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Out Here: Health insurance already unnecessarily complex

Published: Tuesday, Nov. 12, 2013 1:15 a.m. CDT

One of the biggest fears about Obamacare is it will make health insurance more bureaucratic. 

I’ll leave that debate to others, but let’s make one thing clear: Health insurance is already unnecessarily bureaucratic.

Studies have shown that Americans spend billions and billions of dollars each year on health care bureaucracy.

I learned about that firsthand.

In July, I underwent emergency surgery to correct an intestinal problem. Before the surgery, of course, I received anesthetics. 

My insurance company agreed to cover the surgery, but not the anesthetics. 

Say what?

I looked at my insurance policy, and it clearly labeled anesthetics as covered. 

So I called the insurance company. After some discussion with a representative, I was put on hold for a while, then was told the company stood by its decision. I called the next week, and a woman told me that the anesthetics should, in fact, be covered. 

A couple of months later, though, I received another statement from the insurance company that itemized the $2,700 cost of the anesthetics. I had to pay it. 

I called the company and was told I had to pay because the person who administered the anesthetics wasn’t in network.

The hospital was in network, but not this person, apparently. I should have asked the person whether she was in network, the company’s representative told me.

That advice lacked logic. Getting wheeled into the surgery room is one of life’s most frightening experiences. Yet, even though I got pre-surgical clearance with my insurance company, I was supposed to have had the wits about me to ask whether the person administering the anesthetics was in network.

A few days later, I called the insurance company yet again. This time, I was told the anesthetics would be covered. And they were, according to a later insurance statement. 

The insurance company’s representatives must have spent at least a couple of hours with me on the phone. What a waste of time and money for our health care system.

Many doctor’s offices have a single person whose sole job is dealing with billing issues. Is that an unnecessary expense for society? I think so. 

Wouldn’t you rather have the health care system focus on, you know, health care?

Simplicity could save a lot of money. 

David Giuliani is a news editor for Sauk Valley Media. You can reach him at dgiuliani@saukvalley or 800-798-4085, ext. 525. 

 

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