The Dagley Dagley Daily

By Janet Dagley Dagley
Covering the world from the waterfront in Hoboken, New Jersey, USA

ISSN 1544-9114

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$389!!!! Open your mouth and say, 'Aarrrrgggghh!!!!!' (Health insurance: a sick situation, Part II)

(Welcome again, AIRSPACE readers. Please scroll down past the photo to read the article, "Do You Belong in the Blogosphere?" And feel free to check out the rest of the blog while you're here.)

On July 1, readers of this blog were subjected to a textual earful on the topic of this nation's very sick health-insurance industry. Today, a quick update: as I predicted, the bill for the routine tests ordered by my doctor has been rejected, even though I am fully insured. It really doesn't matter why or how it happened; it does matter that something like this happens every single time I or anyone I know (under the age of 65) has the audacity to access the health-care system. No matter what the official reason for the rejection, it will be the same amount of work for me to appeal it and, I hope, get the bill sent to the right place with the right numbers attached to get our insurance company to pay, since that's what we've already paid them for. If I were to go out and take on extra work to get the money to pay the bill in question, I could probably earn it with less time and energy than it's going to take to get this resolved. And that's sick.

Who benefits from a system that works -- or doesn't work -- like this? Maybe some of the insured people who get these bills and threatening notices find them so intimidating that they just go ahead and pay them, thus sparing the insurance company the expense of fulfilling its side of the bargain. Maybe some of them have full-time jobs and young children and they just don't have the time to go through the appeal, so they just pay the bill to get it over with. Maybe what the insurance company gains from holding onto the money just a few days or weeks or months longer is worth the expense of employing all those people who spend their days getting yelled at by irate patients, doctors, or both. Or maybe, the stress from all that yelling, or listening to yelling, causes enough health problems for patients, doctors, and insurance company employees alike to keep the whole industry growing strong. I know my blood pressure went up when I opened the latest rejected bill.

While looking for answers online, I ran across a headline that surprised me: Health insurance industry profits plunge into the red. Then I realized it was about Australia. Here in the U.S., health-insurance premiums, and profits, just keep going up, as does the cost of health care.

It's getting worse: employers are shifting more and more of this growing burden onto workers. Meanwhile, the number of uninsured Americans is up to 41 million.

posted by Janet Dagley Dagley @6:05 PM

11.7.03