Health Care Is A Foreign Country
Do you have a passport? In this case that means insurance. Even if so, the question is: Is this country friend or foe?
Let’s see: If you are sick you are pretty much on our own. Entering the health care system is like arriving in a strange land without a guide or translator. There is no embassy to explain local customs. The customs and rules vary by state and insurer.
No one speaks the same language even among health care professionals, not to mention insurers. They all have their own dialects. There is no interpreter to tell you what something means, even in English.
There are no clear rules. The insurance you have or don’t have dictates the care you can receive and how much you have to pay. Many insurers tell you what hospitals you can use, the doctors you can see, the medications you can take, how much they cost and how much time you can spend with your doctor. Costs differ between insurer and health system. Some are based on your income, age or disability.
There is no central bank, national currency or even one consistent exchange rate or billing form. “Exchange rates” depend on the insurance you have and/or the hospital or clinic you use. Or the state or city where you live. Divide and conquer is the name of the game.
The embassy, if there were one, would not even offer safe haven when there are disputes. Rules and regulations differ by state and type of employer. If you are an employee in a self funded/self-insured company with a multi-state employer like banks and national corporations, you are not subject to state rules, taxes or regulations, unless you are a franchise.
There is no standard billing format. Coverage rules and regulations vary from state to state. Even national programs like Medicare have many choices for supplemental policies that boggle even the most informed minds.
Can you get what you want and need for you and your family? It comes down to the two words that best describe American health care: It Depends. That said, with the right insurance and the right doctors, you can get some of the health care in the world. It Depends.
Coming Soon: The Buck Stops Nowhere: Why America’s Health Care is All Dollars and No Sense(third edition) and more personal stories from Gifts From A Stroke and its new website.
Copyright, Kathleen O’Connor, 10/27/2014