Mr. Crankypants is in awe

Mr. Crankypants is seriously impressed by the brazenness of the health care industry. Dan, Mr. C.’s stupid alter ego, went into the hospital back in August. A few days ago, Dan got a statement from the San Mateo Medical Center. The hospital charged Dan’s insurance company more than $10,000 for a 24 hour stay. The insurance company, Blue Cross Blue Shield, decided that they would reimburse all but $546 of that amount. Dan now owes the San Mateo Medical Center $546.

So where does the $546 come from? Of course they didn’t tell Dan what that money paid for. The statement Dan received does not tell what that $10,000 went towards, nor does it tell what the insurance company refused to reimburse the hospital for.

Mr. Crankypants has got it all figured out. The hospital and the insurance company have figured out how much they can nick people for before they start to get complaints. You stay in the hospital for a day, they figure they can nick you for about half a grand. Oh, sure, if Dan were to ask them what that $546 went to pay for, they would make something up provide documentation listing all the charges, and they’d show that the insurance company refused to reimburse a few dollars here, a few dollars there — nothing that you could really complain about. And besides, Dan was in the hospital, right? He can’t deny that he got the treatment, right? (Of course he can’t deny he got the treatment, they kept him drugged up most of the time so he has very little idea what they did to him.) So Dan, being essentially stupid and good-natured, will pay up.

Mr. Crankypants, being essentially evil and mean-spirited, is in awe at the techniques of the hospitals and insurances companies. This takes greed to a whole new level. Yes, Mr. Crankypants is in awe.

6 thoughts on “Mr. Crankypants is in awe”

  1. Bill Baar

    You can get the line by line transactions you know. You can have the bill audited too for that matter. It might cost you a few bucks but the people who do that usually make it up to you in savings. Just to assume someone is greedy is an awfully big assumption here without breaking down all the charges…

    …and rememeber Blue Cross is paying a discounted bill.

  2. Ms. M

    looking forward to finding out about the 5 day stay this past week – and very thankful for the “coverage” we have, yet outraged by the brokenness of the health care system. found out about a loved one who is foregoing prescribed meds due to the $800 monthly cost in the “gap” of medicare…

    sigh

  3. Bill Baar

    Man, Blue Cross has done well by my family. As has Illinois Medicaid program… no complaints. I had a hard time telling my father-in-law to send the bill back with the Illinois Medicaid case number on it…. no problems once he got into that habit.

  4. Dan

    Bill Baar — Blue Cross has many different products out there — I was happy in the past, but could no longer afford their high-end products. It’s kind of a Catch-22 — I couldn’t afford the regular payments of high-end health insurance, and couldn’t afford the one-time payments that came from using the low-end products. (Two years ago, I got a $1,000 bill for a simple doctor’s visit!)

    Fortunately, my new employer provides Kaiser Permanente, one of the better programs out there. Although we get one of the lower-cost products that Kaiser offers, my employer also offers a Healthcare Reimbursement Arrangement (HRA). Although my HRA account does not yet have enough in it to bother using for this present bill, this should solve the problem in the future.

    But forget my personal situation. The real issue is that there is absolutely no incentive for health care providers to rein in costs — they bill for whatever they want, and collect whatever they can. I’m sure most health care providers are basically honest, but when there are no checks and balances, we should expect them to overcharge — and according to almost any measure, they do indeed overcharge — study after study finds we pay more for health care in the U.S., and get mediocre care. Similarly, there are no checks and balances on the health insurance industry. Most people can’t afford to buy their own insurance, they get it from their employer or from a big group — which means that there’s no direct feedback mechanism. If I hate WalMart, I can stop shopping there, but if I hate my health insurance I’m pretty well stuck unless I want to change jobs and get new health insurance.

    I don’t know what the solution to this problem is — I’m not good at politics. But I am good at moral and ethical issues, and the health care industry in the U.S. is set up in such a way that there is nothing to stop greed and waste. I’ve heard predictions that we’ll see an increase of 10-15% in health insurance costs this year, a year in which there will be little or no inflation — that increase can only come from greed and/or waste. I don’t really care how we rein in greed and waste — free market solutions, government regulation, I don’t care — but we have to do it. And while I’ve been listening to commentators across the political spectrum who agree that the system needs to change, I have no confidence that our political leadership will provide leadership and change on this issue.

    Mr. Crankypants can admire the greed and waste all he wants. The rest of us need to tell political leaders to lay aside petty partisan difficulties and solve this problem — and shame on them if they don’t.

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