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Hospitals & Health Insurance
Jakob’s True Story!
by Jakob Esaw

 

  I had a recent emergency and had to go to the hospital. I am generally a healthy person, and I admit I don’t know much about navigating our healthcare system, at least not when it comes to where you need to go for certain kinds of care. The only Emergency Room in town that I knew how to get to was the one located on the same campus as my general practitioner’s office in Nashville. I like his office, because it’s low-key and the staff are frieSometimes, things just keep going wrongndly.

  I believe the doctors there are competent, but this story isn’t about the doctors. It’s a story about the bizarre and byzantine structure of hospital billing. I would love to understand the life cycle of a hospital bill, but I’m afraid I don’t have nearly enough years in my own life to dedicate to such a soul-sucking academic endeavor. All I know is, if a person has health insurance, in general that person has a contract with a multibillion-dollar network of companies that says: “I am paying a little bit every month so that I won’t have to pay a lot when I need urgent care.” This is, I believe, how it’s supposed to work. Most people believe this is how it’s supposed to work.

 But sometimes, when disaster strikes, things just keep going wrong.

 I always overreact when it comes to my health. I think it’s because of two things. First of all, I’m something of a hypochondriac but that might be for a good reason, because it usually prevents me from behaving like a moron, like drinking too much beer every night, or smoking a pack of cigarettes per day.

  And that leads to my second reason for overreacting: during high school and college, I didn’t exactly treat my body as a temple. It was more like a circus where a daily parade of hallucinogenic clowns and drunken elephants gallivanted under the big top. I got into all sorts of worse behaviors, which led to bad habits, which led to full-fledged addictions. People say, “Oh, a little drink here and there is no big deal. A little drag once in a while ain’t gonna kill you. Why not eat five cheeseburgers a day while you’re at it? And hey, what’s wrong with an occasional snort? None of that’s going to hurt you.”

  And I believe that’s completely true. The adulterants you can find in those little baggies and at the bottom of those brown bottles can alter your perception temporarily, but if you put a certain drug into your body once or twice, well, your body is a beautiful machine of evolutionary brilliance. It can take a lot of the beatings you put it through. But only for so long.

  You’ve seen the lists of crimes stacked against people on those fliers outside of police departments, haven’t you? You see what persistent drug use does to you when you pass one of those most-wanted posters with a meth head looking out of the photograph like a hollow-eyed death camp escapee. If that person had just taken one bump or one smoke, he would have been okay. But the list of reasons a person can’t stop at just one bump or one smoke is long. The human body, still primed for times of feast or famine, feels the ever-present need for unending pleasure.

 So to counteract the abuses of my youth, I live a healthy lifestyle now. I eat well and try to limit my chocolate cake intake, which is the tragic part of getting older. I drink lots of water and try to moderate my alcohol consumption. I walk on the weekends and bicycle to work. And I run. I run a lot—as often as I can. I run in the mornings and during the weekends. I run at Beer Runs, and I run during my one-hour lunch break at work. I love running more than I love writing, and I really love writing. Writing while running—well, that would probably be the best thing of all, if it were possible.

 So being such a healthy guy, why did I have to go to the ER?

 Wild dogs wander with no hint of owners I was running where I usually run on my lunch break, a little trail behind a community center near work, when a dog attacked me. It’s a crummy neighborhood with boarded up businesses and houses, where wild dogs wander around with no hint of owners. They bark at me sometimes, and nip at my heels. I’m surprised the dog attack didn’t happen sooner, to be honest. And I’m shocked something even worse didn’t happen, like a gunshot to the stomach or a hollering homeowner demanding to know why I was yelling at his mad-eyed wild dog, that had about the same level of domestication as a wolf.

  As I crested a slight hill, I saw these two dogs play-fighting. Or at least I thought they were playing. One was a pit-bull, and the other one, the one that attacked me, was a medium-sized mutt. Brown with black stripes and ears like a bat’s. But when I caught the look in the eyes of this savage beauty, I knew he was coming for me.

  I only got away by windmilling my arms and screaming like a maniac. But by that time, the animal had already slipped behind me, and he did not hesitate to sink his teeth into my ankle. The rabies virus, if this dog was a carrier, had already entered my bloodstream. When I realized he had me by the leg, I activated Insanity Mode. Telling the story later, I described myself in heroic (if exaggerated) terms. I told people I flew through the air, punching and bicycle-kicking the dog and pelting him with curses as incomprehensible as snake-handlers talking in tongues. Both dogs, when they saw how rapidly rabid I had become, ran away whimpering with their tails between their legs. I jog-limped back to my car, excused myself from work for the rest of the day, and drove to the doctor.

  I know going to the Emergency Room shouldn’t be an injured person’s first option. But when I walked into my doctor’s office and said, “Hi, I was bitten by a dog and need help getting the wound cleaned, and maybe a rabies shot,” the receptionist at the front told me I should go to the Emergency Room just across the parking lot. I had assumed as much, but money was at the forefront of my mind because I knew the co-pay at my doctor’s office was $25, whereas the co-pay at the emergency room was $125.

 If only I had known I would end up owing more—much, much more—I probably would have locked myself in a dark room and waited for the rabies to set in.

Emergency room crisis

  So I went to the Emergency Room across the parking lot. I walked into the ER on a bad day, probably the worst day possible, in fact. A blizzard had rolled through Nashville the night before, and roads and sidewalks had turned to sheets of ice. The waiting room was filled with people who had taken tumbles on the ice, and had broken bones and as well as bruised egos.

  I was calm and barely even bleeding from the dog bite on my ankle, so I was ready for a ten-hour jaunt in the waiting room. Actually, it ended up being closer to five hours, which was just about the only positive point that came out of this experience. I explained why I was there, and the first question I asked before I got registered was, “Do you accept my health insurance and are you in my network?” These are important questions to ask at any hospital, and of course I expected an honest answer.

  The answer I got was calming and encouraging. “Yes, of course,” said the guy at the front desk who admitted me. He took one look at my health insurance card and waved it away,  no problem. But his reassurance turned out to be less than half true.

  I say it was “less than half true” because when the bills started flooding in, I was shocked at what I owed. Of the total $3,100 that I had incurred at the hospital that day, my health insurance ended up paying less than $1,400, leaving me on the spit to soak up the rest.

Why?

  The answer is simple. The people I talked to at the hospital, the nurses and the doctor, the insurance specialist and the billing manager, lied through omission. When I asked if this hospital was in my network, they just brushed my question off with a roll of the eyes, as if to say, “Didn’t you look online for that information?”

  Do you accept my health insurance?There’s a big problem with relying on the Internet for all of your information needs. Yes, the Internet is a miracle and a blessing, but that doesn’t excuse people in the real world from having a comparable grasp on the facts.

  That’s because information in the real world can sometimes change faster than an online portal can be updated. This is due to organizations not always keeping their resources current. But the Emergency Room I went to does not have that problem. In fact, their website is flashy and professional. A simple click here and there would have revealed they were not, in fact, in my insurance company’s network, which would have saved me a whole lot of grief and beaucoup bucks.

  But when a patient (or any customer for that matter) asks for the facts, a real-life, flesh-and-blood representative should be able to answer correctly, at least to a reasonable degree. And questions as simple and important as “Do you accept my insurance?” and “Is this hospital in my network?” are fundamental, and everyone employed by a medical facility should know the answers. If they don’t know the answers, they should know where to find the answers. They should not just be “Yes Men” who say what the patient wants to hear. As soon as the patient leaves the hospital, a world of rude awakenings begins opening up to him. This is especially true in an Emergency Room situation where a patient might not have time to do even a simple search online to verify a question as absurd as, “Will this hospital heal me and then bankrupt me?”

  I was lucky because I have health insurance. I’m sure my ER bills will be at least partially covered, but I still have to pay more than I feel I should. Rabies shots require multiple trips to the hospital over five weeks, and the total amount of my medical bills will end up being around $10,000. How much of this will I owe? No idea. I’m still waiting—and fighting—to see how much the insurance will actually pay for that first visit. In the meantime, I found another hospital which is, thankfully, in my network. That means I’ll end up having to pay only a fraction of the bills that came after that first ER visit. So, woo-hoo.

 Rabies shots require multiple hospital tripsI wanted to tell my story even though obviously it’s not news. Everybody knows hospitals can scam you, especially the ones in the United States. Multiple hospital visits can quickly bankrupt a family, and hospital business offices are rarely upfront with their prices. In fact, the price of the exact same service or procedure can vary from facility to facility and from day to day. It seems that hospitals will charge one patient one price and another patient another price, based purely on whimsy. Of course, prices vary so much because nobody pays the flat amount that a hospital charges. Attempting to summarize the intricacies of our mind-boggling healthcare system, John Green (co-host of the YouTube channel vlogbrothers and author of The Fault in Our Stars) does an excellent job of explaining why American healthcare costs trend on the high side.

  His conclusion is that healthcare costs in America are obscenely expensive, and there are so many different reasons why that it’s almost impossible to understand the whole ridiculous quagmire. But one supposed assurance, at least, is that insurance will help you when medical costs arise. This doesn’t always happen the way it should, which leads to the second maxim we have to remember when dealing with hospitals and health insurance- a patient has to be patient. Otherwise, he’ll end up having an aneurysm or a heart attack, which will likely result in even more medical bills.

 

www.Dishmag.com / Issue 196 - December 2017
Turnpage Blk


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