The USA: Where Folks Like Massive Bills, Not Univeral Healthcare

Last August I was a good mommy and I made appointments for my two kids to go get their yearly physicals. They were both healthy and growing just fine. They got the 90th percentile for height, 10th percentile in weight, vision good enough to be airline pilots... they had the stamp of approval from their pediatrician. It was a happy day.

A couple weeks later, I got a bill for almost $1000. Let me tell you, not an effing happy day.

I'm not so good at reading those complicated claim forms and bills, and I just knew something had to be wrong. So I called up the billing department at the medical group and politely asked if someone had forgotten to submit something to our insurance. The person I spoke with sympathetically told me that our insurance had already paid their portion.

I called the insurance company who happily informed me that we had a $500 deductible, they only paid 80% of the cost, and they no longer covered one of the standard shots my five year-old had gotten. Too bad, so sad, but yes, we owed the medical group almost $1000.

No, it wasn't an out of network doctor. No, we hadn't gone to any specialists or anything like that.

$1000 for FREAKING routine physicals for my kids.

We worked out a payment plan with the medical group, thank goodness. But let me tell you, it sucked the big one to have to fork over that money. I wondered what the heck I was paying the insurance company for. And all last Fall I pictured that bill every single time I thought about going to the doctor myself.

Never mind that I have not been to a doctor since my six-week checkup after the five year-old's birth. The thought of getting another $1000 bill kept my fingers from dialing to make an appointment. Finally in early November, I decided to make one but nothing was available till after the new year.

A new year meant I'd have to pay that $500 deductible all over again. I said thanks, but no thanks. Terrible, I know, especially because we ended up paying it since my husband had to go to the ER in April, and do follow-up visits to his doctor... more $1000 bills.

Given this, I'm really trying to see just what in our private health insurance system is so fabulous that we need to keep things the way they are. As far as I'm concerned, private healthcare isn't the bombdizzle AT ALL if I'm paying big bucks like that for care.

But what do I know? Maybe private insurance is working super well for other people? Other people are asking that, too.

Everyone I talk to has stories similar to mine, or else they have zero health insurance because Los Angeles is a town of a gazillion freelancer artists and do freelancers get insurance? That would be a no. The only way freelancers get healthcare is if they are married to a spouse who works that 9-5 or 8-6 grind. I wish some of these folks who are against universal healthcare would wake the heck up and recognize that no, illegal Mexican immigrants aren't the ones trying to get healthcare, or whatever other insanity it is that they believe in.

Nope, it's people born in the USA.

Fine, they are racist and don't want my half black behind to be able to go to the doctor. But do these folks not know that there are WHITE PEOPLE who can not afford to go to the doctor? Folks with college degrees, people born into nice, middle-class, pull yourself up by your bootstraps families?

Really, I'm supposed to give a flying feather boa about whether or not a corporation might not be able to compete with universal healthcare? Whatever.

But maybe the people who are against universal healthcare are just ballin' so out of control that they don't MIND getting unexpected $1000 bills?

If you have it like that, kindly rain some of your stacks down on me. You can email me and I'll give you my address so you can send a check and I can go to the doctor.

Actually, send enough so my kids can go, too. Thanks.


nick said…
I hear you loud and clear, Liz. The massive medical bills, the inability to get insurance, losing the insurance if you lose your job etc. The whole set-up is outrageous and inhuman. I sure hope Obama manages to get those health reforms through, though the pundits reckon they'll be much diluted versions of the original proposals. As you say, how can anyone actually enjoy getting a $1000 invoice on the doormat? The fact is they don't, but the big corporations sure as hell don't want to lose any of their colossal income.
Jen said…
Oh my gosh, Liz, don't even get me started on this. There's been all the press about the insanity of the "birthers" (and yeah, I think that label of insanity is justified), but the folks I REALLY don't get are these folks.

The two things our country MOST needs to get back on track economically - availability of universal healthcare and a true infrastructure for national public transportation. We just. don't. get it. It's time we joined the rest of the industrialized world.
The resistance to universal healthcare is just mindboggling to me! Someone told me the other day that they think it will end up being like welfare with a lot of cheats on it! WTF?!

How can someone having access to a physician and early treatment for diabetes, breast cancer or even a frigging yearly gynecological exam be a cheat?!

There is something seriously wrong with the system in America! I have decent healthcare but my children have reached the age where they can no longer be covered by my healthcare so what happens if they get sick or seriously injured?

Yeah this whole healthcare thing has me watching my local politicians very carefully!!!!
Lucrecer said…
Liz! Speak Sista Girl!! I had to share this with a few of my co-workers. All I want to see in this country is people be able to get what they need if they get sick. I can relate to those $1000 bills and not making appointments for myself because I can not see how in the hell I can pay for it. And, I work for a health insurance company.

Something has to be done, because I don't see why it is fair for me to have to pay a doctor over $100 for them to spend 2 minutes with me telling me my child is not sick. That is bullcrap.
Mes Deux Cents said…

Americans are the products of the worst educational system in the Western world. So it's not really a surprise to me that so many people are lining up to voice opinions which are actually against their own best interests.

If only these people could realize they are shills for the insurance industry. But I doubt they will since they are more than happy to hurt themselves and other Americans if it means they can stand against Obama.
Liz Dwyer said…
It's completely outrageous and inhuman! This seems like such a no-brainer but we're totally brainwashed by corporate lobbyists in this country to believe that universal healthcare would be a bad thing. The survival of the fittest, or wealthiest, model needs to be allowed to die. But will it? I just don't see that many people who are really up in arms over this.

The fake birth certificate really took the cake. I wish I could say I was surprised that our news media has probably devoted more time to that story than to the healthcare debate, but I'm not. I agree about the transportation. One of the nice things about Chicago was how EASY it was to get around on public transportation. I really don't get why we don't have a high speed train between here and Vegas or here and San Francisco!

Yeah, folks have really bought the lie that somehow folks are gonna be laid up, living fat off of universal healthcare! Really, how is making sure you can go to the doctor gaming anything?

See, if you WORK for a health insurer and you also don't make appointments for yourself because you don't want to get the bills... wow, when are people going to stop being blinded by prejudice, class warfare or whatever the heck else is preventing them from seeing that what we are doing is NOT working?
Liz Dwyer said…
Sadly enough, alot of this does seem to be about Obama hatred. Talk about cutting off your nose to spite your face. Do folks who hate Obama not have friends or relatives without healthcare? Do they not know anybody who's in debt because of healthcare related bills? Because if they don't I can introduce them to some people. And to people who go to work FULL TIME every single day and have no healthcare.
nick said…
Lucrecer - You work for a health insurance company but you can't always afford to make medical appointments. Doesn't that just sum up the whole rotten stinking system?
pooneh said…
The irony of all this is that health insurance as part of your job started as a 'perk' during the 1940's when there was a shortage of human resources due to the war.... before that, most people just worked it out with their family doctor - who usually worked with the family from cradle to grave for several generations....
of course, medicine and technology have all changed and this model would no longer work no matter what. However, this whole idea that there the link between a job and health care is somehow our heritage and should be protected is just silly.

as to that bill you got Liz -- I'm STILL fighting the insurance company and the medical group over how they billed my son's in hospital checkup! he's almost 2 and they keep saying the other one needs to file something else. Plus, his actual doctor has left the practice....meanwhile, they just keep sending me a $2k bill every couple of weeks hoping I'll pay it...and I spend about an hour on the phone every two or so months saying the exact same thing....I PRAY that healthcare reform is somehow instituted in this country....the current system is so messed up!
Tiffany H said…
Watch out for old bills too. TWO years after a car accident and the subsequent physical therapy the insurance company came after me saying that they should not have paid my expenses. They wanted me to pay back all the money they had spent. It took me months to sort this out and they even turned me in to a collections agency that I had to battle for months before they finally conceded that I did not own them thousands of dollars.
Lisa..... said…
The biggest misconception is that people claim that they don't want Universal Healthcare because they would have to pay for some one else's health care. What people need to learn is that WE ALREADY ARE. In so many ways. This country spends 16.9% of our GDP on health care, more than any other industrialized country. And we ARE NOT the healthiest or the best off. Our system doesn't work and it leaves almost 50 million people uncovered and many more poorly covered. When those people who are uncovered don't get primary care, and never treat that hypertension they have- 20 years later when they need a kidney transplant and get on medicaid/disability we will be paying for it. And paying a lot more.

Call me a socialist, whatever.

But wait, isn't that how we manage our police and fire department??
Sharifa said…
Hey, I just left a comment on your FB too but what the heck. Here we go. Did you read Paul Krugman's book where he talked about the main reason behind the failure to institute universal healthcare after WWII, was resistance to desegregation of hospitals?

My sister has a degenerative disease which keeps her from being able to work and where the drugs cost around 1500 USD per month (same disease as M.Obama's dad had). She gets free drugs here in Sweden. Our taxes aren't nearly as high as the GOP would have you believe and by golly, we get our money's worth. Husband had his gallbladder removed, may have cost us 50 bucks, overnight stay included. Son goes to the doctor for free, same day appt. no problem. Prescription costs to me the consumer are capped at 150 USD per year - I have the choice of going with the generic or paying the difference and getting name brand. You've all seen the tables where the US scores poorly on healthcare despite spending a larger percentage of GDP than other developed countries... it is such a pity because so much talent must be wasted, resources devoured by the bureaucracy.

There is an interesting discussion going on at The Simplest (, with input from people who got screwed by the system as well as people who work in healthcare.
Eve said…
My brother worked as a medical assistant in a healthcare clinic and -- wait for it! -- he couldn't afford health insurance to go to a doctor in the clinic he worked in. Sad.
Shiona said…
Oh my gosh Liz I was just going to do a post on this. I pay $150 a month just for medical and dental. No vision. Which is really what I need. My son and I both get two visits where we pay $40 and after that it's subject to coinsurance and we each have to pay a $900 deductible then er get 70/30. I have no idea what that translates to bill wisse yet but I have an exam on the 11th and my son's 2 yr checkup is next month so we will see.

I work for a small business that doesn't even offer insurance and once I get my massage therapy license my options are limited as well. At last check there are two places that actually offer insurance. The typical way of chiropractors and spas is to make you an independent contractor.
I too don't get the whole argument against universal healthcare. After watching the movie Sicko I got a better understanding. Michael Moore has always been a little over the top but when it comes to healthcare for me and my son I would be over the top as well.
Lotus Flower said…
I feel your pain, Liz. I've been booted off my health insurance this year (it expires when I turn 23) and I'm applying for a student one since I attend college. Even a simple ER visit costs $320. Seriously. A friend of mine is paying $3,000 in out-of-pocket expenses. WITH health insurance.

It seems people here are SO BUSY trying to dig reasons out of their ass as to why universal healthcare is supposedly a bad thing they don't even have an answer when I ask them exactly how our current healthcare is benefitting anyone right now? Other then the top CEOs and the richest one percent? People are too busy trying to knock the idea *gasp* socialized medicine out of the equation to come up with any actual solutions. And that's the problem.
Lotus Flower said…
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Lotus Flower said…
Call me a socialist, whatever.

But wait, isn't that how we manage our police and fire department??

Exactly. It's also how we run public libraries, Republican bailouts/bailing out small banks, AIG corporates who give themselves undeserved bonuses, etc.
AHHH!! Totally agree! I have been meaning to write a post like this, too, and you are inspiring me. I really want people to understand that those of us with insurance woes are regular, hard-working people, not bottom-feeders who want a handout. My husand is self-employed and was involved in a car accident a few years ago, and we have had such a tough time getting coverage. And the plan that we have is insanely expensive and covers NOTHING. I had a baby this year and I think we will have paid $22,00 out of pocket this year.

I am also totally confused by everyone's reluctance for healthcare when we all happily participate in government-funded parks, libraries, schools, etc. . .
Liz Dwyer said…
I didn't know that's how it got started, but it is crazy how folks try to act like corporate run healthcare is as fundamental to America as the Declaration of Independence. I hope the fight over the bill ends in your favor. :(

WHAT??? That is insane! How can they decide they shouldn't have paid? They should've just sucked it up as a loss. Goodness, that is GREEDY!

YES, we absolutely are already paying for it. What's amazing is that for a country founded on principles of liberty and justice for all, those things are left at the door when it comes to this issue.

Haven't read that book but wow, that is absolutely disgusting. And not surprising. This country is so steeped in racism that folks would rather have inadequate healthcare than risk integration. I am jealous of your health insurance. Do you think we can pass me off as one of your kids? ;)

Totally sad. But I guess he was only trying to get something for free, right?

Still write that post. I think the more we mobilize, the better. $1K deductible, each? That is immoral. I'm crossing my fingers for you and your son.

There seems to be no answer as to how the current system benefits everyday people. I guess we're supposed to see it as being patriotic or American to just blindly follow what the propoganda is saying. Folks need to wake up and independently investigate the truth of what is going on with this. $320 for an ER visit... yep, I can relate because I got chest pains when I saw the bill for my husband's visit.

$22K for a baby birth. Wow. I'll tell that to my husband next time he starts bleating about another baby. I don't know anybody looking for a handout. But I DO know folks who are scared they're gonna get in a car crash and then not get adequate care because of having no insurance. :(
Jameil said…
girl i was so PISSED when I heard one of my friends say she doesn't believe in UH. REALLY!?!? B/c you must think you don't know anyone who's gone a period of their life w/o insurance-- ME RIGHT NOW & when I was working part time at the news. Oh they offered it to PT people but it was HALF of what I made in a month. Who can live off of that?!?! And now that I'm a student no mas. Oh the fact that after insurance I paid $600 for the removal of 3 wisdom teeth (I've told this story like 6xs in the last month I feel). $200 per tooth!?!? Insurance is a crock of crap!!!!
Liz....I feel your pain.

The Italian system may not be perfect but at least we're covered.

It is outrageous that the US is the only western country without some kind of UHC. And yes in the end we are paying now. Who picks up the tab for people who go to the emergency room without insurance?

We need spend more on preventive health care.
Maria said…
OK - I'll wade in. Maybe you don't want me too... but...

I am against Universal health care for reasons of personal quality care - it has nothing to do with race. I so wish I didn't have to express that, but...

If people think everyone against UHC is basing it on race or illegal immigrants is lumping a whole lot together.

I think the current plans need to be improved and better regulated. There are so many abuses and wastes that it makes it impossible to keep the costs reasonable for the average person.

I am lucky to be a 9-5er with a job that pays part of my premium. I pay more into my plan (BCBS) because I have heath issues since childhood. I also have 2 little girls who need checkups, etc. My plan does not have a deductible because I had a plan like that one with an 80/20 and it just can't work for me.

Just yesterday I had a conversation with my doctor after having a horrible ordeal at the ER/Doc office/Hospital. She completed her residence in Canada who has Socialized medicine similar to the proposed plan. She told me her example of why it won't work - the 32 year old Mother of 3 with breast cancer was told she couldn't get treatment for a year because they didn't have funds, and she didn't fit into the right group due to her age (apparently 32 is old in Canada). This was a death sentence. My Doc told the woman if she wanted to live - move to the US and get treatment.

I'm all for making things better for American citizens - and for people in other Countries who need things only we can provide in the US... and I'm planning on taking on the daunting task of reading as much of the proposed plan as I can despite my dislexia (God help me... all that text) and I PRAY there is no truth to the rumor the Gov't will have open access to everyone's bank accounts... boggles my mind... so I'm going to look.

Yes, I agree, there should be a solution - My Company and I pay over $620 per week, $32,240 a year not including copays for me and my family to be able to go to the Doctor and recieve treatment when we need to. I pray not to see the day when I have an issue as I had this week and the Doctors tell me I need to wait a year for treatment.

OK - let me have it.
Lotus Flower said…
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Lotus Flower said…
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Lotus Flower said…
I guess financial enslavement is the only way to go then? Yeah, I got my surgery in a week's time but damn these $3,000 cat-scan bills!

I don't have any illusions that America will one day have socialized healthcare - the corporates, board of directors, and oil companies have too much power - but at least people are raising a debate and pursuing some sort of change.

and I PRAY there is no truth to the rumor the Gov't will have open access to everyone's bank accounts... boggles my mind... so I'm going to look.

Sounds like you've been drinking the Sean Hannity Kool-Aid.

She completed her residence in Canada who has Socialized medicine similar to the proposed plan. She told me her example of why it won't work - the 32 year old Mother of 3 with breast cancer was told she couldn't get treatment for a year because they didn't have funds, and she didn't fit into the right group due to her age (apparently 32 is old in Canada). This was a death sentence. My Doc told the woman if she wanted to live - move to the US and get treatment.

Really? Your doc must've lived in a different Canadian province then my cousin (he lives in Saskatchewan) because when my cousin had stage 3 colon cancer the doctors were able to give him surgery within three weeks of notification. Three of my friends who live in Toronto told me time and time again that while the Canadian healthcare isn't perfect -will always be pros and cons to every system - there's no way that they would trade with us because to them those inefficiencies do not outweigh the greater good of having full medical coverage. Obviously it depends on which Canadian you talk to.

I might buy the idea that other countries with universal healthcare are much worse off if they didn't have a longer life expectancy then we do, or were an obese nation like us, or if the U.S was ranked higher then Europe or Canada when it comes to the healthcare system. But unforunately this is not the case.

Does anyone think about the health & well-being of their fellow man anymore? Or is it simply dismissed as "their problem"? Billions of our tax dollars have been spent on pointless wars, failed businesses and yet we're too scared to shell out dollars for our OWN well-being? This logic never ceases to amaze me.
Anonymous said…
we have "good" insurance. and we spent 10k on healthcare last year.
good seeing you yesterday
Maria said…
In the search for Kool aid I found this.


Item 4 Part C on page 59
"enable electronic funds transfer, in order to allow automated reconciliation with the related health care payment and remittance advice"

See Item D on page 58 for eligibility of care based on financial responsibility

Now I have quite a headache, and I know you can't pull a few lines out of 1,018 page document - but I find it scary that these needles live in the haystack - and who decides how it is translated?

I am trying to do my homework to make an informed decision, but man... this is not easy reading.
Rosita said…
Thank you for writing that. You really said it so well. I won't try to add much. I would like to see some protests in support of IHC at some town hall meetings. Why isn't the DRC and others getting their people out?

Some advice to people if they keep having a fight with their insurance about an old bill, or the insurance is not covering something that should be covered (I saw several comments about this). They should report it to their state insurance board. Every state has an agency that regulates insurance. By reporting them, the state can then launch an investigation. If no one complains to the oversight agency nothing can be done. I know several people that get their issues resolved this way.
Liz Dwyer said…
Yeah, that part time but the insurance is most of what you make thing is pretty common. The company might as well not even offer it because no one can afford it!

Why wouldn't I want you to say what you think? You're welcome to, even if I have a different viewpoint. :) However, I do think there are plenty of people who see this as lazy, welfare loving blacks and Latinos trying to get over on the hardworking white middle class. There are a lot of race and class code words being thrown around, which is nothing new.

I know a lot of folks who live in Canada and in Europe and while there are problems with ANY system, the vast majority are very happy and are paying next to nothing out of pocket.

There is a family here in LA that is suing a heath insurance co. because last year the company repeatedly denied treatment for the daughter, and then the daughter died. There was a TON of outrage here. It was just strange to think that someone in an office could pick $ over someone's health. And to thik we're OK as a culture with paying billions for war/killing people. I don't get it. It's also sad to see this going down so partisanly. People's lives aren't about partisan politics or whether or not someone likes Obama.

I commend you for reading the actual legislation. I know lots haven't. I've read summaries of it and that'll probably be it for me.

The discussion is being reduced to either/or. I think false dichotomies are being set up. New system = poor quality is what we're being sold. I'm with you on the war cost thing. Do people not realize how the money spent in Iraq is mind-boggling? Hmm, I guess not. Why not spend that on health and education, something positive?

So good to see you, too. And good lord, that is insane. Yeah, those kinds of costs just can't continue.

So sorry you have a headache. I doubt they'd be able to take your money without your permission. I imagine it would be like how you can have your bank account direct debited if you use your debit card on Amazon.

Thanks for sharing that advice about state insurance boards. It's very good and I hope that works for some folks. I sure hope that one of these days people look back at our selfishness over this. I think it'll be a real marker of how individualistic our society really is.
Maria said…
LA -

Again, I just see the few needles and know the history of politicians - on both sides - one of the biggest issues I have is why the politicians get free health care and the citizens have to pay for it.

I wish there was a middle ground, some great answer to make everyone agree, but it's impossible to get everyone to agree on anything - and when politics are involved people cling to their "sides" and close their ears to the "opposition". It's so easy to say this plan is just another way people can vote for or against OBAMA, but you can appreciate Obama AND disagree -

I just wrote a whole bunch of gobbely-gok and deleted it. What it comes down to - I would LOVE to see people work together to find a solution - listen to each other's points of view, and maybe then we can create something great.

You can't listen if you are shouting at each other.
BlackLiterature said…
I'm late on this post but I hear you. Try this on for size. Husband changed jobs, we opted for self pay insurance until coverage started at the new job. Was 2 months at best. Had a miscarriage, opted for what I thought was a routine procedure. A d&c.

Ended up owing over $11,000 out of pocket after insurance paid their piece. Yes!! Sounds crass, but over 11K for something that I could have paid 500.00 at Planned Parenthood.

You can't tell me there isn't a problem with our insurance system
Maria said…

I am so sorry you went through that - literally insult to injury. I totally agree something needs to be done - but people need to come together and sort out the fine prints of the current proposed plan.

I for one would like to see the insurance Companies downsized so that the overhead is lowered, so that the Doctors can afford to lower their costs, and so that procedures will be mor affordable.

And why do Government workers get a free ride? I we all are to be in this together, then we ALL need to pay in and delete the loopholes...
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