Going For a Bike Ride- Part 3

To the typical rebuttal to the frugal way of life, and working toward our FI plans:

But, what if you get hit by a bus?

Well… I did, sort of.  This is Part 3.  You can catch up on Part 1 & Part 2.

Here’s a brief update on what’s happened since the last installment:

There’s been no movement on the billing or insurance front.  I’ve made more phone calls.  I had an insurance statement that came in, I called to get the bill, so I can submit the claim to my FSA.  Apparently, the hospital has a bill that is $500 more than what the insurance company sent me.  So, now I am trying to sort that out.  Turns out the hospital STILL had the wrong address so everything they were sending out went to some other city, I actually drove to the hospital to pick up some paperwork so I actually had a copy of everything.  I’ll keep you updated on the progress when I have something to report… in the meantime:

Here we go…

Now, I’m not one to lead particularly political discussions, but I feel like I need to vent a little bit.  Dealing with the medical system in this country is so unbelievably frustrating.  This is the 3rd time that the insurance or hospital has fucked up my insurance or billing to no fault of my own.  The other two times I found out when I checked my credit and had an account in collections:

  1. They billed the wrong insurance all together, and I never got a notice.
  2. They had an address that I lived at 5 years ago, and sent everything there, so I saw none of the mail.
  3. They had the wrong information on my file. I called to follow up after not receiving any bills to find out.

Some people will argue (Please, feel free to in the comments. I’m all for a spirited discussion!), but I can’t see how for-profit medicine (and by proxy for-profit medical insurance) makes any sense.  At least in its current incarnation, regardless of which side of the aisle you sit, something needs to be done.

There is a clear misappropriation of information.

I’m all for free market, and firmly believe that the “invisible hand” can manage costs and give more availability to the masses.  I also have no problem paying for medical care, but, when there are no posted costs or choice in the treatment, you can’t have an balanced market to drive competitive prices. The insurance companies and providers have the clear advantage over the consumers. After my accident, the ambulance took me to an “out of network” hospital, so my insurance only picks up 40% opposed to the 80% if it was “in-network”. Because, you know, low-cost medical coverage should obviously be the first thing on the mind of the paramedics arriving on the scene of a bicyclist run over by a car?!?

Imagine a restaurant having to serve everyone regardless of ability to pay for their meal?!?!

A for-profit enterprise can not run under with requirements of serving everyone that walks through your door. If you truly want the market to manage health care, you have to allow hospitals to turn people away that can’t afford to pay.

Now, who in their right mind is going to want that?

As much as I don’t think Obamacare (which we are on now, by the way) is the right answer, I will say, at the very least it was an attempt to change something that is so horrendously broken.

The fundamental question: Is healthcare a basic right, or is it a luxury?

Why can’t we simply cover everyone in the country LIKE EVERY OTHER INDUSTRIALIZED NATION?  I mean we have a Silver Obamacare plan (that’s one step up from the cheapest). It’s about $900 a month for two young healthy people, and that comes with a $5,000 per year deductible!?!  We’re lucky we make a decent income.  It’s sad that Mrs. Wow, at the scene of her husband getting run over by a car, has to ask the paramedics if she can just drive me to the hospital because she knows the ambulance is so expensive.  Why is that even a consideration???

How is this even affordable for anyone not making asinine amounts of money?

I would feel completely comfortable handing over that money to the government, so that I wouldn’t have to worry about whether or not we can go see our doctor, what happens when I lose/change my job and know that I’m covered fully for anything that comes up.  I would also love to have not dealt with this whole mess for the past 7 months and counting.

How can someone working two jobs to support their family deal with this?  You wonder why so many say “F*CK THIS SH!T!   I’d rather declare bankruptcy!!!”  I mean this is really sad:

Randy Farris, 58, a factory worker from Conger, Minn., needed a knee replacement three years ago. His insurance covered 80 percent of the bill, but he needed to cash in an I.R.A. to pay his $4,000 share. “I haven’t been to the doctor since because I don’t want any more doctor bills,” he said. His wife’s retirement savings had been wiped out years before, he said, when he used them to pay her hospital bills after she died of cancer.

Why is it up to my employer to decide the proper amount of coverage for our family?

Our employers, who by the way, want to keep costs as low as possible to increase their own profits. It’s madness, complete madness.

Further Reading:

I actually found an article recently that mentioned how the United States pays more per capita in public money for health care than Canada and Sweden.  This is above and beyond the fact that we spend significantly more than any other nation per capita on private funding of health care, as well.  Check it out here: The U.S. Spends More Public Money on Healthcare Than Sweden or Canada.

There is something clearly wrong here, and something needs to be done, now.  U.S. Healthcare is a Global Outlier, and Not in a Good Way.

Real World Examples:

*Granted I don’t know the intimate details of these situations, these are only surface level observations, so take it with a grain of salt.*

  1. There is a little diner in our old neighborhood that we love and has been there for years.  Their muffins are enormous, and melt in your mouth tasty.  Everything else is pretty good as well, my favorite drink is a Snickers Mocha.  Yes, it’s just as delicious and decadent as it sounds.

    MMMMMM… Muffins

    It just so happens that a couple years ago (maybe 2) the owner got diagnosed with breast cancer.  It’s awful, and she went through Chemo, and had a double Mastectomy, I mean the whole thing.  Well, it turns out there were some complications in her reconstructive surgery, so she’s been dealing with that over the past couple of months.

    When I was in there a few weeks ago, there were donation buckets everywhere, asking for help for her, because she can’t keep the diner open, and pay her medical bills. Apparently, she has neglected the medical bills to keep her diner open, and now it is pushing her towards bankruptcy.  Why is a contributing member of society being put through the ringer like this?

    *Update* – Apparently, it came to a breaking point. Saw this in a neighborhood forum on Friday:

    After almost 10 years in this town we call home, we must say goodbye. In less than two months we will be closing our doors. There is much that would need to be done if we were to attempt to keep XXXXXXX alive and unfortunately we are no longer in the position to keep her. Additionally, many of you have seen the toll the restaurant has taken on our family and we believe that passing the torch along is the best decision.

    Thank you for all of your support throughout these years. Come by and see us before we leave. Let’s go out with a bang!

    With love,
    The Muffin Lady

  2. My dad’s best friend from high school was just rear-ended.  How someone rear-ends you at 2 AM in the middle of Pennsylvania is beyond me, but still.  He’s been completely incapacitated and is in a wheel chair hoping to recover the ability to walk again.  I don’t know all the details, but I know they are asking for donations to help cover the expenses and some of the remodeling they have to do to their house to accommodate his new mobility requirements.

These are just two of the most recent examples that are personal, other than me, specifically.  And I’m lucky there is no long term residual effects from my accident.  My shoulder & finger still hurt, but I’ll live through that.

Here’s an interesting solution

I’m a firm believer that you can’t bitch and cry if you don’t have a proposed solution. So here it is:

The US military has a program that will fully pay for medical school education, in return, you are obligated for 20 years of service after graduation.  I propose we create a similar program for the civilian sector. Doctors can go to school on the government’s dime, but they have to work for the government (at a decent pay) for 15 or 20 years.  With that new crop of doctors, they set up FREE hospitals strategically around the country.  This way the general public can go to these hospitals for no charge.  Then we let the “invisible hand” set the market rates so that the for-profit hospitals have to set their prices accordingly.  They would have to price cheap enough that it’s worth going over the hassle of the free clinic, but too high, they will drive away all their customers back to the free clinic.

I’m not a smart man, and I’m hoping someone smarter than me can figure something out, but that’s my 2 cents.

End of Rant

So, 4 5 6 7 months later, and I’m still dealing with this accident, who knows what’s going to come of it.  I have yet to see any official statement from the hospital on what I owe or how to handle this. I’ve gotten two pieces of paper from the insurance company in vague cryptic language.

At this point I’m just hoping that I get something so I can actually use the money in my FSA that expires in June.  I’m glad that I’m not seriously injured and that my wife doesn’t have to deal with this whole mess and a brain-damaged, incapacitated husband.

I can’t imagine dealing with on-going issues or disabilities through this disaster of a system.  I really pity anyone dealing with this on an on-going basis, what a mess!!!  I have to say it actually terrifies me to have to deal with this system regarding any more in depth type of medical issues.

I guess there has to be a part 4, I’ll keep you posted on the outcome…

12 Comments

  • Mrs. Picky Pincher May 22, 2017 at 7:35 am

    Ughhhhh. I’m sorry how messy and terrible this has been for you. Our healthcare system is sooooo so messed up. Something drastic has to change; we can’t keep going on like this, especially in what’s supposed to be a modern, advanced society.
    Mrs. Picky Pincher recently posted…What A Frugal Weekend! May 21My Profile

    Reply
    • Mr WoW May 22, 2017 at 9:20 am

      This whole thing is such a mess it’s very disheartening. This isn’t some podunk little hospital we’re dealing with either, it’s a major medical center in one of the largest cities in the country. I’m just thankful we’re not having to deal with this for an on-going basis. It’s craziness, and we need to figure it out soon!

      Reply
  • Mrs. Need2save May 22, 2017 at 5:43 pm

    You have summed up well the main drivers in our f’d up system. Profits, greed and lack of transparency! People often forget that the whole system is staffed with profit-seekers. Have you guys ever tried Kaiser? They are big in CA for this reason and have totally different model for paying doctors on salary but our experience here in midatlantic was lower quality doctors in some cases.

    I think you may have grounds to appeal the out of network treatment of the hospital bill if it was an emergency and you had no choice of where they took you. However, for some reason things are always infinitly more ass-nine in California.
    Mrs. Need2save recently posted…Building Our Roth IRA Conversion LadderMy Profile

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    • Mr WoW May 22, 2017 at 7:14 pm

      Well the issue is that MRs Wow has a doctor that she wanted to keep, so we had to find a plan that dr took. So we ended up with the plan we are on. But this whole accident happened when we were on my old company’s plan. It has just been a mess the whole way through. It constantly is. It’s almost as if they want it to be the most difficult and painful process possible to scare people away from getting proper medical care.

      Reply
  • Mr. Need2save May 22, 2017 at 5:45 pm

    Luckily we’ve only had a few ‘significant’ medical situations, but it seems like the billing gets screwed up every time. In some instances we’ve paid more than we probably needed to just to stop the madness.

    I admit that I’m a laissez-faire kinda guy, but the US health system is pretty foxed up right now. I don’t trust the federal government to run it and the current private sector approach isn’t working either. There are SO many issues that small surgical (pun intended) changes aren’t going to help… I wish I could recommend a solution.
    Mr. Need2save recently posted…Building Our Roth IRA Conversion LadderMy Profile

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    • Mr WoW May 22, 2017 at 7:19 pm

      Yeah, I do think that’s part of the game. But it’s not only the hospital. I went to the dentist about a month ago, they told me insurance would cover it. So then I get a bill from them. I called, and they said… “oh sorry, we forgot to file it, I’ll file it now.” WTF?? You would think they would want to get paid. But I guess there are people that will just pay the bill and not ask questions so they get double billed.

      Another great example was that Mrs Wow was going to a PT for a while. We kept getting bills for like $400 for her hour long appointments. So she called them up and their response was, “You don’t owe us that. We just bill a super high rate so that we can capture the most from every insurance agency. Don’t worry about the difference.” Huh??? That just seems a little crooked and wrong.

      I don’t know that the government is the best option, but it seems to work elsewhere. Some sort of hybrid would be probably the best option. Hence the option I proposed… a Government sponsored clinic that is available to everyone, then let the market figure out the rest. Anyway… another good discussion topic sometime.

      Reply
  • Anonymous June 26, 2017 at 2:08 pm

    Currently, If your medical school training is paid by the government, you owe 4 years of service, or potentially a few more depending on the length of your specialty training, not 20 years. This is how the HSPP system works. Otherwise, physicians already deal with a period of indentured servitude, internship and residency, during which time you work 80 hours a week and make very little money while your (often > $200k) student debt continues to grow. I have a friend who went the government route and works for the army. He has zero interest in continuing to do so once his time is up due to the tremendous inefficiencies in their system. The last information I saw about the percentage of US healthcare spending that went toward doctors salaries, it was about 20%, of which half of that is eaten up by practice expenses including malpractice insurance (https://economix.blogs.nytimes.com/2008/11/14/do-doctors-salaries-drive-up-health-care-costs/).

    Bigger changes are needed. Costs of medical devices, pharmaceuticals, hospital administration, and futile end of life care are ripe for culling. The healthcare system and its many problems are complicated. One of the issues is that Americans are entitled. We don’t want to accept that we can’t have access to every brand name medication, we don’t want to accept that our insurance shouldn’t cover non life sustaining therapies like gender reassignment surgery and erectile dysfunction medication, we don’t want to accept that our 90 year old mother in a coma shouldn’t be kept alive in an ICU at the cost of thousands of dollars a day.

    If we want cheaper health care we need to accept that spending should predominantly go toward preventative care, we need to accept that cheaper drugs work (and heaven forbid, generics) work, we need to take care of ourselves so we don’t end up with may costly but chronically life sustaining therapies (for example diabetes medications and dialysis for type 2 diabetics), and we need to tolerate death as a reality of life.

    Reply
    • Mr WoW June 26, 2017 at 2:25 pm

      I fully agree with you. There are many many issues with our system, or just health care in general. Yes, entitlement causes a lot of issues. Maybe we should make it so that the insurance only covers the essentials. And make all these brand names, etc. optional at the expense of the patient. And yes, some grasp of reality is needed. There is no reason to hold out hope sometimes, these are professionals. I understand that it is a touchy subject, but if someone came into your house and said, “This is a complete loss” you wouldn’t argue and pay to keep it around, you’d let it go and start fresh.

      I firmly believe the salary of doctors is not the primary issue, they are highly specialized professionals with years of education and training. There is a misalignment of priorities.

      Preventative care is the main thing that we should be spending money on. What’s scary is that in this country, the health care is so expensive people will avoid preventative care because they can’t afford the cost of going in. They will put up with small aches and pains and discomfort simply because they don’t know what type of financial impact it will have. “Why should I go to the doctor and pay $250? It’s just a little pain.” I know I have that rationalization constantly. We’re causing the problems by having our system set up this way.

      I agree 100% with everything you bring up. So the next question is… How do we start to help make this better? How do we start to fix it?

      Reply
  • Jacq October 6, 2017 at 5:13 am

    Despite providing the correct info when my dad was in the hospital in December, someone in intake or billing listed the wrong zip code. Despite numerous phone call over the last 9 months, my dad and step mom are still dealing with the bills being sent the wrong place. Because they do not receive them, they cannot pay them, so collection agencies have started calling, about $12 bills, because someone decided they live in the next town over and entered the wrong zip code. Talk about wastefulness in the system. My dad can very much afford to pay $12 bills. The hours for my step mom, the insurance company, the collection agency, the hospital etc is ridiculous. Thankfully dad is alive and well, I can’t imagine someone dealing with this sort of fiasco with different results.
    Also glad you are doing well. The short term memory loss in part 1 is scary.

    Reply
    • Mr WoW October 6, 2017 at 8:36 am

      The health care system in this country is such a mess. I’m hopeful that someone will at least start moving it in the right direction. But I have yet to see that happen. I’m glad that your family was ok, and it’s not that big of a deal. But why do we even have to bother with it? It just seems like in those times of need, people should be more worried about their loved ones, not the huge headache that is fighting with insurance and the hospital over bills for the following year.

      Reply
  • Ron Cameron November 3, 2017 at 9:31 am

    First off, I’m glad you’re physically better. I dumped my bike on the road (first adult accident!) pretty hard two weeks ago and my left wrist is still not right. And that’s very mild compared to yours!

    More importantly, healthcare. It’s messed up, I agree. I know that I don’t have all the answers, but I -do- know two things:
    1) If you think the private sector is messing up healthcare, try giving it all to the government to run. Seriously. Think of how many things our government runs correctly! Not many. Your IRS fun with the Corolla is just one example. Social Security being in…”rough shape”…is another.
    2) Suggesting health care is a RIGHT is a dangerous statement. That means I have the RIGHT (pounding fist on table, pointing other finger into your chest) to demand that you take care of my health. I think morally we -should- all take care of each other, but saying it’s a right is a pretty strong statement. I think rights should normally be reserved to -allow you- to do things, not -force others- to do things.

    Again, I don’t have all the answers. And there’s so much rhetoric and crap flying around that I’ve generally given up on paying attention to things that I can’t personally change. Health care is one of them! Not dumping my bike, I can control. Normally.

    Reply
    • Mr WoW November 3, 2017 at 11:19 am

      First, I hope you’re ok. Dumping a bike sucks.

      And I’m glad that you have an opinion. And have a valid reason behind it. I just want to start the discussion. Like you I don’t have the answer, but have an opinion. And together we can come to an agreement to fix this horrendously broken system.

      1) The government is absolutely a huge waste and awful at management. I’m just of the belief that if something is for the greater benefit of society as a whole it should be managed there. I don’t know that I want to privately fund police, fire, military and road maintenance. Those are provided to everyone. And in my opinion, healthcare should be one of those things. Or at least some regulations on transparency of costs and treatment. The opaqueness causes a huge issue.

      2) A “right” is a loaded word, I completely agree. But, in your world, do you turn away people that can’t afford healthcare? So, if I get cancer, and I lose my job and insurance and go bankrupt because of it in the middle of my treatment, am I just thrown out on the street? So, healthcare is a luxury that is only available to those can afford it? The market has a way to control costs. But the fundamental question is: Should healthcare be available to all? Do we value the rich that can afford it more than the poor that can’t? As it stands right now, it’s available to all, but not paid for by all.

      I don’t know the answer. But I do feel like your family should not have to consider the financial aspects of showing up at the side of road with a family member laying in a bloody pool, regardless of their net worth and financial aptitude.

      Reply

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