Jeffrey A Spinabella
Health Care and Health Insurance
Here are my views and opinions on the Health Care and Health Insurance industry.
My views are based on my own personal experiences throughout my life. The whole general concept of health care and health insurance makes sense to me. However I think throughout the years it has become corrupt and unethical. It has become less about the well being and survival of the human race. Why should people be rewarded for not doing their job? Why does a doctor still get paid for not healing you? Why do the pharmaceutical companies get paid when their pills don’t cure you? Why pay insurance companies higher premiums for less coverage?
Ok, so there are illnesses, injuries, diseases and so on in the world. That’s where the practice and study of medicine has come from. Centuries ago medicine was purely about survival of the human race. Now it’s about money first then the treatment. Not that I’m against free enterprise but when it comes to the preservation and well being of the human race there should be some boundaries! I don’t believe that the medical industry should be able to profit from you unless they can cure or help you! Just like anything in life, if you get paid regardless of your performance the effort is sometimes suspect. I bet you are wondering where this is coming from right? Well I have had an issue for years regarding the “practice” of medicine. That still makes me wonder to this day, Practice” of medicine.
As a man you can imagine what it must take for me to seek medical attention for something. “Rub some dirt on it” is a motto I have lived by for years. I think most boys and men are like that. Most boys or men don’t ask for help for minor illnesses or injuries. But when it’s serious enough that we need medical attention we seek out the “experts” in the medical field for help. And when we make that bold move asking for help you better believe we expect a cure.
My frustration has built for years. I get sick and I won’t go see a doctor. Finally I wake up one day and I feel like I’m dieing and I go to the doctor. I go to the doctors’ office and wait for an appointment that is never on time. Why can they get away with never being on time? In business I certainly couldn’t keep my clients waiting for an hour past their appointment? If I did you bet I’m on my hands and knees apologizing and assuring them it will never happen again. So I finally see the doctor only to be told that I don’t have a temperature, my vitals are normal, they can’t hear anything in my chest or see anything in my throat. So take some Tylenol and rest. Call me if you don’t get any better in a few days????? That will be $40.00 co-pay, thank you and see you next time???! Are you kidding me?!
This scenario also applies to emergency room visits. The difference is your wait time is longer than an hour and your co-pay is likely $50.00. “Emergency room” what does that even mean?
Shouldn’t the medical field only receive compensation if they cure you? Shouldn’t you only have to pay for prescriptions that actual fix your illness?
I wrote this blog fueled by years of these thoughts. The situation in this past year was the straw that broke the Camels back. Here is a reader’s digest of the past year plus of my life….
Over 1 year ago I injured myself weightlifting. Ironically I was exercising trying to get into shape and become healthier. I was overextending myself and suddenly felt a “sensation” shoot through my chest and up my neck. Since that time I have experienced migraine headaches unless I take a migraine medication every day to keep the headache to a manageable pain level. Shortly after the injury I realized that the problem wasn’t just going to go away on its own. Every day I was taking handfuls of aspirin and pulling on my hair to relieve tension in my head. Sounds stupid but at the time it seemed to be the only things to do.
Ok, here is the part of the story that relates to this blog. It has been over a year since this injury happened and I am still not cured. I am no closer to a cure or even knowing what is wrong than the day it happened. I have seen many doctors and specialists and have taken a full pharmacy of pills, medications, ointments, physical therapy, acupuncture and injections looking for a cure. I even went to supposedly one of or they best in their field clinics in Chicago for Neurology. Would you believe that is where I received the worst care out of anything I’ve done? Do you know it has been months since I last saw them and I have never even received any follow up from them? I could be dead as a result of this injury or even their care and they wouldn’t even know it! But you can bet I sure have received the medical bills and follow-up medical bills from their billing department. So they got their co-pay, they got their insurance payment now they want the rest. Not that they have any idea how I am and if the case is closed or anything. They just want their money! Why should we have to pay these medical bills until we are cured? Maybe they should only be entitled to the co-pay from us and the medical insurance coverage. And then if and only if you get cured and you sign off that they cured you, you would be obligated to pay the balance. And if they don’t cure you not only you aren’t obligated to pay the balance, the insurance company is entitled a refund of what they paid. Maybe if the insurance companies didn’t have to pay for services that cure the patient then our insurance premiums might be more affordable. Don’t think I believe it to be this simple. I know that there would be much more to it then my couple of sentences solutions. That’s what high priced administrative executives get paid to do. Come up with solutions to these kinds of problems resolved.
Here is another example of the unfair practices within the medical industry. Approximately 6 months ago I had an MRI at an imagining facility. They were trying to verify if they saw any obvious problems in my spine that might be causing my pain. Of coarse because I don’t seek medical attention very often I had not hit my deductible for my PPO insurance. I will get into the insurance companies next, I promise! So the imaging company tells me if I pay cash that day it will be $550.00, but if I run it through the insurance to be put towards my deductible it would cost more???? I ask why? Well we charge the insurance companies more money than if the patient pays cash. WOW! So here’s another reason my medical coverage sucks nowadays and costs more!
Not to jump off track but this reminds me of something. Just the opposite happened to me with a pharmacy. When I got laid off just shortly after this injury I signed up for Cobra insurance. But I couldn’t wait until the paper work all went through the system. I still needed medical attention for this problem. While seeing one of my doctors while my medical insurance was in limbo he gave me a prescription for the much needed migraine pills. So I went to the Pharmacy and they said they didn’t see my insurance reactivated in the system yet. Well I couldn’t NOT get these pills, I desperately needed them for the pain. So I paid for them out of pocket and figured I would just send in the receipt with one of the on-line forms the insurance website provided. After the insurance was re-instated I went on-line and downloaded the forms and followed the steps to get my money back. When the letter finally arrived with a check for my $300.00 out of pocket prescription it was for only $190.00. The letter from the insurance company goes on to explain that they would have only agreed to pay the Pharmacy $190.00 for that medication. So this means that a pharmacy will charge someone much more for a prescription if they don’t have insurance. So how is that ok let alone legal? Why should the Pharmacies be aloud to charge non insurance carrying people more for prescriptions then what they get reimbursed by the insurance companies?
Ok, back to my $550.00 C-Spine MRI. Not that it is relevant in this story but the MRI report said they could not find anything of significance, surprise surprise! A few weeks ago I was seeing one of my doctors and we decided I should have anther C-Spine MRI to see if anything shows different on this one. We also decided on a brain MRI since I never had one before and we were no closer to finding out what was wrong with me. This time I suggested going to a hospital to have an out patient MRI. I thought having it there would be like a second opinion. I went and had my MRI. It was the same as 6 months ago but it just took a little longer since I was basically having two MRI compared to the one I had before. A few days the results were ready, nothing was found. Good news I guess but no answers to my problem.
A few weeks later the bill from the hospital shows up. Are you sitting down for this one? $6000.00 for each MRI!!!!!!!!!!!!! A total of $12,000.00 dollars. Six months ago one company charges me $550.00 for an MRI and now this hospital wants to charge me $6000.00 for the same test?????!!!!!!!!!!!!!!! I say “wants to” because I am not going to pay that. I will find some way to fight that. So tell me how does this hospital thinks it can charge me $5450.00 more for the same test? It’s done with the same piece of equipment and reviewed by a radiologist. And the funny thing is that the insurance company paid their 80% or whatever % of the bill. Another reason why our insurance is so expensive and the coverage sucks!
Earlier I said I would talk about the insurance companies. Clearly I have pointed out some reasons why the insurance premiums are more expensive and why the coverage isn’t the same. I stated how I don’t use my medical insurance very often with the exception of this past year. I would always sign up for the HMO insurance. For someone like me HMO was perfect. I felt it was fair for someone like me who didn’t use his medical insurance very often to be offered a plan that was much cheaper but had some restrictions. This was the way the insurance companies could keep the costs of services lower to their company. I felt I could live within the guidelines and would benefit me and the insurance company. So why aren’t companies offering HMO anymore? I don’t have this answer but I don’t like it. Maybe I’m wrong, maybe it’s just my perception that companies aren’t offering it anymore but my last company didn’t and I’ve heard of others. And now because I don’t have it I have all kinds of medical bills. I never used my insurance for many many years and now when I have to use it the PPO plan sucks and has cost me allot. This is especially problematic when you get laid off.
So enclosing let me be clear, I am not for the Obama medical reform. I am much smarter than that. However, I am convinced that there needs to be something done about the unfair practices within the medical industry. There are many hard working Americans that would benefit from a little sensible restructuring in the medical industry. As I said earlier I am all for companies to make a profit but not to rape and pillage the American people. As it has been discussed I am for our government to have the same medical care and benefits as we do. I will guarantee that this problem will get fixed with something that we can all live with and eccept.
This article isn’t specific to what I wrote. If you use my words as a template you could plug in all sorts of situations and scenarios regarding the medical industry as a whole.
Jeffrey A Spinabella
