Thursday, June 28, 2012

Health Insurance

The US healthcare system is a mess.

Not only is per-capita spending by far the highest of any developed nation. Some 30 million Americans don't even have health insurance, either because their employers don't provide it (they aren't obliged to, so most don't) or because they simply can't afford private insurance.

Luckily - or unluckily, depending on your standpoint - people are guaranteed emergency treatment even if they are uninsured, though insurance companies pass the cost of this is directly on to the insured.

Part of the problem is that there are no fixed fees for medical treatment, so doctors charge as much as they want. For instance, I recently heard of a not uncommon case in which a simple broken leg generated healthcare costs in excess of $100,000.

Another problem is that insurance companies can determine what they will pay for specific treatments, allow you to use only approved doctors, set massive copays (i.e. deductibles) and even refuse to insure people for what are known as "pre-existing conditions" - a catch-all that effectively means they can cherry-pick the healthiest patients and then decide not to reimburse treatment if an insured person does eventually need it. As a result, people are often saddled with astronomical medical bills and must take out huge loans to pay for treatment for themselves or their loved ones.

I never thought this would affect us because we are fortunate to have relatively generous company-sponsored health insurance. But that hasn't stopped me becoming entangled in several bizarre Catch 22-like situations in my few direct dealings with our health insurance company.

To give you an example, our daughter needed braces. But because I wasn't sure how much we might have to pay ourselves, I called the insurance company and asked them.

"I'm sorry, Sir, but I can't tell you how much is covered," the lady on the phone said.
"Why ever not?" I said, somewhat taken aback.
"We don't release that information, Sir" she replied.
"But why?" I said, feeling like a belligerent child.
"Because if we did, people would use it all, sir."
"Then how can I know what I can afford?" I asked.
"You can't," the woman said flatly. "You simply submit your orthodontist's invoice, and we determine your copay."
"So are you telling me it's a secret?" I asked, the adrenalin rising.
"If you put it that way, Sir, yes," she answered.
"But I'm the customer! Surely I have a right to know what I am entitled to for the money I am paying," I almost screamed.
"I'm sorry, Sir, there's nothing I can do about that," the woman replied.

And that was that.

Luckily for me, the orthodontist we chose finally managed to find out what we were eligible to - after three phone calls.

Tepid Praise

Walking along the road this afternoon, I passed a group of young girls heading in the other direction. 

"Are you Tom's dad?" one of them asked. When I replied to the affirmative, she said, "Cool!"

It's odd being considered cool by association with a 9-year-old.

Tuesday, June 5, 2012

Lost in Translation

I had a rather Kafkaesque experience this afternoon at Staples, a stationery superstore.

Having hunted in vain for rulers throughout the shop, I went up to a sales assistant and enquired where I might find one.

"Roo-ler?" the woman asked, rolling the R as if to emphasise my bizarre request.

"Ruler", I confirmed.
"Roo-ler?" she echoed with a look of complete incredulity.
"Ruler", I repeated.
"Roo-ler?" she asked a third time.
"Yes, ruler!" I said, somewhat exasperated.
"Oh," she replied. "Aisle 11 on the right."

What luck we were speaking the same language. I can't imagine what might have happened if we hadn't been able to understand one other.