My name is Katherine Ottaway and I am a Mad as Hell Doctor!
I am a Family Practice physician. I live in a rural town of 9000 and I take care of people from birth to death. I have delivered babies for 18 years.
I am Mad as Hell because the primary goal of the health insurance industry is to make a profit and they must be good at it. Otherwise why spend 1.4 million dollars a day to lobby congress for their industry? Congress, LISTEN TO THE PEOPLE NOT THE CORPORATIONS.
Let us think about the way health insurance works.
Pretend I have grocery insurance.
I go to the grocery store. First, the grocer has to hire a new employee to check me in and make sure that I still have the same grocery insurance as last time, that I have my card, that the billing and payment information is the same. They update it all in their computer. I wait a bit impatiently.
"Ok, Mrs. Ottaway, you can get your groceries."
I go choose $145 worth of groceries. I go to the checkout and again have to hand over my card. "Does your insurance have a copay?" says the friendly smiling clerk as she bags my groceries. "I don't think so," I say, "My employer just switched programs." I have not read the 150 page new grocery insurance policy. Neither has anyone else in my office. We hope that we are covered.
"Here are your groceries. No copay." I leave and make dinner.
Meanwhile, the grocer has another employee that she/he hired, the biller. The biller takes my bill and the insurance information and sends a bill to the insurance. The insurance turns the bill down because of a typo, misspelling avocado as avacado. A month has passed since I got my groceries. The biller goes over the refused bill and resubmits it to the insurance.
My grocery insurance does not cover avocados, no matter how they are spelled. The bill is again refused. The price of the avocado is taken out and it is submitted a third time. This time it is paid, well, part of it. My grocery store is a preferred grocery provider so has agreed to take $125 for the $145 bill. And the insurance pays 80% of the agreed amount. The rest should be collected by the grocer from me. The grocer sends me a bill for the other 20% of the $125 plus a bill for the entire amount of the avocado.
I get the bill and am annoyed. "I'm sure avocados are covered." I look at my policy. I call the insurance. This takes 45 minutes but at last they agree. Avocados are, in fact, covered. I call the grocer and tell them. They submit the bill for the avocado to the insurance, apologizing to me.
After four months, I get a corrected bill. The insurance has now paid for 80% of the agreed upon amount of the avocado. I pay my bill, thinking that the darn insurance ought to pay more than 80% since it is so beastly expensive. I also get a letter in the mail from the insurance saying that they are changing the policy and won't cover avocados, my grocer is no longer a preferred grocery provider and my rates will be going up. My grocer seems to be having a going out of business sale. The insurance suggests that celery be substituted for avocados.
And lastly, if I was over 65 and had Grocerycare, the federal government would have paid $61 of the $145 bill and are talking about reducing that by 20% this year. The bill may only be submitted electronically and there is an 800 number for me to call if I suspect my grocer of MediGrocerycare fraud. My grocer might also have the pleasure of a random audit.
My grocer closes and I have to drive to the next town to get groceries. Good thing I have that brand new Gasassurance!