2009 has been another banner health year for my health insurance company. It hasn’t been as grim as the 2005, the year Zoe was born and was in the NICA for 3 weeks ($60,000), but unlike 2005, when the NICU stay was inevitable and necessary, some of the health care administered to me seemed entirely due to the fact I had good insurance. In January, my doctor discovered I had high blood pressure. Not really surprising since I’d been prehypertensive before and living at high elevations can exacerbate hypertension. Plus, my dad had high blood pressure and my grandmother had high blood pressure. Circumstance predicted I would too. Not great news but not the end of the world either—The cardiologist I was sent to prescribed good medications and the smallest dose seemed to manage the symptoms well. But the cardiologist wanted to be sure it was just run-of-the-mill hypertension. So he scheduled me for a CT scan and an echo-cardiogram. The echo-cardiogram was painful. The CT scan stressful. Both were normal.
Maybe I wouldn’t be writing this if the scans hadn’t been normal but all evidence suggested they would be. Perhaps if the mediation hadn’t worked then maybe the cardiologist should have run those tests. Perhaps if I had any symptoms, chest pain, shortness of breath, palpitations, then he should have run the tests. But what was it to him, the tests? My time and a big check to him..
A couple of weeks after the echo, I got a bill in the mail for $3,460 for the procedure. This wasn’t good for my heart. $3,460 for an hour long ultrasound test that was administered by a insensitive tech? I’m sure the big bucks were for the machine as much as the cardiologist and the tech. I freaked out, called the office. Obviously, my insurance just hadn’t tracked. They fixed it. No problem. Except when I received the statement from the insurance company, the cost of the procedure, $3,460 showed in the left hand column. To the right, the amount allowed by the insurance company. It read $789. The cost of the procedure had been reduced, thanks to the bargaining power of the insurance company, to less than a quarter as much. If I hadn’t been insured, I would have owed that original amount. If my insurance company had less sway, they would have owed more. Did I even need that $3,460 procedure? Would the cardiologist have asked me if I wanted it or could afford it if I didn’t have insurance? How would I be “healthier” if I had to add $3,500 to my debt?
I know I’m lucky. To have insurance. To not have anything truly funky going on with my heart. To have access to doctors and to medicine. But that’s what it is—pure luck that I have a job with health insurance. Why should I be so lucky and someone else who may need the test more than I not be able to afford or not be offered the test in the first place be so unlucky? Too much health care for the lucky ones sucks the health care right away from the not so lucky.
*I didn’t name my health insurance company for fear they would somehow find this, get pissed off, and kick me off their policy. Because luck only holds for so long.