By Ellis Goodman
My wife and I have recently undergone, in her case surgery, and in mine a colonoscopy. It’s been an interesting experience to see the flood of paperwork that followed these two procedures.
In her case the total costs of her surgery, which was an outpatient procedure, was $25,000. Initially, we received notification from the hospital that the procedure was not covered by our insurance and therefore the total amount was due and payable. I had learned from previous experience, not to panic when one receives that sort of notice. I did however phone the hospital and make sure that they had all the correct insurance information. They said they would resubmit it, and sure enough the next communication we received from our insurers stated that, “This is not a bill,” but we might owe $728. Since it was not a bill, I didn’t pay anything but waited patiently. My wife has Medicare and supplemental insurance, so we were involved with two different insurance parties. Again, I waited patiently and sure enough the supplemental insurance finally confirmed that they were covering the extra costs and now the amount due was $25. Altogether I received seven communications on this one surgery experience.
In my case, I had a colonoscopy, a repeat of my previous examination 5 years ago. This saga is still unfolding. I have had numerous communications from my insurer assuring me that “This is not a bill” and indicating the various amounts, gradually declining that are still due for my procedure. Again I am not panicking and will await patiently, the continuing stream of paperwork that will come through advising me that “This is not a bill” until eventually perhaps I will have to pay some nominal amount to settle these total costs.
We all know that the administrative costs of our healthcare system is not only unbelievably complicated but also accounts for some 60% of our total annual healthcare costs. If Obamacare can achieve one major objective, it should be the simplification of the paperwork procedures and the reduction in administration costs.
I know that there are many in the US that are critical of the single-payer system that exists in Canada and many European countries. These systems are not perfect, and maybe at the top end, the services are not as good as those in the US. However all citizens are covered and the systems despite glitches and inadequacies, do work, and at a cost substantially below that of the US.
My daughter lives in Paris, and is covered under the French healthcare system. Her recent experience I found very interesting. She had been suffering from back pain for some months and eventually went to her internist to discuss the problem. The internist felt she might have some degradation in her hip, and was possibly walking incorrectly. He filled in a slip of paper and sent her for an X-ray to a doctor’s office around the corner. She went and found there was no receptionist, just a very small reception area and no paperwork to be completed. The radiologist appeared, and escorted her into a room and took the X-ray. She was told to wait for ten minutes or so, and then received a large envelope, with her X-ray inside and was told to return to her doctor. She went back to her doctor’s office, gave him the X-ray; and, as a result, he sent her to be fitted for some orthotic shoe supports which would help reposition her hip. At the end of her visit, she was asked to swipe her Medical card. She never received a receipt, paperwork, or descriptions of what had transpired, but could have got this information Online, if she had wanted. The shoe orthotics worked and her pain subsided and now she is fine.
Apparently the purchase of drugs is on a similar basis – swipe the card and that’s it. Sometimes there are modest payments for drugs but usually only $5-$10.
Now of course, the French pay mightily for this healthcare service and indeed it is probably a disincentive for employers to hire, since the employers are responsible for the major contribution to health care costs. But nevertheless every citizen is covered, and the costs to both employer and employee compare very favorably to healthcare costs in the US and the system appears to work very efficiently.
Maybe there are lessons to be learned. Perhaps, despite what many of our legislators may think, our healthcare system may not be the best in the world, and before we criticize other countries, we might like to look at their systems closely and see if we can learn something. Because clearly our healthcare system, as it stands at the moment is unsustainable, our costs are prohibitive and rising, and Obamacare excruciatingly eking out congressional agreement, did not go nearly far enough to solving our problems.
Ellis M. Goodman, author of Bear Any Burden: www.bearanyburden.com