Bill Lewis: Getting to the heart of health insurance
by Bill Lewis
April 19, 2012 12:15 AM | 1129 views | 0 0 comments | 4 4 recommendations | email to a friend | print
As I take keyboard in hand, at this very moment, the Supreme Court is quite possibly debating arguments as to whether or not the Affordable Health Act (or parts thereof, actually) is constitutional. The biggest question revolves around the federal government’s right to require all Americans to have health insurance. On one extreme, some would argue, “Access to good healthcare is like a basic American freedom.” Then from the other side may come the cry, “Hey, don’t tell me what to do. It’s the same thing as making me wear a helmet on my motorcycle. It’s my head to worry about, not yours.”

Perhaps it’s because the healthcare insurance debate rages and is top of mind with me right now, but two things recently have brought it even more to the forefront. One is Dick Cheney. No doubt you recall he is now the recipient of a heart transplant. And while that’s a wide-open invitation for Cheney-detractors to insert clever lines such as, “I didn’t think he had one to begin with,” many people claim he shouldn’t have been on the transplant list in the first place.

Cheney is 71 and has already had five heart attacks, his first one in his late 30s. He waited 20 months for a transplant when the national average is around six. Naysayers claim he’s too old and doesn’t work anymore. They wonder just how many more productive years he has left to give vs. the potential of a younger recipient.

I’m not taking sides on that. What got my attention is the idea that perhaps those kinds of “productive years” questions would be asked more frequently if all the provisions of the aforementioned Affordable Health Act were put into effect. Correct me if I’m wrong, but I think implementation would make the federal government the insurance carrier for many, and therefore the decision-maker regarding treatment. So, does that mean Arnold “the Axman” Fitzmeyer, Special Second Assistant to the Third Deputy Secretary for patient treatment determination in the Department of Health and Human Services, will decide who gets a heart transplant? Or any medical procedure for that matter?

Will there be a quota system for hernias? “Oops, sorry,” says the Axman, “We’ve used up all our hernia repair kits for the year. You’ll have to wait til next January.” Will X-rays be rationed?

The same day I was pondering that, I had occasion to call my doctor’s office about a recent bill it had sent me for a routine, regular, once-a-year wellness visit. You know, the preventive care everyone exalts from the rooftops. As part of the exam, I had a chest X-ray, an EKG, and blood tests. The invoice I received indicated my insurance company (which is really a very good one) was not going to pay much, if any, for those three items. So I called the carrier.

Apparently, it (the insurance behemoth) doesn’t think a middle-aged male such as I should have an X-ray, an EKG, and blood tests done as part of routine maintenance. The friendly customer service representative and I had the following conversation:

ME: Let me get this straight. Based on the denial of payments, at my age, you don’t think it would be wise to see what’s going on with my heart, chest, and blood. Is that right?

CUST SERVICE: Yes, that’s right. It’s not something we do routinely.

ME: But if I were to keel over tomorrow, be rushed to the hospital, have open heart surgery, spend a few days in the Intensive Care Unit, and require weeks of rehabilitation, you’d pay for that, correct?


ME: So, instead of coughing up roughly $150 now to catch something early, you’d rather roll the dice and perhaps pick up a $75,000 tab later?

CUST SERVICE: That’s the normal procedure.

ME: Have you ever worked for the federal government?

Actually, I didn’t really ask her that. I just kind of assumed it was true. And this is before Arnold “the Axman” Fitzmeyer gets involved.

Do you remember college watering holes where pitchers of beer would be quickly consumed? Bathroom lines were so long it really just made sense to take your turn and get right back in queue. I’m calling a cardiologist tomorrow to get on his schedule in 2022.

Bill Lewis is a free-lance writer in Marietta.
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