The Cost of My Health

Cost of Surgery

Since my job loss, I have been on COBRA, which luckily was subsidized 60% by the Feds for the first year.  Today I am paying almost $520/month to cover myself. 

Under my medical coverage, the first deductible was a blanket $500 for the year.  After that I paid 20% of my foot surgery.  Plus $40 co-pay for each visit to that specialist (initial consultation, pre-op); appointments 90 days post-surgery were included.  Another $25 to pay for a physical with my primary physician, to assess whether I may might have died on the operating table.  (I didn’t.)  So my out-of-pocket was over $700, not counting my monthly COBRA payments.

A poor person couldn’t handle this.

Many of you are old enough for Medicare, so I’d be interested to hear how much of the cost of my foot surgery would have been covered.

Equipment

My boot would have cost almost $100, although I only paid the copay.  I had to buy it, even though I’m only using it for a month.  My walker, which I only used for a week, was an inexpensive one, for which I only had copay. Unfortunately, I had forgotten that friend N had needed one when she had her hip surgery.  She said that churches around town lend them out for free.  But I’ll sell the crutches (which I bought second-hand, and then never used, due to this fashion-forward boot), the walker, and maybe the boot to the used medical equipment store.

CYA

Whenever I asked the doctor why he had to ask the same questions that I had just answered on paper, why the hospital had to ask the same questions that I had just answered on yet another form, why my boot couldn’t be used again, the answer was always, malpractice litigation.  And why didn’t you ask the patient about her xyz?  Is it possible that the used boot could have harbored the abc bacteria?  Cover Your Ass – part of the high cost of health care.

HNET

One of the issues that our President broached was the need for a national computerized health network. 

President Barack Obama has said that a national electronic health records system will be a priority in his first term, not just for streamlining workflow at hospitals and physician offices but to cut costs and improve the quality of health care.

And while he has pledged to invest $10 billion a year over the next five years on the effort, the price tag for such a system could be closer to $100 billion over the next 10 years, according to experts. They also note that sticking to his five-year timetable could prove to be daunting.

“The magnitude of what we’re going to need to do on the Obama scale is just incredible to think about, when you consider linking all these medical records across all these different towns, cities, states,” said Dr. Charles O. Frazier, a vice president of clinical innovation at Riverside Health System in Newport News, Va. “We have enough of a problem with that in our own health system.”

In 2004, President George W. Bush called for establishing EHRs for most Americans by 2014. Bush created the Office of the National Coordinator (ONC) for Health Information Technology to lead the way. The ONC pushed several pilot projects and created standardized medical records. Even so, a survey of 2,700 U.S. doctors by the New England Journal of Medicine last July showed only 4% were using “fully functional” EHR systems; the rest are all still paper based.

Currently, only 25% to 35% of the nation’s 5,000 hospitals use — or are in the process of rolling out — computerized order-entry and medical record systems, according to Dr. David Brailer, who served as President Bush’s health information czar from 2004 to 2006. Full EHR systems include patient care order-entry systems and networks to share patient data between hospitals, primary care physicians and insurance companies, and to fill pharmacy prescriptions.

When I suggested it to my podiatrist, his answerer was Just another check.  My gynecologist is proactive; because I was a new patient (my previous gynecologist having retired), I had to fill out The Form.  However, it was not four pages of paper sent to me by snail mail; I filled out the form online.  Then, when I was in the office, her nurse looked at a screen, added my height and weight, asked me about my xyz, and added her notes to my record.  When the doctor arrived, she looked at the screen and said I see you’ve had an xyz.  I was impressed!  Imagine if my doctors in SC wouldn’t have needed to have me fill out forms on paper.    Imagine if we never had to!

Health Care Reform

A problem with any such legislation is that it is hard to grasp in its entirety. In the original version, H.R. 3590 as passed by the Senate on Dec. 24, 2009, ran to some 2,400 pages, although with a very large font, triple spacing and huge left and right margins.

With normal margins the document probably would shrink to about 500 pages or so. But even in that form, the Senate bill would be a major opus and a remedy against insomnia for all but the truly dedicated reader.  http://economix.blogs.nytimes.com/2010/03/24/wrapping-your-head-around-the-health-bill/

I am not sure what kind of health care reform was actually passed (other than the main bullets – can’t exclude because of previous conditions, etc), but most of it doesn’t kick in until 2014, so that doesn’t help me whatsoever.

Choosing a Health Care Plan

Right now I have the onus of choosing a health care plan for the next year, as the COBRA will run out in a month.  At least, due to the health care bill, no insurance company can now exclude me after September 23 of this year because of my pre-existing condition (clinical depression).  For exactly what I have now, I’d pay $50 more a month.

So do I go for a low monthly and a high deductible ($5,000, $10,000?)?  20%, 30%, 50% coinsurance?  An HMO, network, or PPO?  Office visit percentage before or after deductible, or maybe not covered at all?  Should I look at the ratings?  (Aetna has no deductible, and is less expensive than my present, but only has a rating of 2.2 out of 5.)  I am boggled by the choices.  Suggestions?

Then there are eye and dental care.  Eye care used to be covered by my company, and dental was a small amount per month added on.  To include them now, it would cost more.  Eye care: add $9/month.  Dental coverage: add $22/month. 

I haven’t gotten new glasses in about 4 years, but probably need stronger ones.  $$$$ 

I didn’t get my teeth x-rayed on my last visit to the dentist, to whom I had gone many years ago, but just the cleaning cost $85!  My most recent dentist in Tucson (who, btw, got terrible reviews online) would not see me unless I got new x-rays.  Is this common?  (Anyway, I just now looked for the Best Dentist in Tucson on the internet.  He is Dr Jay Citrin, and I have left a voice mail re cost. ) Guess this is why so many poor people have bad teeth.

I am, frankly, sorry that we do not have national health care, as my son does in Canada.  Sigh.

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4 Responses to “The Cost of My Health”

  1. Alissa C. Says:

    Just tell them you’re pregnant. Then you won’t need dental x-rays.

  2. Alissa C. Says:

    PS. I do have Aetna and chose to pay out of pocket for a home birth so that I could make my own choices instead of the insurance company doing so. Then decided it would make more sense to have labs done through insurance to save me $ (mistake!), not realizing while my midwife could have done them for $50 I was charged $170 DEDUCTIBLE for having them done WITH INSURANCE. WTF. Our insurance system is complete and utter crap. I’m all for socialized medicine but don’t see it happening anytime soon.

  3. LYN KAGEY Says:

    Go to Mexico for your dental care. Mother Dear is very happy with her dentist there. You do need X-rays so they can see what is going on under your gums and inside your teeth and caps.

    I don’t understand why health care is a for profit industry. It blows me away that they can keep raising the rates and paying their executives huge salaries. Please look into non-profits.

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