Which Came First?

Which came first, the chicken or the egg? Oh, I'm not really asking. But that was my first thought in my head when I started to write this article on the insurance industry and the medical industry. Which came first? I mean, they seem to feed on each other, don't you think? The medical industry sets the price for whatever procedure, office visit, surgery, injection, whatever. But the insurance industry decides what they will pay, and “adjust” the amount accordingly.

I am learning way more than I want to about the two. Recently I received a bill for over $8,000 for my one week of dialysis in Orlando. The reason – the insurance company decided the facility I used was “out of network.” At the same time, there were NO “in network” facilities anywhere within a 100-mile radius of where I was staying. And dialysis isn't something you just put back in the closet and forget about it for a week. So, after my social worker argued with the insurance company, they adjusted it down to $790. A whopping 90%.

My question is – if the insurance company marks it down 90%, why then can't the medical facility have started at $790. Why this outrageous difference?

I've seen it all the time on my “normal” doctor visits. The office charges so much for a visit; the insurance company adjusts it down anywhere from 10% to 90%.

When I was in the hospital in late September, the hospital bill for three days was around $20,000, marked down 50% to around $10,000.

So who's the boss here? And what will the new health care plan be like? Same old same old??? Or worse? Or better?



Recession Depression

Well, isn't this just ducky.

After 11 years, I got laid off yesterday. On a stress scale, I think I'm off the charts.

First there was the thyroid biopsy (which turned out fine).

Then there was the anemia problem.

Then the failing kidneys.

Then 3-days-a-week, 3.5 hour dialysis sessions.

And now I have no job!

I believe it is highly possible for an elephant to fall on my head.

Actually - I think I'll be ok. I'm eligible for SSI, which could take five months to resolve. In the meantime, I'll do unemployment (think a 60-year-old dialysis patient is readily hireable?). Fortunately Medicare (for kidney dialysis) will kick in December 1.

The good news:, , , , , , I do NOT have to drive in snow to work. :)



I Can Fix That!

I’m a computer wizard. Really! With no effort on my part at all – and no license, no degree, no schooling. It just happens. I have built-in radar or aura or something. Maybe a little bit of magic.

I’ve been helping people with their computers for years. I worked at one law firm (as a secretary) where we were switching from DOS-operated Word Perfect to Windows-operated Word. For the first time we needed to use mice, and my job was to teach the attorneys how to use them. To help them get coordinated on the mouse moves, I had them play Solitaire. I cautioned them to not double-click. There are times for double-click and single-click, and the two just never got separated in these attorneys’ minds. They wanted to double-click everything. To this day, in fact just yesterday, I am still cautioning my current attorneys to not double-click on every little thing. I have a coffee mug where a wild-haired man is shouting, “No! No! I said to NOT double-click!”

But here’s where the computer wizardry comes in. Something will go wrong for (usually) an attorney. I’ll get a frantic call to come here right now and fix this whatever-it-is. I’ll show up and stand behind them to have them repeat the problem, and, , , , , , it’s FIXED! Just my showing up fixes the problem. It’s Magic!

They lose their program they were typing in and I’ll show up and can plainly see it in their tool bar, and have them click on the icon, and MIRACULOUSLY, their program reappears.

They have a totally blank screen and call me in a panic, thinking they should just throw in the towel and go home, head in hands, failures, flops, fools, nincompoops. And I will push the power button on their monitor and all is well with the world. Sometimes, I will fiddle with the cords, climb under the desk and make lots of racket, butt waving in the air, and when they aren’t looking, I push the button, slap my hands together, and mutter, “whew, that was a tough one.”

An attorney called me at home on a Saturday, urgently requesting my help with his secretary’s computer because all of a sudden it had hieroglyphics all over the screen. Come now! Hurry! When I arrived and saw her screen I knew immediately that she had turned her field codes on. (This is in Word and the toggle switch is Alt-F9, which she had somehow hit.) So I was there ten seconds, hit Alt-F9, and told her if it happened again, to just hit Alt-F9, to which she crossed her eyes and said, “I think I’ll just keep on filing – these computers just don’t understand me.” And I knew that I would get a call again in days because those funny squiggly {brackets} came back.

My job is never done.