Picking up from the last post:
How do I know Mission Hospital in at least one case did not comply with Obamacare rules to maintain non-profit status as defined in the IRS? A friend in the food service industry showed me his ER bill for ~$3000* for two asthma treatments and one chest X-Ray**.
He grosses less than $12,000 annually and has not been able to afford insurance. And like nearly everyone in the food industry, his hours are kept just below the minimum to qualify for shared cost insurance. So he needed to figure out how to pay one-quarter of his income to Mission Hospital – for an asthma attack.
I’ve heard without ceasing Republicans say they voted for Trump because under Obamacare their insurance premiums had risen. So had ours. There are some provisions in Obamacare that do very much help us, such as keeping a child on our policy until she turns 26.
I also thought the rise was so that everyone could have healthcare, which I believe in. Turns out that there is no correlation between the rise in premiums and the availability of care for the poor. At least that is how I interpret it. Obamacare was the excuse; the rise was due to the fact that insurance companies exist to enrich their shareholders.
Think about it. Why trust the insurance companies? Their businesses are not philanthropies. Neither are most hospitals.
So I started poking about, trying to help my friend. And that is when I realized he was being ripped off by Mission.
Now, I’ve been in a half dozen hospitals in four major US cities. I like the care that I received at Mission. Its ER and floor nurses in particular are the best I know of. Never once did I contract any illness at Mission, which itself says more than you might think.
No, my problem is with whoever is in charge of its financial sector. And ultimately, then, its CEO, Dr. Ron Paulus. He’s the captain of the ship. If he doesn’t know this billing outrage is happening, he is not worth his salary.
To pick up the story: My friend and I trundled down to the Billing Division of Mission Hospital which is not, as you might expect, at the hospital. It is, instead, about 15 minutes away in one of the prime retail properties of the City, Biltmore Park.
You have to ring a doorbell, sign in, and wait in the grand and, when we visited, very empty waiting area before being called in to talk to a billing person who will ask if you are there it pay your bill or set up a payment plan.
This is when you say, neither, because according to the hospital’s own policy, which itself is based on IRS provisions for maintaining non-profit status, I do not owe $3000 for a single asthma attack ER visit.
In this case, the woman looked like she didn’t know what I was talking about, so I presented her with print-outs of the long version of the hospital’s policy on its website and the IRS ones. At this point, she rather nervously skitted off to confer with her supervisor.
In the end, after submitting copies of his tax return and pay stubs, my friend owed $0.00 instead of ~$3000.
So all is well, right? For him, yes, but only because he has a friend who is a crotchety old woman who doesn’t take no for an answer when she knows she is right and has no compunction about questioning authority. I have found that people who are the first in their families ever to graduate from high school tend to think bills are always legitimate. He reasoned, it will be at least another year before I can get a car loan because somehow I have to pay this bill.
The poor are used to being shat upon. I am not.
Moreover, how, exactly, was this guy who at the time didn’t yet have a car supposed to travel where buses don’t go M-F when most of his friends are at work?
If it is just asthma, why didn’t he have an inhaler? Yes, if he had had an inhaler, this would not have happened. If it were me, I’d call my family doctor, get a script or refill called in, and present my prescription card at the pharmacy.
But that is because I have a family doctor and don’t have to wait in a block-long line for the first-come-first-serve free clinic that operates one afternoon a week when I should be at work. And because I can always pay my insurance co-pay with ease.
This is why the poor stay poor, and the rich get richer.
*Includes doctor’s bill.
**He did not know you can refuse a procedure. Someone in his twenties who has had severe asthma all his life knows when he is having an attack. Why the X-Ray?