[quote=commercialappraiser]I am 53 and self employed. I am very healthy and only carry catastrophic health insurance. My Aetna plan offered a “free” physical at 50. At that time I had not seen a doctor in almost a decade so I found one on the approved list and took advantage of the “free” service. All went well. The doc told me I was in perfect health.
The trouble started a month later when I got a bill in the mail, then another and then another. All for different amounts and each very cryptic. I called Aetna (they refuse to answer e-mails) and got put on hold and transferred around and disconnected and was generally treated rudely. The first bill we were finally able to figure out. During the physical the doctor had frozen off a small spot on my arm he thought may have been skin cancer and charged me $70. It took him two minutes and he did not order a biopsy. Aetna said this was part of my deductible so I ended up paying that bill directly to the doctor. No problem so far.
The other bills were for “non routine” lab work associated with the “free” physical. I was told (after more phone transfers and waiting) to talk to the lab or my doctor for an explanation. I called the doctor’s office (hold, transfer, wait, we’ll call you back) and by the end of what seemed like a long day, they reconfirmed that my diagnosis was routine. The next day I called the lab and, surprisingly, quickly got to someone who told me my blood test indicated anemia.
Well it would take more space than I have here to detail what followed. Basically months of getting the run around while the bills for lab work kept piling up with late charges added. At no point could I get the three entities (Aetna, lab and doctor) to get together on a conference call and figure this out. Meanwhile I am wondering if I do have anemia. My doctor says no but the lab says yes.
I finally filed a formal grievance with Aetna. After a month or so their investigator’s finding was that I was diagnosed as anemic and that lab charge was not covered by the “free” physical. It was not until I went through a state (California) agency that investigates insurance abuse that I was able to get Aetna to relent and stop the flow of bills. To this day I do not know if that investigator ever spoke with my doctor.
We hear of the large percentage of our health costs being due to various entities arguing over who pays what. I can tell you from experience it is true. Add to that the opportunity cost of the numerous hours I spent on this fiasco
I am healthy and have the flexibility to arrange my work schedule around being available during the hours the various offices involved are open. What about someone who is weakened by cancer and gets piled on by ineptitude like I did? What about the person working in a sweatshop who buys their own coverage but does not have time during the day to conduct personal business over the phone?
Canada, much of Europe and Australia have shown there is a lot of merit and cost savings to a single payer system. After my experience I am all for it.[/quote]
THANK YOU for your post. USA is the ONLY country among G8 plus South Korea that doesn’t offer some kind of public (govt operation or govt funding) health care. Why? Are those countries socialist countries?
BTW, this article on NYTimes didn’t get much talk but check it out.
excerpt
Since 1974, Hawaii has required all employers to provide relatively generous health care benefits to any employee who works 20 hours a week or more. If health care legislation passes in Congress, the rest of the country may barely catch up.
