THE LATEST THINKING
The opinions of THE LATEST’s guest contributors are their own.
Here’s a tidbit you may not have heard: It turns out that sometimes, in certain circumstances, having great insurance is a liability all its own. Go figure. This is anecdotal, but comes from a reliable source. I should also point out that what is recounted here occurred in a Florida hospital. The situation may be different elsewhere.
I have a friend (“Timothy”), who entered the hospital 2 1/2 weeks ago. He had pain. He went to the ER. He was admitted. They determined it was pancreatitis caused by gallstones. They resolved that the best course of action was to remove the gallbladder. All this, including the routine surgery, took four days. Why, two weeks later, is he still there with no known date of release, when he expresses daily that he wants out?
I texted a mutual friend (“Michael”) as I was getting concerned.
Michael: Don’t be concerned. Timothy has great insurance and the hospital stands to make lots of money. They tell you they’re being cautious: “Timothy has a fever; his white blood cell count is high.” But the truth is his temperature is 99.2 and the white cell count is stable – it’s on the high side of normal. But every bag of antibiotics they throw on is another $400 they can bill.
Me: Are you kidding?
Michael: I went through the same thing last Fall. I had to scream at the patient advocate to get out.
Me: Don’t you have a right to leave if you want to?
Michael: If you “discharge against medical advice” your insurance can refuse payment and you’re stuck with the whole bill, and not at the discounted contract rate. For example, Blue Cross paid $12,000 for my stay but the bill was actually over $50,000. I would have been on the hook for $50K.
(Law or not, are they trying to keep in-patients because hospitals are having financial troubles?)
Me: Whoa! This is unconscionable. I should write an article.
Michael: There’s lots of law that backs them up. (Michael is an attorney). So the better answer is yes, you always have a right to make decisions about your care, but you risk being responsible for the bill.
Me: This is crazy.
Michael: I’m sure you can fight such a determination, but it takes a lot of time and effort.
Me: I don’t think people know this.
Michael: I didn’t. Thankfully I listened to my sister-in-law who was an ICU nurse for 40 years.
Me: But doesn’t the insurance company chime in to save money?
Michael: The hospitals get away with a lot under the guise of “medical necessity.”
Me: Hospital hostages.
Is there any corner of the American experience that isn’t tainted by greed?
It’s not that “Timothy” is suffering more than the guy who gets thrown out of the hospital too early, or more than the guy who can’t afford insurance. But now we know, beyond a shadow of a doubt, that regardless of circumstances we are ALL preyed upon by a health care system gone mad.
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