Treated for Illness, Then Lost in Labyrinth of Bills
By Katie Hafner
The New York Times
October 13, 2005
Medical paperwork is a world of co-payments and co-insurers, deductibles, exclusions and contracted fees. Nothing is as it seems: patients receive statements that often do not reflect what is actually owed; telephone calls to customer service agents are at best time-consuming and at worst fruitless. The explanations of benefits that insurers send out – known as E.O.B.’s – are filled with unintelligible codes.
The system is so impenetrable that it mystifies even the most knowledgeable.
“I’m the president’s senior adviser on health information technology, and when I get an E.O.B. for my 4-year-old’s care, I can’t figure out what happened, or what I’m supposed to do,” said Dr. David Brailer, National Coordinator for Health Information Technology, whose office is in the Department of Health and Human Services. “I can’t figure out what care it was related to or who did what.”
Ellen Mayer, 54, an artist who lives in Chester, N.Y… has a rare type of gastrointestinal cancer that requires constant monitoring through blood work, CT scans and PET scans.
The paperwork nightmare started for Ms. Mayer when her oncologist switched hospitals. Everything suddenly seemed to need a justification, or a new piece of paper with an authorization.
The stacks of papers, folders and Post-It notes related to Ms. Mayer’s treatment have started to take over her house. They fill manila envelopes, boxes and files, which fill closets. They spill from the dining room table onto chairs.
“You can’t just be sick,” she said. “You have to be sick and be drowning in paperwork.”
Insurance companies are, by and large, unapologetic.
“Even though the amount of paperwork a patient has to deal with might seem to be a lot, it would be much worse if there wasn’t a unifying organization like a health plan easing that burden,” said Dr. Alan Sokolow, chief medical officer at Empire Blue Cross Blue Shield in New York.
http://www.nytimes.com/2005/10/13/health/13paper.html
Comment: We can thank Alan Sokolow for providing us with one of the most compelling reasons for dismissing the private insurance industry and replacing it with our own universal program of public insurance. Talk about being oblivious to the problems! At least former FEMA Director Michael Brown recognized that there was a storm. Although the health care crisis has been repeatedly labeled as “The Perfect Storm,” Sokolow’s industry continues to plow through the levees that are failing to hold our fragile health care system together.
Ironically, they’re in the process of drowning their own industry, along with the rest of us. It’s too bad that we can’t prevent more health care tragedies by shrinking the private insurance industry down to size and drowning it in a bathtub!