Gloria's Story: Part Two
Then the medical bills came pouring in, and it started to consume my family. The California branch of our insurance that shipped us via air ambulance because they couldn’t adequately care for Gloria in their hospital refused to pay for any treatment in Oregon. This was ridiculous, and the Oregon branch of the insurance refused to pay as well. This left me in limbo. I had to get both insurances, the hospital, and myself eventually on the line to come to an agreement as to how everything was going to be paid for. I had to utilize my arbitration skills, and in the end it saved the California branch of the insurance money. We ate into our savings, handed over the money from the sale of our home, and then some. We paid multiple high deductibles that year with the job changes and barely staved off bankruptcy by fighting tooth and nail on the hundreds of bills from the hospital, every doctor, and every specialist who walked through Gloria’s door. Nearly every fifteen minute inpatient visit was a $500 bill. The medical industry extorts the inelastic demand for their services and has prices that are detached from reality and that feel dreamed up. I spent hours every day for the next few months on the phone, fighting insurance and billing companies. I delved deep into the second tragedy of a medical crisis, the looming bankruptcy that was staring my family down as bills slipped into collections. I tried to find a job to help dig my family out of debt, but I am a teacher and many of the bills amounted to several years' salary in Oregon for ONE bill.
The final insult came in the form of a delayed test result. Our insurance company had approved and administered a genetic test at the urging of the inpatient geneticist at the initial hospital Gloria was admitted to, before being sent to Portland. The test was run in February of 2014, and the results were made available to the insurance company in April of 2014. On the last work day in August 2014, I called, as I had monthly for the previous five months, to check on the status of the test. I was told it was still not finished. I then called the testing company directly, and the testing company finally admitted that the test was complete and had been available for nearly five months since April. The testing company was floored when they found out I had never been notified. I then called the hospital back, and they admitted their mistake, sort of. I got a fax that evening from another geneticist in the HMO. They said they didn’t have my correct address. I replied that they seemed to be able to find my address without a problem for the dozens of bills they had sent me over the last five months, and that they had lied in stating the test wasn’t ready. They said they couldn’t get into why the test wasn’t made available on time and hung up. Much of the torment and testing Gloria endured during all those months while in the hospital was to discover the cause of her condition, but it had been known for five months and not disclosed by the HMO or its hospital.
I filed a complaint with the state insurance commission about all the mistakes that were made. I was listened to and then told that the insurance company had a deal with my state, and that I had to present myself in person before an arbitration hearing. I was at that time the caregiver for Gloria, and one of the few trained in the tube feedings and suction. It was impossible for me to be there in person. They told me I could hire a lawyer, but I did not have the funds to do so because of all the medical bills.
There are many great doctors, nurses, and professionals in the medical field who feel trapped by the system they operate within. Like many industries, the medical field has been divorced from its primary responsibility of serving its customers in favor of squeezing as much money as possible from society. It capitalizes on the inelastic demand (dire need) of its products to garner as large a profit as possible. There are three types of people in the United States: those who have been bankrupted by medical bills, those who are being bankrupted by medical bills, and those who will be bankrupted by medical bills. The United States can do better for its citizens than this, and it is time we stood together for positive change and a sustainable health care future for our citizens.
--Leslie Rogers MPA
Visit Gloria's website HERE.