I have good heath care from a good employer, but today, I need to make another call to my insurance company because another bill came from the Mayo Clinic, for thousands of dollars. My insurance company told me they would pay those bills, in writing. But that hasn’t stopped them from not paying. I’ve heard this before, but when it actually happens to you, it’s more than annoying. It’s wrong.

Months ago, I called my insurance company several times to learn what they needed for me to go to the Mayo, since the Mayo is out of network. They told me to call my doctors and have them document why I needed to go out of network. I did that. I had to go to the Mayo a few times, so I actually called my doctors a few times, and they sent the necessary documentation each time. Usually, my insurance company then sent me a letter of “Pre-Approval” to go to the Mayo. Some of the letters barely showed up before my appointment at the Mayo, so I had to call my insurance company again to get all the Pre-Approvals, which I did. I have all the Letters of Pre-Approval for all my appointments.

As previous posts in this blog show, the staff at the Mayo were great, just like other doctors, nurses, and staff who I’ve worked with. Unfortunately, my visits to the Mayo were more sad than good. The good part is that the Mayo has scanners that found my cancer earlier than other scanners would. The bad part is that my cancer has spread faster than expected. I still have hope that I’ll live as long as most, but I still have moments each week feeling annoyed and sad. And then, I get bills from the Mayo saying that I owe them thousands, after I made several calls to my insurance companies.

Sometimes, when I explain this to people, they reply that “insurance is complicated.” That means that we should expect some problems, or we should not expect improves soon, after decades with this problem.

Why does complicated matter?

America used to be a place where “complicated” didn’t matter. We fixed it. World Wars I and II were complicated. We fixed it. The Great Depression was complicated. We fixed it. The Dust Bowl was complicated. We fixed it. There are more examples, but the point is that our health insurance industry does not compare to previous complicated challenges America fixed, or used to. All the tough stuff just mentioned were fixed in a decade or two.

America’s Health Insurance companies have fixed other complicated challenges. For example, they created and implemented the idea of pre-existing conditions. It’s very complicated to write all the polices for that, train all the staff, and communicate with all the patients, telling them they could not get coverage. American Insurance companies did a great job with that complicated task. They also do a great job of making profits, which is very complicated. They do that so well that their profits are some of the highest in the country.

If they can solve those complicated problems, I wish they would do what they told me they would do and pay my bill, to the Mayo.

As I’ve mentioned before, I never had to call an insurance company when I lived in England. I also never heard the phrases, Out of Network, Pre-Existing Conditions, or Letter of Pre-Approval. The medical staff in the UK were as good as the staff I’ve worked with here, but they have government run health care, which is the same as single-payer. Almost all advanced countries have some kind of single-payer systems. https://en.wikipedia.org/wiki/List_of_countries_with_universal_health_care

You can dismiss me as some loud-mouth liberal, but there’s a decent chance you or someone you love will face this same problem, be ready to make phone calls when you need help the most.