Thursday, September 20, 2012

Now it’s personal!


I’m back! And this time its personal (queue music) Dun-Dun-Dun-Dum! I’m upset, frustrated, and even a little angry. Why you ask, and with whom? In general I’m mad at America and so many of its dysfunctional systems. Since the political season is just getting into full swing let’s start there. The two party American system is broken and short of a populist revolt or military coup I don’t see how it will fix itself. The problem is that the two sides only have self-interest and re-election in mind. There is no room for compromise because it makes you look weak, and if you look weak you can’t get re-elected. Also if you don’t tow the party line the party “bosses” take away their support and once again you can’t get re-elected.
            
          For most of us Americans, politics is like a spectator sport. We pick our favorite team. We root (vote) for them for a multitude of reasons, anything from they were my parents favorite team, their captain is smart or cute, or for that matter black or white, or maybe because I strongly believe in one small part of their total platform (i.e.: pro-life or pro-choice) or this year’s hot button issue (distraction) “Gay Marriage”. Some of us are diehard fans who wear our team colors with pride but can’t afford tickets so we watch the game on TV. Others of us make the big donations and get to sit in the box seats and rub elbows with the powers that be. When it’s all said and done, most of us know the reality that it’s only a game and no matter which team wins or loses it doesn’t affect our day to day lives very much.
            
        Something that does affect our lives more on a daily basis is Health Care or the lack there of. One of the things that I found very frustrating about the whole “ObamaCare” debate is that it actually had very little to do with health care and everything to do with health insurance. Now I don’t know about you but for me these are two totally different issues. One should be a basic human right the other is just a way for some people to make a boat load of money, you decide which is which.
            
       Now this is where it gets personal. I have health insurance (unlike 50 million of my fellow Americans) but I still can’t really afford health care. Let me give it to you by the numbers. My wife and I pay $660 per month for a PPO plan with a $2500 deductable. Now it’s a little misleading because that deductable amount is for each of us so it’s actually $5000. Then there is the little thing the insurance companies call Maximum Out of Pocket expense, that is on top of the deductable. For us it’s $7000 each for a whopping possible total annual health care cost of $19000 plus the $7920 for the insurance premium for a grand total of $26920. And that’s only if we stay within “system”, if we go to a health provider outside the system tag another $6 Grand onto that. Now if I make the average American annual income of around $50K (before taxes) that would be more than half my annual expenses. How is that going to be possible since I also need food, shelter, & clothing, not to mention transportation.
            
        OK, I know that’s a worst case scenario but that’s kind of where I’m at right now. You see my family had a major “health scare” this summer and as of this writing we are about $8K short of our max out of pocket with more bills to come. Now so none of you worry, everything is OK now health wise and no you don’t need to ask details since you know I don’t tell tales out of school. I always hoped that this wouldn’t happen to us but unfortunately, hope just doesn’t cut it.
            
        I’ve mainly been talking about health insurance now let’s talk health care. Unfortunately the week we got the diagnosis from the WHF was the same week that Dr. Davis left and fortunately we were referred to the UC Davis Medical Center. They have been great. Scheduling, communications, explanations, and the medical care have all been wonderful. And to top it all off they have been more than willing to work with us on that big ass out of pocket bill we have with them.
             
        So that brings me to a last little note for today. I was just looking at one of the bills from UCDMC and I was totally shocked to see that a one hour outpatient surgery with pre-op, anesthesia, post-op and all the other bells and whistles was billed at $36000. But that wasn’t the shocker, my insurance company only paying $7600 or 21 cents on the dollar now that was a shock. So which one is the true value of the service that we got, or is it somewhere in between?
            
       No wonder I’m angry. The only ones who can fix the health care system are the politicians and we all know how well that system works. 


To view the column in it's original form go to page 15 of the following link. Winters Express 09/20/12

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