Saturday, October 22, 2005

Saturday Sick-bed Blogging

And by sick bed I mean my parents comfortable couch, watching Finding Neverland, which I must admit I'm unimpressed by so far. It's too sentimental; they're trying too hard to contrive moments of childhood bliss (I mean, really, have you ever babysat four boys? They are far from this consistently sweet and charming.) Oh, here's Kate Winslet coughing -- she must have bronchitis too! (Sorry to the film's fans, I know that's not funny)

I finally made it to the doctor after not improving for the fourth day straight, and found out I've got a nasty case of bronchitis. Joy. But I can't stop thinking about the excessive urgent care copayment my insurance company demands.

Under my plan, apparently all urgent care outside of your PCP requires a $50 copay. It being Saturday, and my PCP's office being closed, I had no choice but to use urgent care. I had a pretty bad case of bronchitis (I'd been hoping it was a cold -- I went to urgent care as a student one too many times when feeling awful to discover there was nothing to do about it but wait). The doctor told me if I'd waited until Monday I probably would have developed pneumonia.

So this $50 copay strikes me as a perverse incentive. This wasn't an out-of-network office; my insurance contracts with them to provide urgent care. If I'd waited to see my PCP on Monday, my illness could have progressed to pneumonia, which carries a risk of hospitalization -- much more costly than going to urgent care. So why would the insurance company employ this disincentive to seek care when postponing could easily bring much greater costs? I guess I'm lucky I can afford the $50. The last thing I need while waiting around for my leg surgery is to be hospitalized with pneumonia.

In other news, the doctor who treated me was a self-described "flaming liberal" in favor of national health insurance. It's always encouraging to meet doctors on board for reform. Along with her reformist ideas, she was a huge supporter of managed care (which is quite unusual these days). She claimed it "leveled the playing field" in that it gave the same care to her poor patients as her wealthy patients, all for a small copay. My reply was "only if your employer provides affordable insurance!" I disagree with her conclusions on managed care, but it was an interesting exchange.

I'll close with my health stat o' the day, courtesy of my chief information source, the New York Times (I swear I'll be diversifying soon!):
From 2000 to 2005, employees in the most common type of insurance plan, known as preferred provider organizations, saw their premiums for individual coverage rise 76 percent, to $603 from $342, while their deductibles - the amount they pay out of pocket before insurance kicks in - rose almost 85 percent, to $323 from $175, according to the Kaiser Family Foundation. By 2003, a survey by the Center for Studying Health System Change estimated, 20 million American families had trouble paying their medical bills. Two-thirds of these had health insurance.
Which makes me wonder... what was my urgent care copay in 2000?

2 Comments:

At 10/24/2005 1:18 PM, Anonymous Anonymous said...

Kate,
Such a pleasant surprise to have stumbled upon your blog. Hope your bronchitis gets better soon!!! (Remember at NWHN the terrible case of bronchitis verging on pneumonia that I had? Not pleasant.) I found your commentary on Canadians amusing and am looking forward to reading more from our doctor-turned-health-policy buff! xoxo Christina

 
At 10/28/2005 4:19 PM, Anonymous Steve Mudge said...

Hi Kate--hope you're all better....bronchitis sucks!

Question: Will a government healthcare system also supplant Workman's Comp? As an employer I pay 15% WC this year--that's as much as Social Security! To have the added burden of paying regular healthcare on top of that would do me in. I'm a small business and am not confident that more costs can be passed on to the customer--I'm having difficulty just paying for WC and higher gas prices. If a government healthcare system would do away with Workman's Comp that would be great.

 

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