Every time we think that we have health insurance figured out, we are proven that we are and will always be wrong.
You can do it all. Every step. Check it off. Verify it. Dot every i and cross every t.
The insurance companies will still manage to get you.
Actually, it's not always the insurance companies. It's more the laws and the medical profession as a whole.
In Network But, Oh, Just Kidding
The latest example I saw that just floored me was in a New York Times article last week where unsuspecting people need immediate medical care. They do the right thing. They head to their emergency room that they already know is in network and get the care that they need.
It all sounds fine and good, until the bills come, and they realize that while they went to an in-network emergency room, the physician that treated them may not have been in-network.
Meaning, you're stuck paying through the nose.
Apparently, many hospitals can't (or won't) fill all positions with employed doctors, so they contract out some of the staff that they need. This is becoming more and more common. It reduces fixed costs for the hospitals, but it means that you really have no idea what you're going to end up being billed for.
Sometimes, it's a crap shoot. The hospital may have some doctors employed by the hospital, and some brought in as contractors. The one that you get to see? You can't really pick.
Granted, patients can find out if the doctors are in network or not, and if the doctor that comes to see them is not, they could always refuse service or ask for someone else, but honestly, if you're in a situation where you or a loved one needs emergency care, how often do you think this will happen? If you're hurt or having a heart attack, or your child has a broken bone, are you really going to wait around in hopes that a doctor is available that can save you money?
Sadly, that's what our health system in America is coming to, and you may be asked to make this choice.
The hospitals themselves are covered. In the sheaf of paperwork that you sign when you first arrive, you're likely signing something that indicates that there is no guarantee of the network participation of anybody that treats you.
Since most hospital visits incur separate charges for the hospital and the doctor(s), many unsuspecting patients are falling into this trap, and when they call to protest the bill, the hospital can point to the fact that they signed the paperwork.
And, the sad thing, this is all legal.
What's The Better Way?
The bottom line is that the system is broken. I'm generally conservative, but I'm not staunch enough to think that Obamacare is an unmitigated disaster. Many conservative people argue that it should be repealed, and many politicians build their platform on trying to do just that.
I'm not so sure, and the main reason is more of a fear as to what would happen if it was repealed.
Think about that for a second. There are people out there whose goal in life seems to be to get rid of our current arrangement, and they will talk for hours at end about why it is so awful for our country and our citizens. If anybody started that conversation to me, I would politely stop them and ask them how they would propose to make it better. What would they put in it's place that would stop the stupid nonsense and loopholes that screw the average consumer?
My guess, based on the fact that I've never heard one good proposal, is that nobody really knows.
On the flip side, Obamacare has not and will not prove to be a big fix. We've already seen that. It made a lot of promises, and even lived up to some of those as to problems that it was able to solve.
The main issue I have is that for every problem it solved, it often created another issue. You have many paying higher than they used to for insurance. The second problem is that it did not truly reform the system in that there were way too many problems and loopholes left open that didn't get addressed.
Like going to the in-network Emergency Room and getting billed thousands for the out-of-network doctor that took care of you.
Sorry, until stuff like that gets fixed, you can slap any label you want on the health care system, but the one I would slap on it would read: