Obamacare is gaining traction, but there has been a lot of Obamacare-related healthcare horror stories.
As with most government programs, the problems of Obamacare are well documented, but I thought I’d share my personal story to show some of the problems of the U.S. healthcare system in general.
Friends often tell me: “Simon, you never get sick … aside from the occasional brain tumor.”
That’s right. I don’t even remember the last time I had a cold, but I’ve had four brain surgeries and probably know my brain surgeon better than most people know their dentist.
The doctor who first discovered my ping-pong ball size brain tumor in 2005 told me that the residual damage of the required surgery will probably put me in the wheel chair for the remainder of my still young life (I was 28 at the time of diagnosis).
This didn’t sound appealing, so I gave myself four months to shrink this slow-growing tumor with all kinds of natural and holistic treatments and remedies.
I love food and having meals with friends, so four months on an exclusively raw organic greens, vegetables and fruit diet combined with a strict regimen of herbs and natural treatments were a giant pain in the butt.
The natural treatment didn’t work, but during that time I learned of Dr. Keith Black, perhaps the country’s most respected authority on brain tumors.
Dr. Black, who practices at Cedar Sinai Medical Center in Beverly Hills, appeared regularly on Larry King Live and graced the front page of a special issue ‘Time’ magazine.
Dr. Black and Dr. Rick Friedman (with the House Ear Clinic) performed the surgery in 2006. The surgery killed the hearing on my right ear, but I was back on the tennis court two weeks later.
The tumor grew back and was treated with the Gamma Knife about two years later. The Gamma Knife looks high tech, but is a combination of technology and medieval torture.
The Gamma Knife didn’t do the trick, so I had to go in for another surgery in 2010. There were some complications so one surgery turned into two surgeries. The second surgery turned me into a multi-week vegetable.
The complications weren’t the fault of Dr. Black and Friedman.
For several weeks after the surgery, I had a golf-ball sized gulp of leaked spinal fluid accumulated behind my ear. Dr. Black recommended sitting up straight as much of possible to help drainage. This didn’t help a bit.
After weeks of ‘vegetating’ I finally felt enough strength to visit my local chiropractor, Dr. Jeff Phillips. His treatment literally did wonders. Two days after my visit with Dr. Phillips, the golf ball was gone.
I realized that there are things only a surgeon can do, and there are things only a chiropractor (or alternative medicine) can do. Unfortunately there is little cooperation between the two approaches.
Now we get into some interesting financial details.
Dr. Black stopped accepting health insurance payments shortly after my 2006 surgery.
When it came to settling my 2010 invoice with Dr. Black, I remembered a saying coined by my dad: “Either you open your mouth or you open your wallet.”
I just sent a two-line email to Dr. Black’s billing person and received a 20% discount. Just like that. It was the easiest $5,000 I ever saved.
Another experience better illustrates how flawed the healthcare system (XLV) is. Since 2006 I have taken literally dozens of MRI’s and follow up MRI’s.
Here’s how the billing works. Cedars Sinai bills my health insurance company $11,000 for a MRI. The health insurance company only pays the agreed upon PPO rate, which is around $3,600. My deductible is $3,000.
At one point I asked how much it would be if I pay cash. It’s $1,100. What? Yes, I paid cash for my last three annual follow up MRI’s. According to a MRI technician at Cedars Sinai, the hospital has multiple MRIs running 8 – 10 hours a day. No doubt it makes money charging $1,100 for 45 minutes.
Why the insurance companies agree to pay $3,600 for something the cash patient can get for $1,100 eludes me.
My Worst Ever Doctor Visit
Interestingly, my worst ever Doctor experience was with a local primary care physician, Dr. Lawrence Schlitt. I only visited him because my current health insurance (SeeChange) incentivized and pays for an annual preventative Doctor’s visit.
After visiting Dr. Schlitt, it became obvious that many Doctors run a business like everyone else. Businesses need clients and Doctors need patients. The initial visit was a little bit like a timeshare presentation.
Eventually I was billed for services I didn’t request. When I saw Dr. Schlitt for my next annual preventative visit I told him about the erroneous billing. His office refused to bill me for the preventative visit, but chose to code my visit as such that I had to pay out of pocket. So I asked him how he would feel if his car dealer billed him for a tune up although he only requested an oil change.
After offering me the potential for a 40% cash discount (which I declined), Dr. Schlitt actually blamed me for not getting an insurance plan without deductible. I begrudgingly paid for my ‘tune up’ and will be looking for a new primary care physician. I can’t help but think that the system is broken because of ‘money first’ doctors like this.
I personally appreciate the years physicians (and nurses and other behind the scene helpers) spend on educating themselves how the human body functions.
Many use their skills to better the lives of the sick and even save lives (Thanks Dr. Black, Dr. Friedman, Dr. Phillips). Others view their medical degree as an ATM.
It appears that Obamacare makes it harder for many Americans to get access to either.
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