From: kapa@cbnewsc.cb.att.com (k.a.perkins)
Subject: Re: Doctor ripoff, or just reality?
Organization: AT&T
Distribution: na
Date: Fri, 13 Nov 1992 06:13:47 GMT
Followup-To: misc.consumers
Summary: speak for yourself

In article <1992Nov12.202654.25647@cpqhou.compaq.com>, thomasr@cpqhou.compaq.com (Thomas Rush) writes:
> In article <Uf0C8uW00YUnQ1TElU@andrew.cmu.edu> "Bartley R. Troyan" <bt26+@andrew.cmu.edu> writes:
> >>         We expect that this stuff will be covered by the health
> >> insurance company, but we are still a bit enraged at this pricing.
> >> 
> >The costs just keep going up and we keep paying them in the form of
> >more costly insurance...and the insurance companies try to screw you
> >too by refusing to pay stuff that they should (at least mine does)
> > 
> 
> One of the reasons that health care has gotten so expensive is that
> we now expect to be reimbursed for every little visit to the doctor.
> We want low deductables.  

> 
> So once we have such a plan (with all the concomittent paperwork,
> both for the insurer and the insured), we feel that we have to get
> our money's worth -- we go to the doctor when we might not, were 
> the bill ours to pay alone.

Speak for yourself.   I don't know an adult who goes to the doctor
for colds, minor flus, or minor illnesses.  For me, it wouldn't be
entirely an issue of cost, but one of convenience and hassle, combined
with the knowledge that many things will get better on their own just
as fast as with medical intervention.

It is quite clear to me what my insurance is not
going to pay for, like preventative medicine, for example.  My insurance
will not pay a dime for vaccinations, but if I or one of my dependents
got polio or tuberculosious (sp?), they would pay big time.  I am not
talking about anything
experimental or frivolous, I am talking about shots that all board
certified pediatricians would recommend, shots that any kid who wants
to go to public school has to have.  They do not pay for any kind
of well person or preventative medicine, such as yearly pap smears
or physical exams, although the purpose of such an exam is to detect
any problems early so that they can be treated in the quickest, most
effective, and least expensive way.  They do not pay for birth control
pills, although the cost of one full term unplanned, uncomplicated
pregnancy which they do cover would pay for birth control pills for
the entire reproductive life of 1 or 2 women.  This doesn't even take
into account the cost of the medical care of the resulting child.
Their motto appears to be "thousands of dollars for cures, not one
dime for prevention".
The only exception to the "no preventative medicine payments" that I
can think of is that they do pay for prenatal care.

This past summer, I spent a lot of phone time convincing my dental
carrier to pay a covered bill.  After 6 months, they paid up.  From
what I read on other bulletin boards, that was pretty quick for a
problem situation.  I have spent phone time trying to convince Blue
Cross that a 2 year old child, with a sore eye that is swelling shut
from an unknown cause, (foreign object in it perhaps?) whose
pediatrician can't see her until Monday
(this was on Friday afternoon), is an emergency that justifies going
to an Immediate Care facility, which is an ER for low rent type
emergencies.  This kind of dispute is not unusual for this carrier,
from what I can tell from various other sources.

I also got a letter from my employer, who is self insured, by the
way, telling me that their costs for health care had gone up 14%
this past year, so mine were going to go up 150%.  Yet I count
myself fortunate to even have insurance, since 40 million folks
in this country don't.
Newsgroups: misc.consumers,misc.consumers.house