Gratitude Monday: the cost of care

The Explanation of Benefits (EOB) form for my hand surgery arrived a few days ago from my utterly craptastic insurance company, CareFirst. It consisted of 16 lines all identically labeled “hospital services”, with dollar amounts ranging from $2.00 to $9,993.50 (two of those) in the Amount Charged column. The Amount Allowed column was zeroed out on all but three of the lines ($2,946.00 for one of the $9,993.50 charges; $1,067.00 for the other one; $407.00 for one that had been billed at $2,070.00)

CareFirst paid $4.170.00, and I had a $250.00 co-pay.

Let me give you some context: I arrived at the surgical facility around 0900 to be prepped for a 90-minute procedure beginning at 1100. I walked out with my friends around 1330.

Readers—this is what is wrong with healthcare in this country: not only the retail charge of $30K for less than five hours of activity, but that CareFirst “allows” 15% of that figure. If $30K is an accurate representation of the value of those medical services, how does CareFirst get off with paying pennies on the dollar? And if CareFirst’s pennies are accurate, what the hell’s up with that $30K?

I have no bitch at all at the quality of care I received. My surgeon is terrific, and—except for one break in communication, which one of the nurses got on top of before I had to show up—everyone seemed competent. They and the GWU facility deserve appropriate compensation for the top-notch services they render.

I do have a major bitch with CareFirst and all its predatory ilk inserting themselves to dictate what is and is not proper medical care, as well as having the unmitigated temerity to declare what’s a proper fee to charge while at the same time ratcheting up the premiums they charge higher and higher and reporting ever-more obscene profits (with concomitant increases to executive pay and bonuses).

But I’m grateful for that excellent care I’ve received, for having medical coverage of any kind (even from the utterly craptastic CareFirst) and for having the $250 needed for my co-pay. There have been times in my life when none of these things were true.