I read a discussion yesterday on a general chat forum where a guy was asking for advice on handling payment for medical services without insurance. There were a few issues in his posts that I wanted to respond to, but my comments, first, would not have answered his questions, and second, would have sounded rather callous and insulting. But I still want to comment on what was said, so I’m going to make my comments here.

The initial post was this:

My wife has internal bleeding. We saw our regular doctor. Says we need to see a specialist since it could be cancer. Set up appointment with specialist. Specialist cancelled appointment. Why? WE HAVE NO INSURANCE

We are “middle class” so as of so far I have found no help for us. We earn too much. Insurance at work went up 19% this year. We had to drop it.

After reminding the hospital / staff of legal need of admittance they said okay- pay up 500 dollars and we’ll see you (aka- not treat you). Spent all day trying to extend current loans and get new ones to support this 500. Still unsure if I have gotten anywhere with it.

New phone call. We need 650 to see you. “Huh?” I thought we agreed on 500.

Second doctor. aka (1150 to see not treat her)

so…. except killing myself and taking as many doctors with me as I can…. what can I do? I’m not a lazy person that lives off the state. I’m not rich or work a well paying job. I work 70+ hours a week and the wife works 50+ hours a week. We are two months behind on the morgage. We owe the garage 2000+ for car repairs. I have nothing but my anger at this point.

First, I can imagine the panic and worry at having my wife find internal bleeding. I don’t want to dismiss or belittle the feelings this guy has about the medical situation. But . . .

The situation in issue here is not medical, but rather, financial. This guy and wife decided to drop their insurance because its cost went up 19%. That’s a pretty big increase, and I can definitely see weighing the value of keeping it. I can even understand making the decision to drop it. Insurance is a gamble: on one side of the scale, you have how much the premiums cost you each month; on the other side of the scale, you have the likelihood of having a serious and costly medical situation.

This guy and wife made the decision on the side of betting they wouldn’t have a serious and costly medical situation. That’s a legitimate and maybe sound (depending on their age, health, and lifestyle) choice. If they went 20 years or more with no medical problems, they win the bet.

But they had a potentially serious and costly medical problem come up. That doesn’t necessarily mean they lose their bet, though. Most doctors will take cash payments for their services. (It’s actually a better method of payment for many — cash up front versus check payment from an insurance company in three months.) You just tell the doctor’s office you want to pay cash.

The doctor may want payment up front, but that’s not that unusual. There’re many services that you at least pay a portion of the bill up front (especially services that can’t be “undone” if you don’t pay after completion). Besides, with, “We are two months behind on the morgage. We owe the garage 2000+ for car repairs,” it’s not like the doctors’ concern about getting paid are unfounded.

As for this particular situation, I doubt $500 or $650 or $1,150 is simply for a consultation visit — “aka not treat her.”

“I have nothing but my anger at this point.” Anger at what/whom?

Anger that his insurance premium went up? Prices of everything is going up; shop around for a better price.

Anger that doctors want payment up front for their services? They simply want to make sure that they’ll get paid at all for their services. Ask the mortgage company and the car garage how well they get paid without up front payment.

Anger that a possibly serious medical problem struck his wife? This is understandable, but God, Fate, what-have-you doesn’t respond much to anger. But still, it’s an understandable emotion.

A follow-up post said:

one doctor spent 15 mintes with her on Friday. had to pay him 300 up front and still owe him 960 dollars. The main doctor spent 2 hours off and on with her. had to pay him 500 up front and owe him over 8000. I hate doctors thoiurghly now. The good news, results are not in but it appears to NOT be cancer.

The way he explains this in the first five sentences, it sounds like the doctors are charging crazy money just to hang out in the room with his wife, chatting or visually examining her. But the last sentence shows that’s a false portrayal. If there are results to get in, then obviously some tests were taken. And tests ain’t cheap, and often aren’t a cost directly from the doctor — the cost comes from the laboratory.

The most amazing thing, though, is his hate of doctors, now. He hates the people who are helping his wife? This kind of anger at people who are doing something for you amazes me. Anger at people who are helping you, just because they expect payment for the help.

If you think the payment is too much — you can and should check up front (you wouldn’t order food at a restaurant before checking the price) — then go elsewhere for the service. There are lots of doctors, and you can shop and compare them just like you can any other business. If the office tells you, “pay $500 up front,” you have every right to ask what you’ll get for that money.

But it’s dumb to get angry and start hating someone for having the audacity of expecting payment before giving you a service. (Especially when you already can’t pay for previous services rendered by other providers.)

Bullgrit

I don’t [get to] watch much TV nowadays. But it seems that every time I do spend some time surfing through the channels looking for something fun, I come across this Levi Johnston fool thrown up on the screen. Last night was such a time.

I know there are a lot of people who have become famous for some dumb thing they did, or for some dumb thing that was done to them. But usually it’s mostly harmless idiocy – making a sex tape, saying something controversial, or even just jumping in front of a camera to essentially say, “Look at me! I’m a pathetic nobody who’s willing to throw pride and decorum away so I can be famous for 15 minutes!”

But it’s rather shameful how someone can become famous and celebrated for being a true dickhead. Levi Johnston, a teenager who knocked up his teenage girlfriend, then turned on her, her family, and their child, is getting fame and celebrity for being a deadbeat dad.

Levi Johnston is a dickhead. He first got the spotlight only because his sperm could swim, and now it’s staying on him only because he’s abandoned his baby boy and the girl he screwed to make it. And not only has he abandoned them both, he’s insulting and threatening their family. And the celebrity media is supporting this reprehensible attitude!

This guy should be made a poster child for teenage abstinence. Girls, you may truly love your boyfriend with all your heart. You may believe he loves you, back. But if you get pregnant, he can drop you and your baby as easily as he can turn around. And if you or your family is famous, he can get fame and fortune for himself by talking trash.

Yeah, he can stick his dick in you, but he won’t stick around to be a father if you have a baby. And apparently, the media loves and rewards such dereliction of duty. I don’t know which is worse: the dickhead who won’t man-up and be a father to the child he helped create, or the media and public who give attention and adulation to him for it.

Bullgrit

I’ve been told that today is Blog Action Day ’09 — Climate Change.

Blog Action Day is an annual event that unites the world’s bloggers in posting about the same issue on the same day on their own blogs with the aim of sparking discussion around an issue of global importance. Blog Action Day 2009 will be the largest-ever social change event on the web. One day. One issue. Thousands of voices.

Well, OK, I’ll blog what I think about climate change. I think most of the fears about climate change are . . . over stated, to put it politely. Here are my views on this concept of climate change:

1. I just don’t see how the way they measure the planet’s average temperature gives valid or useful information. The coldest regular temperature on earth is below -120° F, the hottest regular temperature on earth is over 130° F — that’s 250 degrees range. So it’s hard for me to see a 1.3° change in the average over a 100 year period as anything more than a statistical blip.  

2. Even if the global temperature is rising (slooooooowly), I just can’t feel the fear of of the supposed global repercussions. Each year, as the Earth revolves around the sun, the temperatures rise and drop by dozens of degrees — I mean, hell, the temperature can change in my city by 30 degrees over a 12-hour period. If a 60° change every year doesn’t cause great havoc to the planet, I’m just not worried about a 1.3° change over a century.

I pay attention to the hurricane season predictions each year (I live in the hurricane belt), and I’ve watched the professional weather and climate scientists get their predictions wrong year after year. I have no faith in the weather scientists to predict next week’s weather, much less next year’s, or the next century’s.

3. Even if the temperature is rising, and the climate change predictions are accurate, I’m not convinced that humanity has any large affect on the global situation. I’ve looked into this, through several sources, and I see just as much legitimate information saying humanity isn’t the main cause of global climate change as I’ve seen information saying humanity is the main cause global climate change.

There has always been some kind of doomsday scenario hanging over the world’s head, and they have most all been some form of man-made disaster. Nuclear war was the global bugaboo in my youth. Now it’s climate change. I fully expect there to be a new man-made sky-is-falling concept imagined within another decade. Some people are always wringing their hands and fretting over what terrible contastrophe some other people are going to wreak on the world. It’s a normal side of human nature.

I don’t want to live in a world covered in nasty chemicals and smoke, and I’m happy with the cleaning up some industry regulations have brought to our environment over the decades. I think clean energy would be a great thing, and so I would support the expansion of nuclear power plants in America.

But I just am not worried that the world is in some kind of climate crisis, in the near future or the far future. I just can’t buy into the kind of The Day After Tomorrow doomsday scenarios that most of the climate change fear mongers warn about. And I’m not convinced that mankind is the main culprit of their projected global weather disasters.

And I notice the name for this situation has been changed from “global warming” to “climate change.” I guess those who carry the banner for this concept got tired of people pointing out that 30 years ago the cry was “new ice age.”

And now, I must grant equal time to a different opinion: Rainbow conspiracy.

Bullgrit