Affording Healthcare – Update On My Surgery Post

August 17th, 2009

A few thoughts since I wrote about paying for surgery when you don’t have health insurance.

First, I need to say that while I don’t have health insurance, it isn’t because I don’t want it.  I can’t write about why I don’t have health insurance, but from my readers I know that securing health insurance is not as easy as you might think.

Get a job and get health insurance… it’s pretty easy.  But if you don’t have a job there are two significant factors that preclude you from *easily* getting health insurance:

  1. Price. I know people who easily pay more than $1,000 each month for health insurance.  This is not an option for everyone.  I have readers of this blog who are just looking for $30 for groceries or their utility bill.
  2. Qualifications. Getting health insurance on your own usually means some contract nurse comes to your house to have you fill out forms, do blood work, and some other tests.  A few weeks later you hear back.  If the health insurance company thinks you are too risky for them, guess what?  NO HEALTH INSURANCE FOR YOU! Worse than the Soup Nazi from Seinfeld.  They own a racket and when you are on the other end, it SUCKS.

So let me reiterate… my post about how to pay for a surgery when you don’t have insurance was NOT about how to get around health insurance, or to say that health insurance is bad or unnecessary.  We’re working on getting insurance, but we haven’t been able to yet.  The post was more about:

  1. Letting you know that you can actually negotiate with the service providers (doctors and hospitals) to get SIGNIFICANT (50%+) discounts, and
  2. just sharing how SCREWED UP (the cost of) health care is if we can get 50%+ discounts by paying THAT DAY.

Here are two comments that came on my Facebook post that triggered this followup:

>> You are fortunate to be able to pay 3400 dollars out of your pocket in one payment. What of those that can’t?

I am very fortunate to be able to pay that out of pocket.  We did have this planned and had time to figure out where the money was coming from… that was definitely a benefit.  But I realize that many people don’t have $3,400 sitting around.  My point in the post was just to share that you COULD save that much money if you could figure out how to get the payment together.  Most people (me included, before this experience) don’t know that you could even question this big hairy institution.

and…

>> It is great that you’re able and willing to self-pay, but what is something happens and your bill is in the hundreds of thousands or even millions? I sincerely hope that never happens to you, but it happens to a lot of people. If you self-pay and don’t have your own insurance, then doesn’t that really mean that you’re shifting the risk to those who… Read More are paying federal taxes? And how different is that than being an advocate for single payer?

Again, this is why I’m writing this clarification.  I’m not saying “don’t get health insurance because you can save 50% by paying upfront.”  I’m saying “Did you know that you could even negotatiate?”  I’m writing more to the people who can’t get or don’t have health insurance – which is A LOT of people.

… so that’s it.

Here’s one more LAME update.  The doctor’s office coded the procedure wrong, so the quote from the hospital was $5,000 low.  That meant we got hit with an additional out-of-pocket $2,500 charge (if we wanted to get the 50% discount) that we weren’t expecting.  Fun?  Absolutely not.  Wish I had health insurance right now, but for us the discount is the only option we have (other than sitting on double the amount and making payments until my kids move out).

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8 Responses to “Affording Healthcare – Update On My Surgery Post”

  1. Thank you for the update, Jason.

    I’m glad to see that your family is not one of those which claims to be independent and says that everyone else should be too but then when the need arises, suddenly all of these government services which went to slackers look like rights.

    Your explanation about not having health insurance is distressing but very understandable. You owe none of your readers any further information. What you told us is more than enough for us to now understand the context.

  2. Thom Allen says:

    Jason,

    If someone who has health insurance takes a close look at what the Doctor actually gets paid from the insurance company, it’s a fraction of the amount billed. What I don’t understand is if the Doctors are willing to take the reduced amount, why don’t they just charge that rate to begin with?

    What’s funny, it’s not Healthcare that has failed, the care in most cases is extraordinary. It’s the cost barrier, plain and simple. Next to my mortgage healthcare costs is my biggest annual expense. And it’s purely defensive.

    Great post. This has been a subject that affects me on many levels.

  3. Jeff says:

    Interesting how we most always approach these problems of expenses by how to reduce the cost.

    There is another option – increasing the income. There are many more options here than most people take the time or believe are available.

    The internet has opened new worlds to people and where there is a will, there is a way.

    Yes the govt could have a program in place to cover these costs for you, but that really only means that we all will get to pay for it and is that really what we all want? Unfortunately the commercials would lead you to believe that there is a great clamor for global coverage. Most people I talk too, Obama voters included, just shake their head and bemoan another govt fiasco waiting to happen.

    Jeff

  4. bill says:

    Why not negotiate the $2,500? If you’re shopping in a grocery store, and they labeled the produce with incorrect price, they’ll honor whatever price you saw on the label. You should at least get some discounts given the estimate errors by the doctor office. :-)

    Also, regarding getting insurance for self-employed people, have you checked any trade associations, local chamber of commerce, etc? I heard that sometime you could get “group discount” for health insurance if you belong to certain trade associations/non-profits/alumni association/etc.

    It’s scary to hear your story. I’m thinking about starting my own business one day. My wife is stay-home mother. After reading your blog post, I start researching insurance options for self-employed. Unless I hire a few people and make my company eligible for “small group health insurance”, the options for self-employed are pretty limited.

  5. bill says:

    Re: “What’s funny, it’s not Healthcare that has failed, the care in most cases is extraordinary”.

    I totally disagree with this statement.

    I lived in multiple countries. The doctors/nurses/medical professionsls in the United States are not better. In some cases, it’s much worse.

    Examples:
    1) my wife had a routine skin condition. It was mis-diagnosed by 4 doctors, including 2 specialists. It’s funny — when we talked to our OBGYN, she immediately pointed out the problem. In the end, we went to the specialist who was one of the best doctor in the area (according to a survey), and he immediately identified the problem.

    2) My son went to this hospital for a blood draw. They poked him five times. Finally, they got the blood, but they spilled the bottle! Another time, they poked him 3 times. We went home, and got a call. They’ve accidentally leaked air into the blood draw. We had to drive back.

    When I was single and didn’t see doctor often, I too had the misconception that doctors/nurses in the US are the best. Now, with a family and little ones, we see doctors quite often. If there is one lesson I learn, it is not to trust doctors. As a patient, research as much as you can. do all of your homework. You get to control your own treatment process.

  6. Thom Allen says:

    @bill – never said they were the best, only that I had received exceptional care when it was needed most. Are there problems, oh yeah, they far outweigh the good things. But it’s all we have. If another country has better healthcare providers, more power to them.

    Also, when you say I shouldn’t trust Doctors, thats kind of a misguided statement don’t you think? You make Doctors out to be evil and untrustworthy. I’ve been seeing the same Doctor for over 10 years. He knows me. I trust him. Is he perfect? Heck no. But neither am I.

    If I do as you say and not trust Doctors, how could I ever have control over my own treatment, unless I administer it myself? That’s ridiculous.

  7. Jeff says:

    One other thought about insurance.

    If you and your family are basically healthy, you can self insure for the run of the mill, day to day expenses and locate a catastrophic care policy. These cover major expenses such as the surgery you are discussing in the original note.

    Very few of us use any where near the amount that is going into the pot for insurance. We are basically covering the unhealthy, many of whom are now paying for the unhealthy life style that is so prevalent in our country.

    The other thing that always bothers me about doctors and dentists is they are forced to reduce their rates for their insurance patients and pass the rest of their costs on to their other patients, many of whom have been loyal to them for many years.

    Jeff

  8. [...] insurance company told us to do.  But without insurance, it is different. What we learned was we could negotiate with the hospital and pay 50% LESS than before (as long as we paid the 50% in cash, before we left).  Did you know you could save thousands on a [...]

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