Friday, April 30, 2010

The Hidden Costs (literally) of Health Care

I am coming up on the 2 year anniversary of my 2+ week hospital stay and I've some thoughts regarding health care in these United States.

One of the thoughts is that the reform bill that recently passed Congress places restrictions and regulations on Insurance Companies, which is a good thing, but it doesn't really address the outrageous and hidden Cost of Health Care.

One of the things that became apparent to me as I reviewed the nearly $200k worth of bills that racked up as a result of my bout with septicemia was that I didn't consent to those charges. Why is it that being admitted to a hospital and providing insurance information is a license to bill?  As it is, my insurance company covered less than half of the cost of my care.

I lost count of the number of doctors who poked their heads into my hospital room. They'd say "hello," ask how I was feeling, and walk out.  And bill me $150 to $300. And I'm not talking about my surgeon or the infection specialist, both of whom had good reasons to check in on me. I'm talking about the physician who was on duty when I was admitted, along with numerous others whose names I didn't remember and who didn't seem to contribute anything to my care.

Even my mechanic lets me know what the cost of repairs are going to be before he starts, and is required to let me know the cost of additional issues that pop up when he's under the hood.

But doctors? Hospitals? No.  No one knocked at my door and said "May I come in? If I do, I'll bill your insurance $150." No one said, "If Dr X looks at your chart, it will cost you $300, if Dr Y does, he'll bill $275, whereas Dr Z will charge $325 -- Do you have a preference?"

I got a menu to select my meals, but not my treatments. No one presented me with a list of proposed treatments to select from. No list of the various blood tests and their fees. No option to opt out of any of the 6x a day blood pressure / temperature / pulse tests. No option to choose which Docs I wanted to see to review my medical records. I was stuck in a bed and it felt sometimes like I was little more than a sponge to squeeze money and blood out of.

And the same can be said about office visits.

I've never seen a list of services and fees. I've only ever been able to get a verbal quote, which, or course, isn't legally binding. The doc walks in, chats with me for at most 10 minutes, and bills $175 for the office visit. Then s/he hands me scripts for prescriptions (sans quotes for cost) and instructions to visit the lab for tests (again costs unspecified). Sometimes I've gotten a carbon copy page that shows the office visit fees -- after the fact.

How can we be responsible consumers of medical care when the costs aren't disclosed in advance? Why can't medical professionals be bothered to explain the costs of their services and the services they order for their patients? And if they don't want to be bothered, shouldn't they have someone on staff to  do the explaining?

Perhaps doctors, medical offices, laboratories, hospitals, etc, should be required to post their fees in public places. Perhaps then we'd have incentive to shop around, to haggle or bargain or even decline certain services that we feel we don't need or don't wish to be billed for. And then perhaps, just perhaps, the cost of insurance would also go down.

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Thursday, April 29, 2010

Mirror, Me

This is an incredibly expressive poem.  I think most women will find that his poem touches a chord in them, in the place where our mystery resides, often covered with a veneer of socialized shame.

Mirror, Me
by Kathleen Landerman, from the book Pagan's Muse.

Breathing in, I am
one with my shame.

Fear to look holds my whole body
immobile; my weight holds me
with more than gravity.

Breathing out, I am
my ugliness.

Vile, wretched, contemptible thing.
If the Way is Love,
then I should not speak of these things
to myself.

Breathing in, I am
my body.

If I gaze only at the reflection
of my pale belly,
then I will not see myself cry.

Breathing out, I am
this image.

If I light candles,
and do not think of you,
then I can see a goddess
full of adundant harvests,
round and smiling,
in my thighs.

Through the smoke of incense
these curves change,
become secrets,
invitations in velvet Braille.

If there was another woman here,
we could whisper the secret,
tell each other why a mirror
conquered a gorgon.

Breathing in, I am
no longer turned to stone
with shame, regret.

Breathing out, I am--
I am.

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