Sunday, May 24, 2009

Real health care reform

                         WASHINGTON - President Barack Obama predicted travails ahead for
                         the struggle to pass health-care reform but offered a hopeful outlook
                         for passage of legislation providing access to insurance coverage for
                         all saying "the stars may be aligned" for a deal on a goal that eluded
                         the last Democratic president... Obama said he is "absolutely committed"
                         to moving forward with a health-care plan...

I watched President Obama on C-Span speaking about health-care reform and was frustrated because he was only addressing one part of the problem. All he talked about was affordable health-care for everyone. That’s great. I have affordable health-care. I pay $278 a month for it. But whether it's affordable or not, a big problem remains.

Okay, follow me here...

I have to go to a dentist that deals with people who've been through radiation for head and neck cancer. The dentist is $350 a visit. Even though my Delta Dental insurance covers the treatment, the dentist makes me pay him in full after every visit. He says the insurance companies often refuse to pay him, so he leaves it to the patient to deal with it. After every visit, I pay the dentist, and the dentist gives me a “super voucher” that I send into the insurance company in hopes I’ll be reimbursed.

Then my first ENT wouldn't take Blue Cross because they don't pay, so I had to pay after my visit. He was $600. Then there’s my other doctor for vitamin C drips and other "alternative" treatments that are very necessary but not covered by insurance at all: $550 a visit. If you haven’t been doing the math, that's $1,778 out of pocket. The $1,500 that I paid out and sent in super vouchers for reimbursement, so far I've gotten back $0 from my insurance company.

I also needed two procedures when I had cancer that my oncologist said were necessary for me to be cured. One cost $2,700 and the other was $800.00. My insurance company insisted that both the procedures were not necessary and would only cover one of them. They paid the $800 one and left me to pay the $2,700. After eight months of phone calls to my insurance company they finally paid for both.

My question: Who's treating me? My doctor told me I needed those two procedures and my insurance company told me I only needed one. Who do I listen to?

Why not eliminate the doctors and let the insurance executives treat us?

I hope you can see the inconsistencies within the system. Simply put: insurance companies won't pay the doctors, so the doctors don't take insurance and have "pay immediately after visit policies" and let the sick chase the insurance companies with super vouchers.