HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Friday, May 2, 2008

Professor Elizabeth Warren on Health Care Insurance

Writing at TPM Cafe, Professor Elizabeth Warren writes about our complicated and bizarre health insurance stystem,

. . . .   But even those who have health insurance and can afford to pay are knocked around in a broken system. A friend--with insurance--had some minor surgery a while back. She bounced back quickly, but the pain of trying to pay is still not over:

I got a letter from the hospital very nicely demanding payment of over $500 today.The hospital thinks I owe them $438 more than I actually owe them because the insurance company sent that amount to the doctor. The doctor, of course, won't send it to the hospital. Instead, I had to call the insurance company to ask them to recall the payment so they can then send it to the hospital.
This isn't about getting more health insurance. This is about a system that is broken even for those who have health insurance. This is about waste and inefficiency and burning up dollars that should go to medical treatment. Where are the serious proposals to cut through this nonsense and waste?

If I fax the explanation of benefits to the hospital, they won't turn my account over to collections (that, despite the fact that I have already paid $300 and call them about once a week to work on this problem.) And most amusing is the fact that the doctors' group and the insurance company are managed by the same company. . . .

Complicating this is the fact that the hospital keeps a running total of all amounts due, so the fact that I had another expense (bone scan) makes it hard to keep the surgery bill separate. . . . .So today I figured out that I owed only $2.30, to the pathologist (somehow that was my copay!) and about $98 to the hospital after they track down the payment that went to the doctor.

How on earth would a sick person work through this mess? And how would a person who couldn't take an hour a week off for 6 weeks to deal with this ever get payments straight? The worst part is that I am incredibly lucky to be in this situation because I have health insurance.

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