Here Comes Trouble: Stories from My Life

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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

April 25th, 2012 10:14 AM

Profit-Driven Medicine Violates American Patients Young and Old

Though my grandson and I are in two different sections of the country and both facing different cancer scares, we share one thing more prominently than anything else.  We are being violated as human beings in need of medical care by our health providers’ need to protect profits.  The money comes first; the patient is but a necessary cog in the healthcare revenue wheel.

I know that most of the time when those who advocate for a more sane system under an improved and expanded Medicare for all, for life model target their list of “evil-doers,” we tend to focus on the for-profit health insurance industry.  Clearly, having to fund all the administrative costs, shareholder profits, and CEO salaries for those companies is a driving factor in the ever rising costs of healthcare in America.

But the insurance companies aren’t the only ones targeting patients for profits.  The providers of care are right there in the middle of the mix with the insurance industry and the pharmaceutical companies.  Everyone wants their bite of the cash to be made, and the patients are caught in the middle of this epic struggle of financial giants in the U.S. economy.

Back to the two stories playing out in my own family as I write this since our family with all its glory and flaws seems pretty representative of people across the nation.  My 18-year old, not-yet-graduated from high school grandson was required to sign a guarantee of payment for his biopsy procedure before being treated, and I discovered one of my providers is creatively “unbundling” services provided in one appointment in order to collect a co-payment from me for each segment of my clinic visits.

For my young grandson, taking on this financial obligation before he is even out of high school is shocking and frightening.  He was born (along with his twin brother) in late November, so began school when he was just short of six years old.  He is preparing to graduate from high school in May, right on time.  He lives at home with his parents and siblings, and he is a really great, young man.  But a couple months ago, he started losing weight, and he found a lump just underneath his ribs.  The imaging studies show that the mass needs to be biopsied.  His mom, my daughter, made the appointment for his biopsy.  We were all upset and frightened.  But imagine our horror when not only was our daughter required to sign papers promising to pay the $1,000 deductible but our grandson also was asked to step up to the desk and sign his own set of promissory paperwork.  It’s all legal, they said.  He is 18, after all.  They both signed their own sets of documents. His biopsy is tomorrow and now he fears not just the results of the tests but also being dunned by the hospital where he’ll have his procedure.

On the other side of the country, I am still in the process of getting test results for my cancer work-up. After always paying my $15 co-payment required before I am treated, I began getting multiple billings from one of my providers (a large, teaching hospital with a world-class reputation) that showed me owing more co-payments of $15.  If I didn’t pay those multiple bills very quickly, the provider was almost instantly turning those $15 “debts” over to a very aggressive collection agency.  For $15, I was receiving calls several times a day.  When I called to ask why I am getting these bills when I always pay my co-payment at the front desk when I sign in for appointments, the billing clerk told me that the $15 I pay when I come in is only going toward the physician services portion of my visit and that the new bills I am getting is for the clinic charges for the same visit.  What?  They are splitting one doctor visit into two or even three bills and requiring me to pay a co-payment of $15 for each segment of that bill as if it were three separate visits?  Yes.  That’s exactly what they are doing.  And before I even have final test results and treatment plans, the world-renowned provider is sending one of those split-billing co-payments to collection?  Yes.  I paid $30 more to stop the calls, and the clerk advised me that I should ask my insurance company if I am responsible for multiple co-payments and get reimbursed from them as the provider is billing legally for their services.

Oh, it’s all legal all right.  It just isn’t ethical or just.  Patients like me and my grandson – and millions of other people all over the country -- are being injured by our healthcare system and all of the profit-takers within that system.   This week we all learned about breast cancer survivor Lisa Lindsay of Herrin, Illinois, who was thrown in jail over a mistaken $280 medical debt.  But even if our debts are really ours or assigned to us in error, we have almost no recourse in the face of aggressive providers who hire aggressive collection agencies to aggressively collect their profits.  Yet, we often direct the outrage at collection agency practices and not back to the source:  the providers who stand right alongside the for-profit health insurance companies and pharmaceutical giants as they all injure patients and families in pursuit of the almighty dollar.

It’s ugly out here for patients in America.  And if any other nation thinks emulating our healthcare system is a better way, please think of your children and your grandchildren and imagine them standing at the front desk of the clinic signing legal documents to protect provider profits, and then think again.  Our profit-first healthcare system is brutal from top to bottom, and we won’t change that brutality until we identify all of the culprits and put health first over profits.

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