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PNHP RESOURCES

A single payer system could mean more coordinated care

By Paula L. Stillman, M.D., M.B.A.
Philadelphia Inquirer, October 16, 2017

I do not want to have to switch my health care coverage.

For the past 15 years, I have had multiple spinal epidural injections to relieve my sciatic nerve pain. The injection lasts for 4-6 months and I am pain free during that interval. All of my records and images are at a major hospital in Delaware where I worked for 8 years.  When I left that position I went on Medicare. My injections continued without a copay. I now work at a major health system in Philadelphia and receive health coverage through that health care system.

Recently, I went down to Delaware for my epidural injection before a major out of town trip. The injection worked and I was pain free. Imagine my surprise when I received a bill for a copay for the hospital facility fee for over $1200. I did not realize that the hospital in Delaware was a tier 3 provider. I was never told this before the procedure or the amount of my copay. In fact, I received the bill almost 3 months after the procedure. I appealed this case to Blue Cross and am waiting their decision. I told them that I was never told about the co pay before the procedure and it was bad medicine for me to change providers. I am awaiting their decision.

I should be able to go to whatever health care system I choose and to stay with the hospital that has all of my records and has past experience with my problem. I do not want to switch. For years, I have been very satisfied with the care that I received in Delaware. I have been essentially pain free and able to travel, exercise and enjoy life. Just because my insurance coverage has changed, I should not have to switch my providers. This is bad medicine.

A single payer plan could solve this problem, and Bernie Sanders’ proposal would be a good first step. No one should have their care disrupted because they were forced to change insurance.

Dr. Stillman is Director of Community Engagement of The Institute of Emerging Health Professions at Jefferson University.

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