to do this twice in the last year. It took a lot of my time and frustration and it took a lot of their time and frustration, but I got a reasonable solution each time. (Actually one is still in process, but I think it will be solved.)

(No political message here, but keep in mind that in most other modern countries none of this is necessary.)

Health Care Reform # 8

I watched Barrack Obama’s speech to the joint session of congress while eating dinner last night. I purposely haven’t read any commentary yet. I wasn’t optimistic about the speech, but I had hope. Here are my thoughts:


He is starting from a position where he has already compromised on critical issues. He’s proposing a regulated private system with public funding for the poorest. He is being accused of communism. Since he is already demonized, he may as well take the step to a government funded capitalist system like the rest of the world.

I think I heard him say that a single-payer system is a government controlled health care system. If that’s what he said, he’s wrong. It is a taxpayer funded capitalist system. He says that we must support the health insurance and the pharmaceutical industries which have served us so poorly. If we want savings and improved outcomes, we have to make a difficult transition. We may as well do it now.

As I listened, I didn’t hear anything about the public option until near the end. He seemed to describe it as no different from the health co-ops which have been discussed. His public option seems to be available only to those who could not otherwise afford insurance. This seems to guarantee that no one would choose it voluntarily. It also makes it impossible for the public option to become the dominant health plan. That should mollify the critics, but probably won’t. I think it makes it a failure over all.

He didn’t do anything to contradict the stories about his deals with the pharmaceutical industry or hospitals.

He teased Republicans about malpractice law. He got them excited. Then he showed that he wasn't serious. Think how betrayed the Republican’s felt after sitting there applauding his idea. Of course abuse of the legal system is not a major part of the problem, but it is part of the problem. Why not compromise here. At least establish standards of care and caps on pain and suffering.

I didn’t hear anything he said that would really decrease costs. He’s adding layers.

I don’t like the idea of punishing people for failing to buy insurance. We should have a system which provides for all instead of a system which punishes people for trying to manage without government involvement. I respect people like that. That is going to anger and mobilize many people – for good reason.


Most importantly, he had no specific plan to offer. The current hodgepodge of messy bills still exists. There is no one plan which can be explained and defended. I can’t believe he doesn’t see this.


Good things:

He made it clear that insurance companies had to be reasonable.

He did refer to some statements as lies, but he didn’t get specific. He addressed death panels, cuts to Medicare and illegal immigrants.

He made clear that Medicare, Social Security, and Medicaid were all seen as disasters for the country and they weren’t. In fact, we are dependent on them.


I’ll work for this, but he’s fighting for a small thing. We have to fight as hard as if he were trying to accomplish a big thing.

Health Care reform - # 7

Another letter to the President:

Mr. President,

I can't believe you are screwing up health care reform. You are too honorable for this. You are too wise for this. You're greatest strength is your ability to look at a problem from many sides and at many levels. You're a smart guy.

You've got to step back and take a fresh look at health care reform.

If you don't know how, try this: http://schreiberbike.blogspot.com/2009/07/health-care-reform.html. I sent it to you earlier, but clearly you didn't take it seriously. Nor are you taking your supporters seriously. We voted for change, not for the appearance of change.

If you can’t do better than this, hope fades.

Sincerely,

John Schreiber

cc blog

I'm getting frustrated. I want so bad to believe.

Health Care Reform # 6

From: Joe from Philly a.k.a. Joe the Nerd a.k.a. Joe Ferraro
To: The President in a call in radio show

I'm getting a little ticked off that it feels like the knees are buckling a little bit. We have overwhelming majorities in both the House and the Senate. And we own the whole shooting match. And I'm just not getting - it's very frustrating to watch you try and compromise with a lot of these people who aren't willing to compromise with.

Joe says he was satisfied with the answer. I have been a strong supporter of Obama since the Iowa primary; I’m not satisfied.

I think Obama is throwing this away. Why is he doing that? In order, from least to most likely:

1. He’s a fraud

• He doesn’t really believe this stuff, but it got him to be President and that’s what counts.
• Not impossible, but I can’t stand to think it.

2. He’s overwhelmed

• The fight and the issue and the politics are complex and he can’t adapt proactively.
  
• This is what it looks like, but I don't think it can be true. Thinking at many levels at the same time is his strength. He proved this during the campaign.

3. He’s threatened

• My most paranoid side says that he has been told by some person in a position of total trust that awful things will happen to his family or to other innocent people if he threatens corporate interests.
• Like I said, it’s paranoid, but sometimes you can’t be paranoid enough.

4. He believes that creating a new kind of politics is more important than actually achieving any one goal.

• The political/ideological environment in the USA is toxic. People are shouting and playing for points rather than talking to each other and solving problems. The influence of money has made democracy a cover for plutocracy.
• Barack Obama wants to change that.
• Perhaps he believes that compromise on principle and accommodation to those who are dedicated to his destruction is the best approach.
• I think instead that non-violent struggle lead from the bully pulpit would be the best approach. Organization, moral persuasion, mass action and negotiation from a position of strength are tools which he knows. He can persuade us to recognize dignity in us all and demonstrate the best of progressive values. That would lead to a change in the public environment.
• Health care (and other) reform would be a natural outgrowth.

5. He’s part of the system

• There are two sides of American politics: 1) a savage, “beat the peasants in submission” capitalist side and 2) a realistic “keep the peasants from seeing the need for revolution” capitalist side. Another way to put it is that there is just one political party in this country, the Republican Democratic Party of Money. He’s a member of the party.
• He was acceptable to the corporate media, ‘nuff said. This is realistic but sad.

6. He is hoodwinked by corporate interests

• He doesn’t trust his own judgment and he has given in to pressure from inside and outside the government.
• It seems clear that this is what happened in the finance crisis, so perhaps it’s happening here. He is to some degree part of the system, and if he is being overwhelmed by the pressures of the Presidency, then this may be what is happening. He may even be justifying his weakness and vacillation by telling himself that he is moving toward a new kind of politics.

At least # 4 puts a a kind of positive spin on this. I desperately hope he wants change and that he can get back up on his feet and lead the country.

Health care reform # 5

I just sent this off to the White House.

Office of the President:

I know it doesn’t work like this, but I just wrote a draft of a statement I’d like to see the President make. Please give this approach some consideration.

Statement begins:

I don’t like to tell you this, but the fact is; I can’t get a good health-care bill through the congress right now. The insurance companies and the pharmaceutical companies are pushing millions and millions of dollars into lobbying your senators and representatives. The people’s voice is not being heard in Washington. There are also those who legitimately disagree over the place of government. They don’t want a government which solves problems and serves the people.

I could work with congress and entrenched interests and have a measure passed and signed this year. But that measure would have so many compromises that it wouldn’t really solve the problem. I want to work with the Republicans in the House and Senate, but I’m disappointed to say that I can’t find enough Republicans who share my beliefs and there are too many who for political purposes are willing to sacrifice the public good because they want to bring me down.

I know from the people I talk to, and from reading the stories that are sent to me, and from studying the polls, that Americans want a health care system which provides for all Americans. I know that they want a system which controls the skyrocketing cost of our health-care system. They want a system that doesn’t fail them when they need it most. They want a system where illness does not bring financially secure families into bankruptcy. We want a healthcare system that we can be proud of – one where American rates of infant mortality and lifespan are as good as those of the rest of the industrialized world.

Here is the plan I put forward today. In a year and a half, we have midterm elections for the House and the Senate. There will be 35 seats up for grabs in the senate and the people will vote for all 435 seats in the house. I will campaign for some of those candidates.

By the end of 2009, I will announce and publish a clear and simple proposal for universal health care. It will be a smart plan. It will not be a confusing - conflicting - costly plan put together by the competing interests of corporations. It will be based on the best of American health care and the best of other countries around the world which have had universal health care for 30 – 40 – 50 years. If the people who support my plan are elected into office, then in two years we will pass real health care reform. This will be a national referendum on health care.

No plan will make everyone happy. Entrenched interests will oppose it. I know the fact that it will not be good for every industry. But it will be good for America. It will give America what it wants, what it deserves, what it needs.

End of statement.

I truly believe that this is what the President should do at this time. A single-payer plan or its equivalent is the only way to solve this problem.


Sincerely, John Schreiber

Copy to blog

As I said above, I know it doesn't really work like this, but maybe it could. At very least, it helped me think through my feelings.

Health Care Reform # 4

The President has a lot on his plate right now. I’d rather he take health care reform off the table and deal with it right in two years.

I’ve been reading about health care systems around the world and I’ve been reading about proposals being made to change health care in the USA. In my opinion, NONE of the proposals being advanced by those in power are worth fighting for. Here’s what I believe we need:

• Single payer or even a public option is not necessarily required. But for health care to work without it, insurance companies must become public utilities, simple administrators of a plan set by law. That appears to be the format in other countries which do not have single-payer plans.
  

• Primary care must be the emphasis. Most health care is simple and people can take care of it themselves. Most of what remains can be handled by a family practitioner. Expensive specialist treatment should be the exception not the rule. Reimbursement rates should match usefulness. That means more time communicating with patients and fewer expensive tests and high-tech images.
  

• Evidence based standards for health care should be established and practice guidelines recommended. There is no reason why 10% of pregnant women get cesarean sections in one town, but 45% get them in another. This would also set standards for testing. That eliminates unnecessary testing and testing performed merely to prevent lawsuits. Similarly if a doctor follows established guidelines, they should be protected from lawsuits.

• I’m willing to make medical school free so that doctors don’t have to start out with huge debits. Of course, I think that should be true for all higher education, but I’ll start with those who serve our health.

• Mental health, dental health, optical care, substance abuse treatment, and prescriptions should all be included in the plan.

• Fraud should be investigated aggressively and punished harshly. Stealing from the public damages the public trust out of proportion to the dollars stolen.

I don’t want to sound like a revolutionary who wants things to get worse instead of a little bit better. But all the “serious” proposals being advanced support entrenched “traditional” interests which sap the current system and do not allow for real progress. I guess I am a revolutionary. I want CHANGE. Can we have it? YES WE CAN!

Health Care Reform # 3

I got an email from My.BarackObama.com asking me to "join up with local supporters, get the facts, make a plan for building support in your neighborhood, and start putting that plan into action." I attended that meeting this evening.

Of the 20 people there, almost all specifically advocated for a single payer health care plan. There was recognition that the perfect can be the enemy of the good, but there was also fear that the plans currently being discussed would effectively be a sell out. They would be so far less than perfect that they won't really solve the problem.

There was much to discuss, but it was hard to move forward without answering the first question. Is it worth working for anything less than a single payer plan?

Although we didn't resolve that, the next step seems to be some sort of a Health Care Day of Service on June 27th.

Health Care Reform - # 2 Letters to my representatives

While each letter below says basically the same thing, I think of what I know about the person while I write and edit. They each come out a little different. Probably says more about my assumptions than anything else.

Senator Durbin,

A single-payer health care system is the solution. The math for real solutions only works for a single-payer plan. The people have made it clear in poll results that they want a single-payer. Any other solution just pushes the problem down the road.

Right now, opposition to the insurance industry may seem to be a politically expensive choice, but I believe that opposing a single-payer plan will cost more. We are capable of rising above deceptive advertising and scare tactics. In the modern media environment - deception will be uncovered and the facts will speak (not always, but enough to make a difference).

If you and the Democratic party take the lead, there will be a tidal wave of support as people stop having to worry about health care costs. In fact, if we get this done, I can’t imagine the Republican party coming back for 20 years.

There are millions of us out here ready to fight the good fight for a single payer plan. I hope I can be part of your legacy of solving the health care crisis.

Senator Burris,

I hope you are able to rise above the controversy surrounding your position and are able to work for the people of Illinois.

I want you to know that a single-payer health care system is the solution to the health care crisis. The math for real solutions only works for a single-payer plan. The people have made it clear in poll results that they want a single-payer. Any other solution just pushes the problem down the road.

The insurance companies do not own you or congress. We are capable of rising above deceptive advertising and scare tactics.

If you and the Democratic party take the lead, there will be a tidal wave of support as people stop having to worry about health care costs. In fact, if we get this done, I can’t imagine the Republican party coming back for 20 years.

There are millions of us out here ready to fight the good fight for a single payer plan. I hope I can be part of your legacy of solving the health care crisis.

Representative Johnson

I believe that a single-payer health care system is the solution our country needs now. The math for actually solving the problems only work for a single-payer plan. The people have made it clear in poll results that they want a single-payer. Other proposals just push the problem down the road.

A single-payer health care system is good for business, good for entrepreneurs, good for America. There will be strong opposition from insurance company lobbyists, but we are capable of rising above deceptive advertising and scare tactics. In the modern media environment - deception will be uncovered and the facts will speak (not always, but enough to make a difference).

If Americans put the troubles of this crisis behind them and the perception is that the Democrats made this happen and Republicans stood in the way, I don’t think it will be fun to be a Republican for a long time.

There are millions of us out here ready to fight the good fight for a single payer plan. I hope I can be part of your legacy of solving the health care crisis.

Each letter above submitted to the representative's website. I do put "cc blog" at the bottom of each to indicate that I consider them to be open letters.

Health Care Reform - Letter to the President

Mr. President,

I missed the health care reform conference call last week due to a meeting.

I want you to know that there are millions of us out here ready to fight the good fight for you like we did in the campaign. If you really want me on your side giving it my best, you need to push for a single payer plan.

The people have made it clear in poll results that they want a single payer plan. The math for real solutions only works for a single payer plan. Any other solution will just push the problem down the road.

I think you can call on the people to go over the the heads of the insurance lobbyists and make this happen. I'd love to be a part of your legacy of solving the health care crisis in the USA.

Thank you.