Thursday, May 5, 2011


I was trying to chat with my wife around 8am this morning.  It was difficult as I had been up late last night, drinking wine, playing with the spell-check feature on my computer, challenging it in various competitions.  I answered the phone because I thought that somebody out in this great vast world wanted to reach me. There must be a reason for it. Perhaps there was money involved, fame, or something even better than both of those things.

It was my dr.'s office, wanting to schedule a follow-up appointment.   My wife had called about 90 seconds before this and cancelled the appointment I had because I had left her a note asking her to do so the night before. I didn't know any of this because I was still submerged in sleep only a minute previous to any of this. They waste no time with this thing, health.  They were quite interested in when I would be coming back into the office for a "follow-up."  I asked what was it that they had not done the last time I was there?  The woman on the other end of the phone, who had a voice like an angel, though I'm sure it concealed the eyes of an anemic rat, told me that a follow-up appointment is customary.  I said, What if I've just lost my insurance? She asked if I had and I said, No.  But I said, Look... I don't care if you guys rape the ass off of my insurance company, but why do you always need me to do it? 

I then went on to suggest that I didn't even much mind the idea of coming back in but it just bothered me that I had to pay a co-payment.  The co-pay is there to prevent me from going nuts and running completely amok with my insurance, the way that the doctors offices do.  I've seen the enormous cost/price/service differential involved and we all know what's happening here.  So I again suggested that they could either charge my insurance company as if I had come in and we'd split the profits. Or, I would actually come in and they would look at my paperwork, charge my insurance company, but at least have the decency to forego the co-payment, as an incentive, to sweeten the deal for me a little bit, etc.

None of this reasoning worked.  I explained that after taxes and deductions for things like insurance I end up walking with about $3.12 an hour.  Now that might sound like a lot because you're automatically calculating it based on an 80 hour work week, multiplied by 54 weeks a year, and you then end up with something like $13,000. A figure of fortune in anybody's mind, right?  But I call in sick a lot.  I had to qualify this right away because I didn't want her getting excited.  I said that I call in sick a lot. I didn't say that I was sick a lot.  If I made anywhere what their office was making from being sick then you can rest easy that I would be calling in sick even more, perhaps hourly. But in this topsy-turvy arrangement they actually punish me for being sick, financially that is. 

This must have come as quite a shock to somebody who is accustomed to handling and procuring large sums of money based on people presumably being sick.  Yes, I said. It sure is a crazy, twisted world, but it's the only one we've got.

I went on to tell her that I would even be willing to leave my job duties altogether if I could just find a way of guaranteeing some of my insurance money would head towards me rather than away from me and towards them.  A deal that benefitted both involved parties. She explained that going on disability required that I was sick, then she asked me if I was sick.  Make sure you've read that last line carefully. She asked me if I was sick.  I said that I have gotten a reasonable amount of raw and rotten deals in my life, but for the amount of cash their office is getting for the monitoring of my health, they really should possess a much clearer idea of my health status. No, I am not sick, and you know it...!!!

But it did occur to me that maybe I should come in for a follow-up, and arguing in this way was probably raising my blood pressure.

I said that enough money was getting paid out to them to justify some sort of sickness, right?  She breathlessly exclaimed something about fraud and it simply not being possible, something along those lines.  I said that I have seen the financial breakdown of what they do... and if my walking into the office, paying $30 at the desk to do so, and sitting across another desk from a doctor for 5 minutes nets them $400 from my insurance company then they probably know everything there is to know about fraud, and I will trust them on this matter.  My mistake.  I'm still a beginner in this game.

I used to not have a job, sort of.  I didn't do anything that provided me with the benefit of health care.  So I was considered an indigent and I went to an indigent hospital.  It is a famous one, Bellevue.  It used to be a madhouse here in Manhattan. I believe that's the term, madhouse.  It is where they would bring the crazies and the drunks and drug addicts to keep the prisoners in jail safe and far away from them.  But they loved me there and they didn't charge me for any of the services they performed, pretty much.  Every now and then I would have a big spot of red cancerous cells growing on my chest or back or eyeball and they would get excited about slicing it all off and, not wanting to disappoint them, I would let them.  Things worked out pretty well between us.  But then I got a job.  It was for a big company and they had exactly what you would expect, a big set of choices when it comes to big insurance plans. I chose the very best one.  I looked at all of them and I thought... I deserve it.  I've earned it.  

Well, I got what I deserved.  I have never had so many ill-defined bills in my life.  I go into the dr.'s office, oftentimes because they've called me and invited me in, whether it is for them to look at my eyes, or watch me breathing, or check my weight, etc.  I pay the amount they ask me to, for coming in, which is enough to keep me from wanting to be there very much, or coming back very often. They wave and say goodbye and give me the type of gracious and friendly smiles that make me feel that my health is pretty much a guarantee, and is in the best hands available for such a thing.

Then a few weeks later I will get a bill in the mail from them, explaining that insurance is a confusing operation that involves many layers of approval and special codes that denote one thing or another, and attached is a request for much more money. Recently I sat down and looked at all of it and it turns out that I have been paying a larger share of the dr.'s bill than my insurance company has. Because, and this is where it gets really strange: They give my insurance company a break on what they charge them, but then they try to get the difference from me. This is considered standard procedure, I'm told.  It is the way that these things work.  

So, now I'm sitting here typing this post rather than calling my dr. and rescheduling this follow-up visit.  It should be called a finish-up visit because that is what they've done to me.  I think I just want to be a poor indigent again but I'm not sure if they'll let you go back. Maybe if I grow a fresh new spot of cancer on my good eye they'll let me come in for a visit, for old times, or before it's too late.