$47,000.
That's what the plastic surgeon that did my four-year-old daughter's stitches -- 11 of them -- charged my insurance company. $2000. That's what I went out of pocket to cover his costs back in June, before he knew what the insurance would pay.
$24,000.
That's what my insurance company - after repeated calls from me - told me they were going to give him. "No! You can't!" I shouted into the phone. If $2k was his bottomline, then why oh why give him $24k for stitches? I bet he can cover rent on his Park Avenue office for just one payment of $24k. But they did.
My sister, Genevieve London, is a pediatrician at a clinic in Maine. As I told this story at the Thanksgiving dinner table, her face contorted into an angry sadness. Her lips parsed and her eyes just sunk. Then she tells me there is a boy who she treats in clinic with a disease that leaves him with a suppressed immune system, and frequent hospitalizations. His condition is treatable with a prescription drug, but it's a drug that is not covered by his insurance, despite letters she and other doctors have written imploring them to do what's right. Genevieve tells me that it's not if, but when, a new hospitalization for the boy will come, at a surely greater monetary cost to the insurance company and an unfathomable cost to the family.
Recently, we took my four-year-old for a check-up and found out that our insurance was lapsed. Yes, I'm a bad dad. In August, my wife lost hours at her university job and we were given a three-month window to get new insurance, only I set the clock wrong. Luckily, we were still eligible, and I had a day to sign up for new insurance at the end of October. I chose Oscar. $972/month for a high deductible insurance program that, it turns out, our pediatrician doesn't take. And anyway, it's all out of pocket until I spend a $7000 deductible.
Today I've got to sign up for insurance, but decided to write you all instead. The marketplace is less competitive than it was last year, and more expensive, in large part, as I understand it, because swarmy Marco Rubio 'succeeded' in ways his revolutionary saboteur cohorts in Congress haven't. See, Rubio found a way to plant an Obamacare poison pill into a bill last year that led to the bankrupting of over a dozen insurance programs and exchanges, while he gets insurance thru Obamacare with a $10k Congressional Members-only subsidy. He sees it as a taxpayer success. I see it for what it is: hypocritical government leaders reneging on a promise to support nascent, competitive marketplaces for insurance. It's a political win at the price of the people, for the indebted pol with Obamacare himself.
Good policy can fix these kinds of problems. That's why I support Hillary Clinton as a public servant who has always been committed to, but often stymied, in her efforts to make insurance universal and affordable for all Americans. We aren't there yet.
So, good luck to everyone looking for insurance by the deadline. I'm gonna keep trying out these new plans until I find one that fits without draining me dry. I guess I'll get my $2k back and we'll be protected in a way. But I can't feel good about a system where a plastic surgeon got $24k for doing 11 stitches, while my pediatrician sister can't get life saving medications for her patients.
Obamacare, I wish you had a better chance. I wish you had support in the House and Senate to be improved, but instead they are neglecting you, the unloved child of Washington dysfunction.
Good health to everybody. I wish you as few visits to the doctor and interactions with the insurance system as possible in 2016. And justice for pediatricians!