Friday, April 3, 2009

Day 52 - Insurance crooks


In one of my posts, I revealed that my surgery cost nearly $30,000.00. That now needs to be amended. I just got a new bill from the assistant surgeon for $2,091. So the new total for the surgery is about $32,000.00.

As if that wasn't bad enough, my insurance company, Aetna, is trying to stick me with the entire cost of the $2,091. When I asked why I was responsible, Aetna gave this as their actual explanation (I am not making this up. This is the actual quote from their letter to me): "The charge for the assistant surgeon, co-surgeon, or surgical team is not covered under your plan."

Huh? The surgeon is supposed to do this surgery without a friggin' surgical team? Are you kidding me? I hope whichever bastard at Aetna who came up with this preposterous policy goes to prison someday because it is essentially encouraging unsafe medical practices. You can almost hear this bozo's brain coming up with new ways to cut costs: "You know, if the surgeon did 2 operations at the same time, that would save some money. Oh, and instead of doing the operations under all those bright lights, why not just do it in the dark. And what's with all the gloves and washing? Is all this sterile nonsense really necessary?"

I'm not the only one who has been hit by this policy. In February, the American Medical Association and several state medical associations filed a class action lawsuit against Aetna for dramatically under-reimbursing physicians and trying to stick patients with an excessive amount of the costs. The suit charges that this practice was going on for more than a decade.

In 2003, Aetna settled a case over similar charges for $100 million.

A lot of adjectives come to mind: Crooked. Dishonest. Criminal. But regardless of which one is most apt, the real culprit is our health insurance system, which ensures that companies will continue to rip off patients in order to improve their bottom line. And that's disgraceful.

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