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Friday, April 18, 2014
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Published: 4/17/2009

Americans can't afford to get sick - or be healthy

I COULD get sick about the state of health care in this country, but I can't afford to. Can't afford to stay healthy, either. I've discovered how prohibitive out-of-pocket costs for even preventative or precautionary health-care measures can be too.

Paying for anything medically related, with increasingly limited health insurance, or none at all, is easily America's biggest headache. Take two generic aspirins in the morning and call me when you come up with a way to make it better.

Our health-care system - and I'm telling you nothing new - is a recurring nightmare of crushing costs, lousy coverage, and crazy bureaucratic hoops to jump through whenever doctors, specialists, hospitals, and insurance collude over a patient. The deck is hopelessly stacked against consumers.

As one such consumer, I need an outlet for my frustration with the way things are, but chances are you're as fed up as I am, starting with eroding health coverage that costs more and pays less of your health-care bills every year.

There's no getting ahead in this game. If you dare to contest either a medical bill or insurance payment, lotsa luck. Be prepared to take a sabbatical from your day job - it could take that long to resolve a disputed account or claim.

For more than two years, I've been waging a fruitless battle with a major medical institution over a bill that would have been paid in full by insurance but for the fact that it was improperly submitted by said institution. When the wrong medical coding was applied to the bill for fully covered services, only partial payment was made by insurance with a substantial balance due from you-know-who.

In challenging the infuriating error, I have spent countless hours wading through a vast medical bureaucracy, making phone calls and umpteen follow-up calls to multiple billing representatives and their supervisors. Again and again, I've had to relay my story for the first time.

In a bulging folder containing correspondence about the erroneous bill are numerous letters I've sent to select individuals within the institution outlining my unresolved grievance - which, as of this writing, is still unresolved. At this exhaustive juncture, I'm probably expected just to give up and eat the questionable charges.

Sort of makes me wonder if that wasn't the plan all along. But I've invested too much time and energy into the matter to give up on principle, not to mention pocketbook.

Still, what a disconcerting experience when all I sought was preventive care, the kind lauded by health-care reform advocates as cost-effective in the long run. But why pursue prevention as a health agenda when the price tag will kill you?

It's insane. Americans spend more on health care than residents of any other country. Soaring medical and insurance costs set us back $2.2 trillion in 2007, or $7,421 per capita.

Higher-than-inflation health-care expenses cancel out any wage increases and drain already depleted household budgets.

Businesses aren't faring any better with many folding, in part, because the costs they assumed for employee health care, while always a challenge, are simply unsustainable in a severe economic downturn.

Those who argue that health-care reform can wait until the economy is stable are wrong. Financial stability, as well as bankruptcies and foreclosures, are intrinsically linked to runaway health-care costs.

Unless those costs are reined in, we will continue to be at the mercy of a system that already accounts for more than 16 percent of gross domestic product - nearly twice the average of other developed nations - and is projected to rise to 25 percent of GDP in 2025. The Obama Administration and Congress have pledged to make health-care reform a priority with legislation passed this year.

At least that reflects the priority out here in the heartland, where ordinary Americans can't afford to get sick or stay healthy if either involves entering the health care/insurance maze of incorrigible money-changers.

Marilou Johanek is a Blade commentary writer.

Contact her at: mjohanek@theblade.com



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