I want to move on from this topic, but pain currently has a starring role in my life, and issues I didn’t run into when I had adequate health insurance keep surprising me.
For instance, the reason people without health insurance use the ER as a primary care facility became clear to me last week when I finally caved in and sent detailed notes about my chronic pain, and some rather grotesque pictures, to my primary care physician. She referred me to a specialist, but due to the exclusion rider on my pre-existing condition that basically states that nothing having to do with my chronic pain will be covered, I would be considered a self-paying patient, and the doctor she referred me to doesn’t take any self-pay patients.
“So that’s why people go to the hospital when they don’t have health insurance,” I said to myself. A hospital has to treat everyone. A private doctor does not.
When I explained the situation to another specialist’s office, its billing department said to come in anyway and that I would be billed after the doctor decided what he wanted to do. Perhaps self-paying patients get second-class treatment in his office; for some reason, he saw me for less than five minutes even though I was at the office for an hour and a half. In that five minutes, he wrote a prescription and ordered another diagnostic test. A representative from the billing department later called me about the appointment I had set for the test. The rep told me that my insurance company said that “no diagnostic tests relating to (my pre-existing condition) are allowed until the year 2011.” This really means they’re allowed, but I would be paying for the $1800 test out of pocket.
If she had said those words to me face to face, I think I would have punched her. That’s not true; I just would have been embarrassed because she would have seen the rage heating my face and the tears forming in my eyes. I smiled through the droplets and in my most chipper phone voice, I said, “Cancel all my appointments. If I have an emergency, I’ll just go to the hospital.”
Would a visit to the ER cost twice as much as the diagnostic test in a private office? Probably. Would I get the treatment that I need? Definitely. Would I end up paying the bill? Maybe. But there’s also the chance that the hospital would just pass the cost along to all of you lucky, fully insured people who are afraid of losing health insurance that you don’t even realize sucks. And you don’t even realize that one of the reasons it sucks is because you’re covering what the very company you pay won’t cover.