Ma'am, It's how the system works.

The health care system.  It gets a lot of press.  It is a big controversial subject.  It is incredibly not fair.  We sit at the top of this food chain.  I recognize that in the last week Jason has received better health care than 99.9999 % of the rest of the world at relatively little cost to us.  It is the cost to the system that boggles my mind.  I know the services rendered to us Westerners enjoying modern medicine are very expensive.  But sometimes the lack of efficiency is as downright annoying as the fifty styrofoam cups they give you in the hospital.  Let me walk you through the last six hours.

Incident #1: Those of you who faithfully read through my ramblings in the previous blog post know that Jason is currently being treated with heavy doses of antibiotics through an internal catheter called a PICC line.  This is a very efficient system set up in the hospital which enables him to go home to receive intravenous antibiotics without being in the hospital.  After a few visits from a home health nurse both he and I are trained to give the medicine.  We've had a standing date at the same time each day for the last few days for lots of sterility, saline washes, drugs, and other fun things.  The only cost to our insurance for this (not counting the drugs)?

The 1x/week visit from a home health nurse= $200.

We find out today that this is NOT covered by our insurance because Jason is receiving OUT OF HOME physical therapy for his knee.  So, technically, if he can get out of his home for physical therapy,  he should be able to get out of home for his meds.  So what IS covered- by the letter of the law- is for him to trek out to a hospital infusion center  EVERY DAY to receive his medicine.  You do the math.  Even if the infusion center is cheaper, let's say for kicks $100/visit, the insurance company is agreeing to pay for these visits EVERY DAY for the next two weeks instead of paying for only one more visit from a home health care nurse.  Like I said...you do the math.  Our health insurance is covering medical expenses, but it is at an incredibly higher cost to them (and eventually to all of us) as well as effort to Jason.  

Incident #2: Eleanor needs to visit her pediatrician for a minor health issue.  I make an appointment for later in the week, but as we walk past the office on our way home from school I decide to step in to see if they can fit her in this afternoon.  The receptionist, who looks like she should be at some shady lawyer's office in a cheap movie instead of in a neighborhood pediatrician's office, says with a fake smile, "Ma'am, I could let your child see the doctor, but I'll have to charge you an extra $80 for being a 'walk in' patient."  She quickly releases the muscles surrounding the lipstick that has bled into the cracks of her upper lip, and her smile disappears.

"You mean," I ask incredulously, "that if I stand in this lobby and call you on my cell phone to see if Eleanor can have an appointment at 3:45 I will be considered a scheduled patient?  But if I actually talk to you and ask if she can see the doctor at 3:45 you will charge me an extra $80?."

"Yes, Ma'am, it's how the system works."