Thursday, February 02, 2006

Those Wacky Health Insurance Companies!

As soon as I got my first real job, I finally got to experience the wonder of having my own real health insurance benefits, not as a dependent.

Actually, I think I technically may have had health insurance as a grad student, but I never used it because I wasn't sure that it was a serious policy that actually covered anything. So as a grad student I had always just gone to the cheap student clinic on campus. I found the service there to be pretty good, but I can't really judge it because I was healthy the whole time and really only went there for contraceptives, which I understand usually tend to be the main specialty of a university campus clinic.

But once I had a real job working as a programmer for a real company, I had real health insurance!

Or at least I thought I did. And since I was still young and healthy, I didn't have much reason to test it out.

After almost a year of working as a C++ programmer, I decided I wanted to switch to Java, which was impossible in the job I was in (since the company didn't do any Java). And since I also didn't care for the hour-and-a-quarter-each-way-through-heavy-traffic commute, I decided to quit my job so that I could train myself to program in Java.

Since I was planning to be unemployed, I said to myself "What the hey, maybe I should go out and have a check-up first before joining the ranks of the uninsured."

This was a really stupid idea, and I'm only telling you about it so that you can learn from my foolish example.

The lesson to be learned is that the correct sequence is as follows: (1) Go to the doctor, (2) wait until you receive evidence that your insurance has paid the bills as they were supposed to, then (3) quit your job. Important: Do not invert these last two steps.

When the insurance company refused to pay the bill, I called up their customer service department and found that not only was I not currently insured according to their database, but in fact their records showed I had not been insured by them at all.

I had papers to show that I was indeed insured by them, but unfortunately such proof is irrelevant when complaints are apparently placed on automatic redirect to the circular file.

And here's where having quit my job became a problem. When I called the H.R. person at my old job, she assured me that she had all the paperwork necessary to show that the check-up should have been paid for by the insurance company, and told me she'd contact them and straighten it out. But obviously she didn't want to waste her day on hold with the insurance company any more than I did. So each call I had to make to "remind" her to help me when she didn't contact them was a bit uncomfortable since my former employer hadn't wanted me to quit my job in the first place.

So I mailed the bill back to my doctor explaining what the error was, and included copies of all of my insurance papers as evidence, and requested that his office redirect their billing inquiry to the insurance company. My considerate and understanding doctor responded by sicking a collection agency on me.

So I heard from the collection agency next without even a note from my doctor's office as to why the complaint in my letter was ignored, which was in my mind a rather humiliating example of adding insult to injury. The only bright side of it was the chuckle I got from the collection agency's return envelope, which in the return address area explicitly included a line for the victims to write down their telephone number. Ha ha! Does there really exist anyone on the planet dumb enough to fall for that?

I of course sent my whole packet of evidence and explanations to the collection agency, which of course they ignored. As if they want to waste their time on hold to my insurance company any more than the rest of us!

So what do you imagine I did?

I paid the bill out of my own pocket of course. The time and stress of worrying about it was more costly to me than the $100 or so requested on the bill. I would have continued pursuing it on principle if I'd thought my efforts were anywhere near as inconvenient for the insurance company as they were for me. But it turns out that sacking your customer relations department and replacing it with a perma-hold answering machine is a very cost-effective solution for them.

Two months later I got another job, closer to home and using Java this time. This new one also theoretically had health insurance, but I didn't dare find out. Kind of like the experience one gets from a "scared straight" program, I was "scared healthy." Any disease or injury I might seek out medical care for had to pass muster of being scarier than the collection agency. None were, so I mostly just relied on my trusty immune system.

My only other experience with American health care after that was when I brought my husband and kids to visit my folks. My toddler threw up, and my husband thought it would be prudent to take him to a pediatrician. Of course the receptionist at the pediatric clinic was terribly worried when she saw we had no U.S. medical insurance, and made us sign a paper that we would pay on the spot.

For a bunch of random tests and about two minutes of having a doctor look at our boy, it came to $400.

Then the punch line is that after we paid this in person, two days later the clinic sent a new bill to pay the amount again for the same services! Fortunately I had saved the receipt that showed I'd paid, and mailed a copy of it to them. If the clinic went on to hire a collection agency at that point, I don't know about it since I went pack to France and my parents haven't forwarded me any mail to that effect.

This episode was a bit of a shock to our French sensibilities, being accustomed to having a real doctor come to our house and give a kid a proper exam for closer to $40 (which is paid anyway by some combination of our insurance or the state).

When I was a kid, I'd occasionally hear jokes about "house calls" and how doctors don't make them. I always wondered why this was even a joke since of course doctors don't make house calls. Duh!

Interestingly, in France they do.

Actually, I have to be honest here. Aside from that one dentist (see last week's column), I haven't had any complaints about the health care here in France. Both of my sons were born in a state-of-the-art facility, with tons of top-notch prenatal and follow-up care. And all of it without having the positive health benefits cancelled out by a sticker-shock-induced stroke.

You'll probably say "Well, sure the French can handle routine procedures like births, but if something really bad happened to you, you'd wish you were back in the US!" I can't really answer that charge either way since fortunately nothing really bad has happened to me.

Plus you might point out that I'm paying for it anyway, just through taxes. I can't really comment on that one either since my husband does my taxes. I know I'm being a bad feminist to allow that, but I guess my feminist spirit doesn't extend to the point of jumping up to volunteer to do some annoying paperwork when it looks like somebody else might do it instead.

That's just one person's experience though, so take it however you like.

Published in the Utah Valley Monitor January 19, 2006.


Anonymous said...

I agree 100% ,from experience, the health care service and doctors in france are great, and yes they make house calls for 40Euros, the doctors here are doctors not businessmen.They seem to have roots back to the high esteem of a shamanic healer. Dentists here on the other hand fall into another realm with roots that might stem back to that of the shaman's helper ie blacksmiths who work on the patient as if they are already dead.

C. L. Hanson said...

Hey d333gs!!!

You may be right. Like I said, I haven't visited all that many dentists, so I can't say. I took my kids to a pediatric dentist in France, though, just before moving to Switzerland, and she was very professional.

The Ridger, FCD said...

The thing about an insurance company is: it exists to make money for its shareholders, not its policy holders. Selling policies and collecting premiums = profit. Paying claims = losses.

I don't blame them; that's capitalism for you. In fact, if they didn't act like that, their shareholders would have a legitimate beef.

I just don't think decisions on what health care people get belongs in the hands of people who are motivated to pay for as little as possible...

C. L. Hanson said...

Hey Ridger!!!