Monday, June 25, 2007
Let's Get Physical
It's a landmark birth year for me, so I scheduled a physical, which I had today. There are always those terribly uncomfortable bits to physicals - the poking, the prodding, the checking of orifices, the drawing of blood. I find that it helps to get through the process with a minimum of discomfort by being of very scientific mind about the whole thing. Sort of mentally removing myself from the process by thinking, what am I going to learn today about this here specimen? I learned today that my delicate bone structure means that my shoulder muscles aren't very sturdy, which is why they tend to get sore easily. The doctor gave me some strengthening exercises to do. I also learned that if you are well hydrated, it's much easier for the lab tech drawing blood to find a vein. I always thought I had hard-to-find veins because most of the times I've had blood draws I was dehydrated from morning sickness. Now I know better. I'm pretty much ship-shape, thankfully, but still have a mammogram to go through at the end of the week. Then I'll be good to go.
Labels: birthday, blood, doctor, healthcare, hydration, me as specimen, physical, shoulder, veins
Thursday, November 16, 2006
Criminalizing Poverty
I received the renewal application for MinnesotaCare yesterday. The program works pretty well, except for a couple of things. One is the tone of the application. There are constant reminders that if you screw up the application and don't report every single cent and asset, you will be charged with fraud. (A $250,000 fine!) If you don't send in each and every proof for those assets, plus proof of citizenship, you will be dropped from the program. It says so under each item you have to report.
The second issue is the time requirement for notifying MinnesotaCare of changes. The application arrived yesterday and is due December 1. What's that, a couple weeks? To pull together birth certificates, bank statements, insurance statements, pay stubs, proof of insurance from employers, plus other miscellaneous proofs. If there is any kind of change within the year you are receiving MinnesotaCare, you are required to report that change within 10 days. TEN DAYS. Plus, you better remember what things MinnesotaCare requires you to report on within 10 days. (They don't give you any reminders with the monthly bill.) Don't know if that's 10 calendar days or 10 business days, but it seems to be 10 calendar days, in which case you can kiss a couple of weekend days goodbye, and any holidays that happen to fall within the time period. There is no way you're going to get ahold of a worker on weekends and holidays. Many people on MinnesotaCare fall into the category of working poor. If you work when the MinnesotaCare office is open, you'll have a devil of a time finding time within your day to call as well. The upshot is that you can easily play phone tag with a worker and not ever speak to someone within those 10 days.
What the tone and the unrealistic deadlines do is set up the feeling that the poor are criminals trying to take advantage of the system. In fact, it's almost as though the unrealistic deadline is an attempt to prove that the poor are criminals by setting them up to fail.
When the state comes up with these forms & rules, do they ever talk to poor people to find out what works for them? Or is that too much to ask? (I know, I know. We poor people are asking for a handout, so we should just shut up and take what we get.)
I'm not sure I have any suggestion to alleviate the tone of the forms, but I do have a simple solution for the deadline. Instead of making it 10 days, how about making it a billing cycle of 30 days? Would you expect business people to pay a bill in less tha 30 days? Why do we demand more of the poor? To remind people of the changes they need to report, MinnesotaCare can print a simple statement on their monthly bills listing the types of things people need to report. (Everything but this is now printed on the bills.)
I feel a letter to my legislators coming on.
The second issue is the time requirement for notifying MinnesotaCare of changes. The application arrived yesterday and is due December 1. What's that, a couple weeks? To pull together birth certificates, bank statements, insurance statements, pay stubs, proof of insurance from employers, plus other miscellaneous proofs. If there is any kind of change within the year you are receiving MinnesotaCare, you are required to report that change within 10 days. TEN DAYS. Plus, you better remember what things MinnesotaCare requires you to report on within 10 days. (They don't give you any reminders with the monthly bill.) Don't know if that's 10 calendar days or 10 business days, but it seems to be 10 calendar days, in which case you can kiss a couple of weekend days goodbye, and any holidays that happen to fall within the time period. There is no way you're going to get ahold of a worker on weekends and holidays. Many people on MinnesotaCare fall into the category of working poor. If you work when the MinnesotaCare office is open, you'll have a devil of a time finding time within your day to call as well. The upshot is that you can easily play phone tag with a worker and not ever speak to someone within those 10 days.
What the tone and the unrealistic deadlines do is set up the feeling that the poor are criminals trying to take advantage of the system. In fact, it's almost as though the unrealistic deadline is an attempt to prove that the poor are criminals by setting them up to fail.
When the state comes up with these forms & rules, do they ever talk to poor people to find out what works for them? Or is that too much to ask? (I know, I know. We poor people are asking for a handout, so we should just shut up and take what we get.)
I'm not sure I have any suggestion to alleviate the tone of the forms, but I do have a simple solution for the deadline. Instead of making it 10 days, how about making it a billing cycle of 30 days? Would you expect business people to pay a bill in less tha 30 days? Why do we demand more of the poor? To remind people of the changes they need to report, MinnesotaCare can print a simple statement on their monthly bills listing the types of things people need to report. (Everything but this is now printed on the bills.)
I feel a letter to my legislators coming on.
Labels: criminals, deadline, healthcare, minnesotacare, poor
FtTP - Canadian Healthcare + U.S. Healthcare
This post, too, is in honor of my brother. During our hour-long phone conversation tonight, we got to talking about healthcare systems. He suggested this Frankensteining the Talent Pool idea: For perfection in healthcare, combine the best of the Canadian & U.S. systems. Use the universal system of Canada so that everyone is guaranteed care, but use the speed of the U.S. system so that people wouldn't have to wait too long for care. I'm sure all it'll take is the wave a magic wand . . . .
Labels: brother, Canada, frankensteining the talent pool, FtTP, healthcare, magic wand, U.S.
Saturday, November 04, 2006
Inflating the Cost of Health Care
I got a statement from my health insurance company for a chiropractic visit. This was one of those "Explanation of Benefits" reports that shows how much the provider charges, how much the provider lops off the price for the insurance company, how much the copay is, and, finally, how much the insurance company pays. I was astounded at how much the chiropractor charged - $126. Let's bold that - $126!!!! For the barest of adjustments. The chiropractor lopped off $46.77. I paid $25 as a copay. The insurance company paid $54.23.
Let's think about that $126 for a moment. The chiropractor needs to make enough money to make the business pay. If the insurance company decides it's only going to reimburse a certain amount and no more, but that amount won't cover what the chiropractor needs to charge, what do you think the natural reaction of the chiropractor is going to be? To raise the overall cost, of course.
Now, what happens when an uninsured person comes into the office? They get charged that exhorbitant $126 fee. The chiropractor can't not charge that fee, because the insurance company is supposed to be getting a deal.
In essence, the insurance companies, along with government medical programs, inflate the true cost of health care because they refuse to pay the full cost of what the chiropractor charges. You might argue that if insurance companies and government programs don't cap what they are willing to pay, health care providers will rake them over the coals. As it sits now, the ones getting raked over the coals are the uninsured - along with the rest of society that has to pay for a broken health care system.
Between my copay and the amount reimbursed by insurance, the actual amount paid to the chiropractor was approximately 65% of that $126. If $80 is what an appointment actually costs, then why aren't we all paying $80, instead of $126?
Let's think about that $126 for a moment. The chiropractor needs to make enough money to make the business pay. If the insurance company decides it's only going to reimburse a certain amount and no more, but that amount won't cover what the chiropractor needs to charge, what do you think the natural reaction of the chiropractor is going to be? To raise the overall cost, of course.
Now, what happens when an uninsured person comes into the office? They get charged that exhorbitant $126 fee. The chiropractor can't not charge that fee, because the insurance company is supposed to be getting a deal.
In essence, the insurance companies, along with government medical programs, inflate the true cost of health care because they refuse to pay the full cost of what the chiropractor charges. You might argue that if insurance companies and government programs don't cap what they are willing to pay, health care providers will rake them over the coals. As it sits now, the ones getting raked over the coals are the uninsured - along with the rest of society that has to pay for a broken health care system.
Between my copay and the amount reimbursed by insurance, the actual amount paid to the chiropractor was approximately 65% of that $126. If $80 is what an appointment actually costs, then why aren't we all paying $80, instead of $126?
Labels: chiropractor, healthcare, insurance
