November 24, 2024
Column

Patient’s perspective on insurance

I need to vent. I read Dr. Erik Steele’s column on MaineCare (BDN, June 7) and cannot dispute his facts. My perspective on medical insurance is one taken from a patient’s point of view.

I have been diagnosed with a life-threatening condition. My illness was difficult to figure out, and took five months to finally get labeled. I do have health insurance (not MaineCare). What strikes me the most is the emphasis on people who lack insurance, when there are other equally important players in the looming health care implosion. To illustrate my point let’s take extreme positions.

If a visit to the doctor cost $15, most people could cover that without the need for insurance. You could change the word doctor to specialist, emergency room, per day cost of hospitalization, etc., and still not need insurance. The other extreme would be that a visit to the doctor costs $1 million and everyone would need to have insurance, if it was available (the premiums would be too expensive for most people). Because so few could afford to visit the doctor and meet their financial obligations, the doctor would have to swallow the cost or overcharge other patients to stay in business.

The reason I am citing these extremes is because I believe we are fast approaching the latter situation. I have my billing statements in front of me. Let me mention a few of the things that are striking. I needed to be hospitalized. Each day the attending physician would drop in to check my status. In some cases, several physicians would drop in as there was concern about infectious conditions. In each case the visit lasted between 10 and 15 minutes.

According to my calculations, I was charged roughly $10 per minute, per doctor. I also needed pumps to deliver medications. They are rented to the patient. Somehow I managed to get two in my room for about a week. Only one was being used. An alert nurse remarked that I was being charged for both and probably one should be taken out. Medications, some readily available off the shelf, are overpriced by as much as three or four times.

Each visit to a doctor or hospital required a new form, even though the same information would be attached to it. I had to repeat all the information and history behind my condition. In some cases, I had to repeat tests, because what was valid in one place didn’t matter in the next. There is no real competition in the health industry.

I go to my primary care physician and he recommends a specialist, if needed. Do I know enough about medicine to know if a good choice has been made or not? Could I make a better choice about my own care? What if I don’t have the luxury of time to “shop around”?

Please understand that the care I received was top-notch, but the system is broken and fast becoming unsustainable. Doctors, hospitals, insurance companies and pharmaceutical makers charge too much. When we figure out why or artificially control the costs, people won’t have to worry about the choice of bankruptcy or death.

Encouraging people to take care of themselves helps to a degree. Eventually, however, we will all need the health care industry to assist us.

Nobody stays in perfect health forever. It’s just a question of time.

Daniel J. Bryant is a resident of Warren.


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