The Freedom of Information Act doesn't apply.....

When you buy a car, a diamond ring, a can of soup, a house, there is redundant documentation to indicate what you are purchasing, and what that item costs before you purchase it. If you are a reporter, you are now allowed access to files that may have otherwise been classified. For most consumer transactions, you have access to information.

However, if you want to know what a visit to the doctor costs, that's another story. Patients, no longer called patients, but "consumers" or "clients," (who having already spent quite a bit of time navigating their way through phone trees, and subjected to circular numerical mazes, interspersed with episodes of muzak,) may eventually make it to a human being, or not. Who will tell them only that they don't handle billing and you will have to talk to someone else. Repeat the procedure and you discover that everyone at that phone number( the main switchboard for a university hospital) will be in meetings all day. Or it's someone's vacation, or " leave a message and someone will get back to you, have a nice day."

Grudgingly you will have gleaned the information from the appointment maker at the doctor's office that there is a "base" rate for the doctor even stepping in the door of your cubicle, after which the meter ticks over for every additional complaint you bring up. Oh, did I mention there are two rates: one for people with insurance and one for people without? Guess who gets the discount.

That brings up medical insurance. An individual policy. On the state's health care site, which is part of the regulatory agency which allows companies to sell their "products" and regulates the cost, it appears that there are a variety of plans with sample charges listed. Call a provider and oops, the amount listed on the state site is less than the company charges on the day you call, and the criterion are different.

A suspicious salesman, who can tell me nothing about what is covered in detail or what the insurance company will pay, as I ask about sample procedures--- an MRI, an outpatient cataract surgery-- speaks to me airily about the percentage the company will cover. Well, I ask, how much does the procedure cost exactly.... why should I purchase your plan? He is suspicious because I quote the info on the state site. Wheredya get that figure, he mutters? ( that's what it says it cost in July, this is three months later, does this mean costs go up $20.42 every three months?) Gotta putya on hold, is that ok? Sure, why not.

It's the same for everyone over 63. Where does it say that, I ask?

Well, our plan is better because it is cheaper. Cheaper. Hmmmm.

Thirty percent of an unspecified amount for a doctor's visit. A friend relates a typical medicaid itemized reimbursement. $175 -200 for the doctor to see you for three minutes. Ok. that's a good baseline figure. 30% of 200 is $60. Wouldn't take much time to reach a deductable at that rate, would it?

I have to ask. If insurance companies require itemization, and medicaid requires itemization, and hospitals have to itemize and justify their costs to all sorts of regulatory overseers, why should the person who foots the bill not be able to see a bill of fare posted on every medical establishment, or online, detailing the costs? Granted no patient is alike, the coding for patient procedures is standardized and I believe that along with being treated with respect and dignity, it is important to be treated with financial respect and dignity through clear and appropriate labeling of health services.

I believe I have the right to know what I am paying for medical care, medical insurance, and I believe providers, whether they are the state or federal sources for information on these services, people who make a profit from my health fears and issues, which is what the insurance establishment is about, and health providers themselves--doctors and hospitals-- need to be equally transparent and their information sources, e.g., websites, need to be frequently updated with contact numbers that result in contact.

It should not require six hours online and on phone to find out that this information exists and to attempt( still haven't succeeded) to obtain it. I should not have to hire someone to do this. And I should not have to make decisions that affect the well being of my family without appropriate information.

Let the Freedom of Information Act be applied here.

It certainly isn't when it comes to Medigap policies. Same obfuscation on federal, state, and provider sites, same circular telephone mazes( trees is a euphemism.) Tell us everything about you so we can sell you something and we won't tell you anything about what we are selling or what it costs.

We need redundancy. We need the same basic and clear information posted in a number of sites so that anyone accessing any point can get the same answer. Not one person who just doesn't happen to be in the office when you call, after three redirections of referrals.
Instead of twenty million privacy notices in the mail I would like to get twenty million statements of health care costs and procedures from each of these vendors with whom I have to do business, and I would like them to say the same thing. Truth in coverage, truth in costs, dollar amounts, not percentages which require five steps to calculate. Because all these health care entities are regulated, they should be required to repost and update these to all their consumers on a regular basis. It should be the responsibility of these providers to acknowledge personal milestones, much as social security does, in a timely manner and relate enrollment and cost updates to those milestones.

Let's make some changes.

The Doctor is Out.....for how long?

My husband better not get sick. He better not need medications, stitches, lab tests, inhalation therapy, or any of a myriad of covered expenses detailed in our health insurance policy.

I, on the other hand, may have my throat swabbed for strep, physical therapy for my knees, x-rays, even an MRI under the same policy. And our college student offspring, thanks to a rider, can have a pediatric nurse (since she hasn't been home long enough to find a grownup doctor) check to see if she is wheezing under the same insurance policy.

What kind of medical policy excludes one out of three family members from insurance paid doctor's care?

Is it a .......business family health plan? Close.

Is it a .....small business family health plan? Closer still.

One more guess?

Is it a very small business health plan, say a self-employed covered person plan?

How much does it cost to have such a family health plan if you are a very small busines?

Let's just say that it's over $1000 a month.

That's a lot of money for health insurance, but hey, it pays for hospitalization, doctor's visits and such, and prescription drugs.

But not for three people. Forgot to mention. The self-employed person is 65. Two years older than the covered insured whose bills for the same procedures are paid.

Could sign up for Medicare Part B... why not just toss another hundred bucks after the other ten. There aren't any more hours in the work week as it is to earn it. Shouldn't have to.

An explanation?
Stay tuned. Still trying to find out.

Reuters

Too bad.

You cannot create a just world with Photoshop.

Only reality can be cloned.

577 Square Feet

If you are willing or able to wait, oh, say eight, ten months, maybe a year or two, you may find yourself at the top of a senior housing list, and have the opportunity to inspect, yea, perhaps even occupy, (paying 30% of your income,) a place of your own. And occupy it you will, seeing as it will be virtually impossible to participate fully in the life of the greater community by going very many other places. With only a few existential exceptions....the grocery store, the doctor's office, a hospital, a church.... you can't get There from Here.

Work. You want to work? You need to work to make your property tax payments, to fix your roof or your mower, or your teeth? To go to the movies, a friend's house, out to lunch, to a yard sale or committe meeting? Forget it. No transport to third shift work, from outlying communities to jobs, to work on Saturdays, or Sundays, or evenings. Transportation to work is not seen as essential for seniors.

Many of the members of select boards, planning committees, zoning committees, and various town offices have traditionally been held by elders in the community, elders who are used to mobility, used to autonomy and independence. People who brave snowstorms and twenty-degree below zero weather to hear and act on citizens' concerns. People who cook for community suppers, sorting for book and plant sales, support school activities as audiences, attend town meetings and speak up in person and on the pages of community newspapers. When we've wrung all that work out of those folks, what do we offer in return?

577 square feet of warehouse. People in dead storage: leave your imagination, your passion, your intellect, your courage, your outrage at the door.

Think about it.

-Lady Grey

The grey ceiling is alive and well in Burlington, Vermont.