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Heated debate and fierce emotions are often present when engaging in conversation regarding the business of our nation’s healthcare system.  There is plenty of finger pointing as to the causes of skyrocketing insurance premiums as well as the cost of medical services provided.  Hospitals, physicians, insurance companies, pharmaceutical companies, drug stores, employers, attorneys and even politicians are all stirred into the spicy healthcare soup. 

It is not uncommon to be satisfied with the services provided by your local healthcare provider.  We live in a country where adequate medical services are generally available. This certainly is not the case in many countries.  It is also not uncommon to hear the rants about the price Americans must pay to have these accommodations as well as the medical debt families incur.  I often hear “you can’t put a price on good quality health care.” True, but price is absolutely a concern when you get the bill from someone who put a price on it and mailed it to you.  

Privatization of healthcare is often discussed as a possible means to hold down out of pocket costs, yet few Americans are willing to pay 50 percent of their income toward taxation to help support  such a plan.  Canada has a plan, but many drawbacks exist in their system when looking at timeliness of services, for example.

The finger pointing for blame is everywhere.  Hospitals buy expensive equipment, and this equipment must be maintained.  Technicians require schooling to operate the equipment.  According to EducationData.org, the average cost of a medical school degree is $238,420. Surgical and other specialties are far more.  Factoring in liability and the demand for qualified care givers is no wonder why costs are high.

On the flipside, insurance companies blame the rising costs on hospital administration increases, lack of competition due to mergers and partnerships driving up provider costs.  

For years United States pharmaceutical companies have been in the national spotlight for charging far more to US citizens than they do to those living in foreign countries.  This higher price also comes after the US taxpayer pays billions in subsidizing the development of new drugs.

Physicians are frustrated when their procedures, tests or pharmaceuticals prescribed are denied by insurance companies.  Physicians are angry and patients are caught in the middle.  Slow pay to the hospital or physician by insurance is also a problem.

It is safe to say that many of us have been denied a medical claim and went through the process of filing a grievance, only to be denied again.  This is especially frustrating after you called your insurance provider in advance and you have been told “yes, you should be ok according to your plan.”

Recently, my wife and I have gone through a healthcare headache in dealing with an out-of-state provider and our insurance company.  Two procedures were denied and then after phone calls back and forth by the provider and us, we managed to get hit with “only” $1,500 out-of-pocket.  As a follow up to an MRI my wife had in Cleveland, the MRI was paid, but the contrast (chemical to help with visibility) was not.  To me, that’s like buying a tire to be mounted on your car and then being hit with another bill for the air.  As a follow up to the MRI, my wife had scheduled a video conference with the doctor to discuss the MRI results.  On the video conference call, the doctor’s computer began having technical difficulties, so she told my wife to briefly wait for a phone call from her.  The phone call lasted five minutes at best and my wife was told the MRI was “inconclusive” and that she needed to set up another test.  The call ended.  A month later we received a bill from the hospital for $423 for the phone call.  Not only is $423 outrageous for a follow-up phone call for a test we had already paid for but the fact that our insurance company “only” pays for in-person and video calls, not phone calls.  

I asked my insurance company “what do people without smartphones or computers do to avoid this travesty?”  Her response was “that most insurance companies will not pay for a phone call with your doctor.”  All of these things contribute to the high cost of healthcare and when will we reach the breaking point?

I was so angered by the response from the insurance company as well as the $423 five-minute phone call charge, which if you are keeping track, works out to $5076 per hour or $40,608 for a standard eight-hour day, that I reached out to my Senator on his government email and told him this needs to change.  About an hour later I received an email back from him thanking me for taking the time to write to him with my concerns about “animal cruelty and product testing on animals.”  What???

So, in closing I will say this, our healthcare system needs help and all of the players must step forward and find a path to common sense and fairness.  Also, it seems that when it comes to healthcare, some politicians do not know the difference between human beings and lab rats.