Sicko, the 2007 Michael Moore film, was an eye-opener for those of us who breathe a sigh of relief every day that we are fortunate enough to have insurance. We are annoyed by the capriciousness of our insurance companies when they inexplicably deny coverage for a new medication that would forestall a lengthy illness and possible hospitalization and blithely cover medications that are subject to potential abuse or dependence (I won't name them...we all know what they are) because they are available in generic form! But we soldier on, the lucky ones, the insured.
As it happens, having insurance is not a guarantee of good medical care or of avoiding the financial disaster that looms when the uninsured cross the threshold of any medical facility. Moore points out the many examples of insured citizens in the U.S. receiving care that is inferior to third world counties or being bankrupted due to the whims of managed care. While we await the election of a Democrat who will tackle the monster of healthcare reform, we can rest assured that if things get too bad, we can always go to France or England or...Cuba?
OK, now on to the sequel. The sequel will tackle the question of how insurance companies can possibly make money when they don't seem to have a lick of business sense in their collective heads.
Here's a quick question to determine if YOU have a lick of business sense:
You are a large, well-known insurance company (for the sake of this example, we'll call it True Floss...since I don't want to cast aspersions on any particular company). You need to explain to a customer what was paid and what wasn't paid during a 13 day hospital stay. What is the most cost-effective means of accomplishing this goal?
(a.) e-mail the pertinent documents to the customer
(b.) mail an itemized listing of the charges and benefits via mail
(c.) send a total of 16 separate Explanation of Benefits forms in 16 separate envelopes with 16 separate stamps on the same day
Hmmm...cue Jeopardy music. Yes, YOU have a lick of business sense because you opted for (a.), with (b.) as a reasonable back-up. True Floss, in its infinite wisdom, chose (c.)
So in the mail today I received a separate Explanation of Benefits for EACH DAY I was in the hospital, a separate EOB for the ER, a separate EOB for each test I had and strangely, a separate EOB for my release from the hospital. They even charge you to LEAVE!!! This takes us up to the day of my discharge. I have been back to the hospital as an outpatient five times since then, so I can only imagine the trees that are shivering in their boots in anticipation of the mountain of paper THESE visits will waste!
How can I feel like I am making an impact when I recycle my newspaper, carefully breakdown, fold and recycle boxes and painstakingly rescue every can or bottle from the trash and bring it to the proper bin in the garage? The amount I recycle in a week can be undone by one insurance company's paperwork on one hospital stay.
I have no more words.
Di
Sicko was an excellent film, but what amazed me was the virulence of those who reacted against it. The very people who would benefit most from not having to pay medical bills were foaming at the mouth in rage at the idea of actually being deprived of co-pays, deductibles, bills, collection agencies and the whole sordid panoply of the support system for medical greed.
Our insurer is constantly sending explanations of this or that. We just dump them in a file drawer.
Posted by: Nicholas | January 25, 2008 at 05:14 PM