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The American Medical Community and Insurance

A Factual Account By - Bert

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My son recently had his appendix burst and he went to Emory University Hospital emergency. He was not insured under our policy because of the fine print on the policy, stating that upon graduation he would have to get his own policy at a much higher rate. The insurance company failed to point this out.

The insurance company was still collecting for his part of our policy. It was a simple oversight they claim and we have been credited for the couple of months we paid in error. I wonder how long that would have continued had it had not be brought the forefront by his medical emergency.

I can almost see them scrambling through the fine print looking for a way out of their responsibility.

He started a new job and applied for medical insurance but he had not satisfied the requirement of ninety days on the job so it was not in effect as yet.

That all brings me to where I am now.

You know I don't understand why the hospital only collects 54% of the bill from insurance companies and they are satisfied with that. Yet if you are employed you pay the whole thing and if you pay within thirty days they will knock 3% off for prompt payment. Oh, they are so benevolent. If you are poor and jobless or on welfare it's free.

I looked over the bill and the hospital pharmacy charges were unbelievable almost $5,000.00. One over the counter Tylenol capsule $9.00, just outrageous.

Four nights and four days and part of the fifth day charges for the room... $14,788.79 that works out to $3,697.20 per day. That is insanely ridiculous.

The surgeon's bill has not arrived but I called and it will be just shy of $5,000.00

I tried to negotiate with the hospital. They were cold, hard and
calculating. The advice was,

"Pay it within seven working days or it will be turned over to collections."

In a vain attempt to use logic and a little leverage form our position. I tried to explain that they would surely force my son into bankruptcy, and they would get nothing. (I didn't let on that his mother and I were going to help, we will have to borrow against our retirement money)

I said,

"It only makes good business sense to accept a reasonable offer. When I was in business part of something was always better than all of nothing. Wouldn't the prudent thing be, to accept an offer to pay the same as the insurance companies and you (The hospital) would have your money immediately"

The woman snapped back,

"First of all, we're not forcing your son to do anything. We will accept nothing but the terms offered and you may as well stop bringing up what the insurance companies pay. It has nothing to do with this. We (The hospital) have a contract with the insurance companies and we do not have a contract
with you."

Then she repeated,

"It will be turned over to collections in seven working days if it's not paid."

I did some investigation on bankruptcies.

In America, one of the top three reasons given to the bankruptcy courts for instigating the procedure is Doctor, clinic and hospital related.

There is something terribly wrong with our system. Our system rewards the very well off, (insurance companies) lets the indigent slide and puts the entire burden on the working middle class.

We, the middle class are literally paying for the entire infrastructure expense of the medical community and it's time for medical reform. I despise what they are doing to me and my family and the rest of you as well.

I suggest you look at your insurance policy very carefully. It may have a clause saying.

"You are not covered if the moon is full and the Grimmies are not spawning in the Upper Yambezzi."

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