Tuesday, May 17, 2005


Healthcare in the US

I've tried both styles of healthcare system -- socialised in the UK, and the system in the US. The US system, like democracy, looks bad only if you've never tried any other system.

It's tough. Everybody wants great healthcare. In the US it's rationed by cost; in the UK it's rationed by waiting lists.

My problem with healthcare here in the US has to do with the billing practices of the hospitals and the attitude of the insurers.

You go into hospital for some work. For me, this was a revelation -- spotlessly clean, private rooms, smiling staff, sleek, well-paid doctors, nobody sleeping in corridors, etc.

The problems start after you leave. You start receiving random invoices for things you don't recognize. Every so often a bill will arrive with cryptic references and codes on it. You wouldn't tolerate this from a car repairer, why should hospitals be any different?

You find your insurance has got various pathetically low limits. For my daughter's vaccinations -- a legal requirement, without which she can't attend school -- I very soon blew through the $500 limit and ended up paying out of my own pocket. (The government in effect forcing me to pay to risk my daughter's health)

The insurance and the hospital don't communicate with each other and you turn into an unpaid project manager, with both of them on the phone together, relaying messages, working out all the issues. (How the hell do people cope when they don't speak good English or are not comfortable arranging and managing conference calls?)

Hospitals, doctors, and so on have had to spend millions complying with the new HIPAA "privacy" act... which, I suspect, actually reduces your privacy.

Instead of that nonsense, why not compel them to producing clear invoices for their services instead of relying on obfuscation? What is so hard about producing a clear bill for services rendered?
It's a challenge isn't it. I ran into a similar incident when my wife had some extensive surgery about five years back. One specialist I've still never quite placed in the scheme of things, months after the hospital stay, had my "account" turned over to a collection agency. That was the first I knew of this "specialist", of the debt owed, of the bill outstanding, etc. Never had received a single thing from him prior to the notice from the collection agency.

To this day I'm not sure if this person actually rendered a service to my wife,or was owed any money by me, but to avoid further confusion I paid the bill. I did ask if they would please explain what service he was being paid for and why I'd not received a bill prior to the collection notice, but never even received a receipt for the money. I still feel I was scammed, but didn't want to fight it for a couple hundred dollars.
International readers may be amazed but I'm not. Collection companies can trash your credit rating which is very important here. And good luck getting a hospital to explain their charges.
Great blog I hope we can work to build a better health care system in the U.S.. Health insurance is a major aspect to many and we deserve to have great health coverage.
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