Thursday, December 24, 2015

When the Customer (Your Doctor) Fires You

One of the biggest problems I encountered as Obamacare was being implemented- was a doctor shortage and a surge of customers. I can't prove it but I think a number of doctors saw this coming and started removing cash paying, uninsured people from their patient lists. We just aren't money makers.

Why help patients fill prescriptions for free when millions of newly insured patients are lining up for new patient visits and tests? Including pre-existing conditions! Obamacare was a huge windfall-bonanza for doctors and hospitals.

Cheap cash payers like myself were edged out. Cash paying individuals question the necessity of drugs and tests because we are paying for them. Doctors, clinics, and hospitals don't like that. You are supposed to shut up and do what they say. Patients have simply become a conduit for income.

So in 2013, I received a registered letter from my doctor which stated that she could no longer be my doctor. She blamed me for not using her services which is partially true. My last scheduled 3 minute visit with her cost me 185 bucks. The truth is, I never really liked her much.

It takes me 15 hours, or two shifts, to make enough net money to pay her 185 bucks for 3 of her minutes.

Having been banished from my village, I began the odyssey of trying to find a new doctor and keep my prescriptions filled.

My first appointment ended in a disaster when my new prospective doctor noted  that I was uninsured and then asked me to have my protime checked monthly at a cost of 1200 bucks a year. Since I have never done that in 25 years of taking blood thinners- I balked. When I tried to rearrange a monthly test at my little private lab which would only cost 300 a year- she stated that we weren't a good fit. The good news was- she didn't charge me for the visit.

I noted two things about that visit. Two female doctors and two giant female egos. Both of them acted indignant when I questioned them or offered a cheaper solution to testing. I don't know if it's me- or them- but mulling that over was not going to solve my problem. I decided from that point forward that I would not visit a female doctor again unless I was dying and a female doctor was the last option on the planet.

I searched for an independent doctor- one not affiliated with a giant, money sucking hospital. I found a "doc in the box" who might have worked- but I literally could not get a prescription filled. I would call in, leave messages, go to my pharmacy- it was unreal. It took weeks to get anything done. I went in to the clinic 4 or 5 times to complain in person. It was simply the worst service I have ever been subjected to. I paid in cash every time I went in so it wasn't like I was some deadbeat.

After about 9 months of that- I gave up. I began searching for an independent doctor outside of Boise. I found a guy, perhaps 10 years older than I am, that doesn't appear to have any axes to grind or imposing egos. Everything has been smooth sailing thus far- but his staffing issues are causing me problems. They don't like that I use a private lab to have my blood tested- I can tell that. They charge about 150 bucks and my lab charges 24 bucks. Every time I have any issue whatsoever- his office wants me to make an appointment and come in.

As an interesting note, it was nearly a year later (about 9 months ago) when the "doc in the box" finally discovered that I wasn't coming in and fired me. That it took them nearly a year or so to send me a Dear John letter was not surprising. In fact, it made perfect sense.

I am currently on my fourth doctor in 4 years. I've paid my Obamacare penalty last year. This year I have had nearly 10k in medical and dental expenses and I qualify for any number of exceptions to paying the penalty. (This is really worth looking into) I absolutely refuse to line the pockets of predatory insurers and a complicit government pissing down my back and telling me they are just trying to warm me up.

Friday, November 27, 2015

The Great Blood Test Rip Off

In the spring of '08, my health care plan terminated. I was 47, in reasonably good health, and the only thing I needed that year was a tooth extraction which was a few hundred bucks.

In the fall of  '08, I landed a new job with a small private employer that offered health insurance. It would be a fun job- reintegrating juvenile felons back into the community. It might have been a great job but it was managed so poorly that I knew I wouldn't be able to last. I hadn't had a physical exam for 3 years so I found a new doctor recommended by my old doctor and I scheduled the appointment. I couldn't get in for 6 weeks.

While waiting for the appointment date, my new job was getting worse with each passing day. It was becoming rather obvious to me why my employer was experiencing a 75% annual turnover rate. I had one of those bosses with no real management skills who liked to verbally abuse employees in front of everyone else at the weekly staff meeting. In the spring of '09, I had a young offender "no show" at the agreed upon time and I talked his mother into returning him back to the program in return for not reporting him as an escapee. It worked but I had violated the rules. I knew the public brow beating would happen at the staff meeting in a couple days so I simply quit before the meeting.

This kind of pissed off my boss who immediately cancelled my insurance by not paying the premium. When I arrived at my scheduled appointment, I figured I'd be paying cash for it. The appointment cost 185 bucks and my new doctor ordered a 6 panel blood screen which is a fairly routine test. That test costs about 79 bucks at a private lab that I had been using so I figured the whole thing might cost me 300-400 bucks.

I arrived at the hospital lab a few days later. The blood draw took two minutes and was performed by a young phlebotamist who told me he was making 12 bucks an hour.

A few weeks later, I received the doctor's bill and the lab bill because my insurance had been cancelled. The doctors bill was 185. The blood test bill was 1102 dollars. My little physical exam had cost 1300 bucks. Wow.

I paid for the doctor's appointment. I then focused on trying to resolve the lab bill. I called my private lab and they assured me they were doing that draw and test for 79.00. (I recently had it done again and it was 114.00) I then contacted St. Lukes hospital billing department and scheduled an appointment. I explained my situation and that I would like to resolve the fee for 200-300 bucks which I assured them was a healthy premium over the going cost at my private lab. They asked me to submit an indigent form. I explained to them that I was not indigent nor would I fill out a form asking me for every personal piece of my information and history. They said they would send my request into some committee for review.

A month later, the committee refused to reduce the bill. I received an email.The bill would stand at 1102.00 dollars. If I did not pay it would go to collections. I did not pay.

Soon thereafter, I got a call from a collector demanding payment. I told her this. Why don't you sue me for the 1102 dollars and we will see if the judge agrees that 1102 dollars is a reasonable price for a simple blood test? I never heard from them again.

Since 2009, that bill has been listed on my credit report.

What was the net effect of not paying? My credit score hovered around 700. I lost a great rate on a conventional home loan in 2011 and got booted into a higher rate loan. In return, I simply paid an extra ten thousand in principal and effectively reduced the rate and thus the payoff which meant refinancing into a conforming loan at a lower rate with lower principal. I got shoved into a higher car loan rate which I paid off early. That was the only way to reduce the ill effects of higher interest because of a hostage taking health care system that has been an economic train wreck for all of us.

It's been 7 years. My credit score is now around 760. All of this because of a blood test which should have cost about 79 bucks.

Wednesday, November 18, 2015

An Introduction to My Obamacare Nightmare

For 25 years I waited for the magical number, 1/1/11. My retirement date. I was only 50 when it finally came and I was feeling blessed that I got out when I did. Unfortunately as life and politics go, my time as a small town Police Chief would be shortened a few years. I left public employment near the end of 2007. I was 46, almost 47.

A few months later in 2008, our world changed. The greatest financial crisis since the Great Depression was unfolding before our eyes.The United States lost tens of millions of jobs. That meant we lost tens of millions of people who were receiving health care benefits via their employers. When those folks left the workforce, mostly healthy folks, hundreds of billions of low risk premium dollars left with them.The health insurance industry was on the verge of collapse. The only avenue left open to them (other than raising rates through the roof and watching everyone else flee) was some sort of law to force people back into the managed risk markets. Full time jobs were leaving and the insurers knew they weren't coming back. They would hire lobbyists, make giant campaign contributions. They would make concessions. They would survive with the help of their Congressional cronies.

A health insurance industry bailout. To sell it, they would have to call it a palatable name.

Our leaders bailed out the bankers in 2008 with our tax money and they felt the anger and the backlash of the taxpayers. They did it anyway. In 2010, our leaders bailed out the health insurance industry with something called the "Affordable Care Act" which was one of the most misleading and deceptive titles ever conceived and placed on a piece of legislation. It rivaled the "Patriot Act" in terms of pure deception. Without the ACA or Obamacare as many of us call it, the health insurance industry would have surely gone out of business. Rather than misappropriate tax money again- our politicians and then only democrats, wised up and passed a law that forced people to buy health insurance. In truth it is a seizure. It seems odd to me that not one legal argument has been based on our 4th amendment right which guarantees that our government cannot unlawfully search or seize our assets. The ACA certainly constitutes a seizure. So much for the Constitution.

In the meantime, real people are struggling and getting ripped off by a healthcare industry that no longer cares about delivering a quality outcome- just so long as the checks keep coming in.

About a week ago, my significant other talked me into starting a blog about my journey around the Obamacare quagmire. She convinced me that there were millions upon millions of other people- people like me- caught somewhere short of medicare with no health plan. I scour the internet, I talk to providers, I cut cash deals, and I order drugs from Canadian pharmacies to escape the stranglehold big pharma has on me. I am even considering flying outside the United States to get some elective surgery done.

The odd thing about American health care right now is that it has gotten so bad that I will never embellish a story. I don't need to. The healthcare situation in this country has gotten so bad that often- I think I must be dreaming. Maybe I can no longer tell the true from the false. That's my current reality.

This then, is my Obamacare nightmare.