Back in the early 1920s my great uncle, Leonard Ward, had the good fortune to meet and wed Mary Hittson. Leonard was a rodeo cowboy. Mary possessed a home movie camera. She filmed all his rides and roping events along with those of the highest caliber competition. She sat Leonard down and ran the footage of each and every event. Then she'd run the film again, and again, until Leonard or she spotted something that could improve his riding and roping technique. Whenever Leonard slid into the chute to mount the likes of Old Midnight, Tipperary, or Five Minutes to Midnight he was doing so with more foreknowledge than any other cowpoke of his age, culminating with an All-Round Championship of 1934 and a place in the Rodeo Cowboy Hall of Fame.
After meeting Mary Hittson and her movie camera, the phrase, “This ain't my first rodeo,” applied most aptly to Leonard Ward. In those days of the Roaring Twenties and the Great Depression most rodeo injuries, short of a major fracture, were literally spat upon. You sucked it up, dusted off, and climbed back in the saddle. Care for broken bones was paid for out-of- pocket. If you broke too many bones you moved on to another profession.
Uncle Leonard was lucky (he was inordinately fortunate throughout his long life, surviving four years in Japanese prisoner of war camps during World War II being just one example of his good luck); Medicare arrived on the scene just when he reached the age to receive it.
Leonard didn't require much of any medical care until his late eighties when he developed melanoma. This could have come on through years of outdoor sun exposure or it may have been a delayed reaction to having stood within shouting distance of the atomic explosion that destroyed Nagasaki on August 9, 1945.
Leonard's ten brothers and sisters lived into their eighties and nineties and beyond with the exception of two who were killed as a result of automobile accidents. My mother, an only child, lived into her late eighties despite being born two and a half months premature in the most rural of settings. My father's mother lived into her nineties while working a hard ranch and farm life from childhood on. My father survived into his late eighties as well, working in the woods as a timber faller much of his adult life.
The major point of all this is that there isn't a lot of debilitating illness in my family tree. These were rugged people who toughed it out. Nevertheless, these hardworking folks welcomed Social Security, Medicare, and health insurance. One of those auto accidents, referenced earlier, took the life of a maternal great grandfather and Leonard Ward's eldest brother. The horses pulling their wagon in 1919 on a Nebraska sandhill road were spooked by the noisy horn of a passing automobile. The injuries they sustained did not kill them. In fact, they lingered for more than a year. The medical expenses incurred during that time essentially cost the family their farm/ranch.
So, though I stem from this hardy breed I, too, have been a consumer of mainstream health insurance and have maintained a fairly steady habit of checkups and preventative care. In the spring of 2008, having reached an age at which one is supposed to undergo a colonoscopy, I did so locally at the Mendocino Coast District Hospital. In 2008 colonoscopies were not yet fully covered by health insurance policies. The hospital required a check for several thousands of dollars well in advance of the procedure.
Two polyps removed, let's move on to 2013. At the beginning of that year I made sure that my new Anthem Blue Cross health insurance policy was one that fully covered colonoscopies. I even kept the personalized checklist Anthem produced for me, which listed two things: an annual physical and a colonoscopy. Underneath the colon cancer screening part of the checklist are the words “No cost to you. Covered at 100%.”
I didn't get around to the colonoscopy until three days before Thanksgiving. It not being my first colonoscopy rodeo, the whole procedure went painlessly, even the preparation period that voids your body of all things foodlike. No polyps, good to go.
Not so fast, spaketh Mendocino Coast District Hospital. Exactly one week before Christmas I received a bill in the mail from the aforesaid hospital for $2,635.47. Immediately after arriving home from the post office, I called the hospital's billing department. I spoke at some length to two women who worked there. They both claimed that the colonoscopy was billed as a surgery, not as part of some sort of system of preventative care. Neither was willing to concede the concept that charging people for follow up colonoscopies might prove quite a deterrent in getting any patients to come back for further colonoscopies. The most I got out of the woman with a seemingly higher position in MCDH's billing office was a very grudging, “I'll look into it.” I gave her my phone number and have yet to hear back from her or anyone at Mendocino Coast District Hospital.
Readers might guess that the insurance company, Anthem Blue Cross, would be the outright villain in this situation. No sooner had I gotten off the phone with the unwilling-to- help women at MCDH's billing department than I gathered all my Anthem Blue Cross paperwork and called Anthem's 800 number for customer service. Lo and behold the phone answerer turned out to be understanding. Without any prompting she noted that the colonoscopy should be fully covered, that the problem lay with either the doctor or the hospital marking it down as some sort of billable (to the patient) surgery. When pressed as to which was more likely to have made the mistake, she said, “The hospital,” because they are the ones sending out the bill.
As of New Year's Day, when Anthem Blue Cross workers were answering the phones in contrast to Mendocino Coast District Hospital, Anthem had left several voicemails with the MCDH billing department, but the situation wasn't expected to be cleared up until January 7th of the new year.
Lest readers think giant health insurers like Anthem Blue Cross have turned over a completely new leaf: Right after my colonoscopy in late November I, like many Californians, went through the process of switching to a new health insurance policy, since Anthem had eliminated the old one. Using the Covered California website and some assistance from a Covered California agent on the phone, I navigated the system successfully enough that by mid December I had received approval through Covered California and a bill from Anthem for my new health insurance at a reduced rate from the previous policy. However, on December 31st, I got a bill in the mail from Anthem Blue Cross for a completely separate health insurance policy. A bill that was nearly double the amount of my old 2013 premium, and the due date for payment was the next day, January 1, 2014! Presumably, this is simply a result of the health insurance companies being overwhelmed by vast numbers of new and changed policies under the Affordable Care Act.
The whole debacle, from the unthinking, inhumane creatures at Mendocino Coast District Hospital's billing department to the crossed wires at the huge health insurance company reminds me of my forebears best medical and insurance advice: “Don't get sick.”
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