Monday, September 10, 2012

Health Insurance and Medical Bills

I had a fairly urgent outpatient surgery done on me a few weeks ago. A quick trip to my GP verified that I needed the procedure and he scheduled a meeting with the surgeon for the next afternoon. A week later I showed up at the hospital shortly before seven in the morning and I was sitting in this chair typing on my blog and eating an early lunch by 11:30. No complications and knock on wood so far it's been a very easy recovery which I am now half way through. My care was very good and all the services rendered were timely and professional.

Melissa, Carter and I have a fairly comprehensive medical policy through Blue Cross. Being self employed, we pay the whole break for us We have pretty high deductibles and the deductible is 3X higher for our "family" than it is for either of us, but I'm not going to complain about that right now. We walked into our health insurance policy with our eyes wide open and there are legions of cheaper if less comprehensive options out there.

What I *AM* going to complain about is the tiered billing system that seems to be normative in American health care. We got our hospital portion of the bill today.  Combine that with my surgeon's bill and the anasthesia bill and my little surgery looks mind bogglingly expensive. And so it would be if I was uninsured and had to pay for it out of my pocket which is why I have health insurance in the first place. But what I would have to pay if I didn't have insurance isn't anything like what my insurance company actually pays and thanks to the explanation of benefits they are required to provide I get to see this. Think 20-25 % of the actual "bill" between my deductible and the insurance company's portion and you'd be in the ballpark.

Can you name another service where the difference between the negotiated price for a large entity and the price for a guy off the street who wants to pay in cash is a 75 to 80 %  reduction in favour of the large entity? If I walked in to a feed store or a fertilizer depot and asked for a 75 % discount  I would get laughed out of the store and our customers would be up in arms if we tried it with them...rightly so. In my opinion whatever the price of my surgery is it ought to be pretty well the same regardless of who pays the bill. I understand that a portion of society won't or can't pay their bill and I understand that collecting the money or writing it off needs to be built into the cost. That's standard business procedure. But charging an individual four times what an insurance company pays is not standard business procedure in any other industry I can think of. If what the insurance company pays is actually reflective of the charge then the public is getting hosed in a very, very large way. Frankly if I knew I could pay what the insurance company pays I would probably change my policy from comprehensive to catastrophic and pay the difference out of my pocket. In this writer's opinion addressing this issue would go a very long way to making health care and health insurance a whole lot more affordable for everyone, insured or not.

Getting off my soapbox now. :)

Wednesday, September 5, 2012

His Name is X

[ I wrote this post nearly a year ago, just before our first trip to Russia to meet our son. He's asleep in his room as I write this addendum and we couldn't be prouder or more pleased with how our story has turned out. ]

His name is "X", and we don't know very much about him at all. We don't even know what he currently looks like which is odd given that in a few weeks we're going to Russia to begin the process of making him our son. I can't speak for Melissa but I have the butterflies a hundred times worse than I've ever had them before in my life. And I've got questions running through my mind all day every day. Will he like us when we meet him ? Will he like his life here with us ? What does his life look like now ? Am I fit to be a parent ? What is Russia like ? What's being an orphan like ? Each day that goes by, the questions intensify. Those of you who are or were first time parents get the idea, I'm sure.

Right now, child X remains one of 750,000 unclaimed and abandoned Russian orphans. He's lucky compared to some because he hangs his hat and bib in a relatively well endowed Moscow baby home. In spite of his current circumstances I think it's fair to say that he'd have no chance if he wasn't adopted. Most children aren't adopted because most Russians view orphan kids as broken and unfixable. The system ensures this perception remains accurate because the kids are kicked out of the orphanage system when they are sixteen and statistics say that forty percent will die or be in prison within two years. How sad is that ? How bad must your own circumstances as a parent be that you would voluntarily give up your child to an institution to raise knowing the probable outcome and thinking that they would still do a better job than you will ?

For me, the worst part of this process is that although this is one of the biggest moments of my life I can't share it with anyone because it's not a sure thing yet. There is still some niggling chance that a Russian family could claim this child ahead of us. I know some of you reading this are saying to yourselves, well if not him then you're going to bring home another, so what's the fuss ? I guess that's right to a degree, but if it's possible to love someone you have never met then child X is already loved. And claimed. And wanted, too, very much so, as every child should be. We have thought about him and talked about him every day since we got our referral.

As much as we can make it so, this child's life here ought to be a good one. We've built our farm and our business around the idea of raising a family in a nurturing, safe and supportive environment with his mom and dad both available to him at a moment's notice and with at least one set of grandparents close by. We debated adoption for a long while. In the end, I wonder why we debated the concept for so long when every critter in our large menagerie is adopted. What could be better than sharing the wholesome farming life we've created with a needy, unwanted and unloved child ? At this point, I can't wait to find out.