Tag Archives: healthcare

My Idea Of Simple Living Doesn’t Exist

For some, simple living means leaving urban areas for rural farmland, preferably with a vineyard, animals, and fields of lavendar.   For some, it’s about staying home with the kids.  While I understand the appeal of these common dreams,  I’ve realized lately that all those fantasies have their complications.

A rural life can be back-breaking and tough financially. You trade suit and tie for mud-covered overalls.  You don’t clock in at 9 am to 5 pm  but you probably work dusk to dawn if you need money to survive.  Of course you can run a bed and breakfast in Tuscany or Provence or other more “rural” paradise, but you need a lot of money to buy into that dream (and it requires work also).  Less commuting and less office politics would be a welcomed bonus however! 

Staying home with kids holds obvious appeal for many exhausted working parents.  But it’s important for me to remember that I wouldn’t be spending hours and hours reading to them, walking in the park or just playing with them.  I would have to do a lot more laundry and house cleaning, too!  It’s not that I’m spared those chores now but I definitely can offload many chores and errands due to my work schedule.

So other than rural escape or quitting my job, what is my ideal simple life?  The answer: A life free from mounds of paperwork, bureaucracy and bills.  If only I could live life without having to call so-and-so about an incorrect charge on my bill, write letters to insurance companies, call my cable or phone company to renegotiate my rates, or fill out forms ever again.

This is probably at the top of my mind because I’ve had the pleasure of dealing with both the government and private insurance for a myriad of reasons.  I know the words government and bureaucracy go together while corporations are seen as more efficient.  That may be true if you compare the government with Walmart or Coca-Cola, but if you compare the Big Government with Blue Shield, Cigna or any private health insurer, you’ll soon get a huge headache with rude or inept customer service reps, overwhelming bills, billing errors and paperwork, too. 

I supposed I could simplify this area of adult life if my husband took care of everything but I don’t think it’s a good idea to step back that much or be that clueless about finances and other bills/paperwork that affect us both.   Maybe that’s why we cherish our childhoods so much. That’s when our parents scheduled doctor appointments and dealt with all our bills! 

Other than running off to a tropical paradise and living off the land, is there really a way to escape from paperwork?

I Love Walmart

Love is probably too strong of a word, but I am feeling very thankful and appreciative (i.e. warm and fuzzy) toward this mammoth corporation right now.  I’ve heard about their less-than-stellar treatment of employees, unsavory business practices and the damage that they’ve done to mom-and-pop stores across the country.  Yet I overlook these for my own practical, selfish reason: I save money at Walmart.

I’m not talking about saving quarters on shampoo and cheaply made goods. I’m talking about saving hundreds on prescription medication.  Recently I had to pay out-of-pocket for a medication not covered by my insurer.  I checked online and called around to the usual pharmacies; they all quoted me about the same price.  Then I called Walmart.  Their price was approximately 60% less than everyone else! 

Walmart offers hundreds of prescription medications for $4 to $9 (1 month to 3 month supply).  For millions of people without insurance or with flimsy prescription medicine coverage, this is the difference between following their doctor’s orders or not.  Vons and Ralphs have tried to match these low prices but they wouldn’t have done this if not for Walmart’s lead.

After checking out a range of Walmart drug prices, I realized that my husband and I could have paid $5 -$20 less per prescription over the years; their prices can even be lower than my insurance co-payment.  This recent 60% saving was the biggest price difference yet.

Many people I know won’t step foot into Walmart on principle (moral reasons or aesthetic reasons — garish overhead lights, the depressing feeling of being trapped in a giant box, etc..). However, it may be worth making an exception when it comes to their pharmacy.  Medication in this country is outrageously high.  Costco may be just as cheap but many people cannot afford to pay a membership fee.  In many cases, Walmart can be a life saver.

Are there any other reasons to love Walmart?

First, I’m not entirely convinced that other mega-chains, even my beloved Target, have better track records in terms of employee treatment and imported goods. I see plenty of cheap China-made products at Target, too. Walmart has taken steps to reduce its carbon footprint and pressured its suppliers to reduce packaging.  Their employees may not be the the most enthusiastic or well-trained but I’ve only had good experiences with their pharmacy staff.

I know that Walmart was the subject of a scathing documentary a few years ago.  Since that time, I hope that they have taken steps to become a better corporate citizen. I have to look into it one of these days but for now, I’m burying my head in the sand for selfish financial reasons.

Do you avoid Walmart at all costs? 

Evil Health Insurance Company, Why Do You Bother Denying My Claims?

Over the past three years, I’ve gotten quite good at battling my health insurance company, or hereforth known as Evil Health Insurer, for their denial of office visits and diagnostic tests recommended by my doctors.  I have to thank the internet for my newfound expertise. When my insurer first denied a legitimate visit to a specialist, I did some research and found very helpful tips on letter writing and on navigating the process in general.  Using these tips, I wrote a letter and included documentation to back up my claims.  A month later, they said I was correct and paid for the visit.

Since that first victory, they’ve denied various claims (for the same medical condition) at least four times. I’ve lost count.  Each time, I pull up my letter template…yes, I now have a handy insurance letter template…fill in the blanks, and re-attach supporting documentation from my benefits manual.  I recently won my latest battle and I admit that I’m feeling cocky enough to post about this. I want to say or shout from the rooftops:

Dear Evil Health Insurer,

You may screw over millions of people just when they need healthcare the most but you’re not screwing me. In fact, the next you see a letter from me, why don’t you just approve the claim without re-reviewing the case because you know I’m right!!!

Or better yet, why don’t you stop denying legitimate claims in the hope that the victim is too illed, too uneducated, or too busy to fight back?  I truly cannot believe that each denial is an honest mistake. I saw Michael Moore’s “Sicko” and have read enough horror stories to know that this is simply how most insurers conduct business.

Hopefully this post will become irrelevant if healthcare reform actually goes through. In the meantime, here are my tips if you ever get denied:

1 ) Your letter should not be emotional.  Be as factual as possible. Throw in legal-ese if you can!

2 ) Send your letter via certified mail. Don’t bother calling more than once. A paper trail is critical.

3 ) Back it up! Copy pages from your benefits manual that support your claim.

4 ) Keep a copy of your letter and use it as a template if/when you are denied again in the future. This saves a lot of time and makes the process less of a headache.

You can also ask your HR department for help if you’re not able to resolve this on your own. Remember, most people don’t fight back and insurers know this. They are more likely to approve your claim if you’re one of the few who bother to fight back. I don’t know if fighting back counts in my “Just Ask! Negotiations” challenge.  After all, my company and I pay for health insurance and expect legitimate expenses to be part of the deal. It’s not the same as asking for a better deal on rugs or shoes.

I’ve left out the name of this Evil Health Insurer because they’re all pretty much the same so I don’t feel the need to single them out by name

Boycotting Whole Foods, And A Health Care Quiz

Note: I wrote this a few weeks ago after reading about a post against healthcare reform from John Mackey, the CEO of Whole Foods.  It may be a little late to the debate but I felt like I had to post this…

Healthcare is too important of a topic to leave to the political blogs, media and politicians. It’s an issue that affects everyone. If the U.S. were to offer universal healthcare, I would jump on it. Unfortunately, I have to endure this current system due to gun-toting protesters and big-time CEOs like that of Whole Foods.

His ideas for reform clearly shows that he is out of touch with middle America’s needs. This isn’t surprising. What is more surprising is that the average Joe, i.e. anyone not in top 1% earning bracket, is against any reform that would benefit him/herself and their families.

For example, he suggested removing legal obstacles which slow the creation of high deductible health insurance plans and Health Savings Accounts. What he clearly does not realize is that these high-deductible plans (he cites a $2,500 annual deductible) are cost prohibitive for the average worker. $2,500 is a drop in the bucket for CEOs but not for the average family.

He also suggests that our skyrocketing healthcare costs is due to government mandates and ruinous lawsuits.  While ruinous lawsuits can be a problem, healthcare costs are outrageous due to the greed of our pharmaceutical company, insurers and hospitals that benefit from high prices.  When everyone operates to make a profit, the consumer (us) pay the price.

He suggests making costs transparent. I agree with this. However, comparing costs  about cable bills is one thing; comparing these costs during stressful and possibly life-threatening situations is another. If you’re single and need to undergo surgery, how much energy do you have to compare the cost of surgery, in-patient hospital stays and the various aspirins and bandages that the hospital will inevitably lump into your final bill.

And of course he brings up countries with universal healthcare like Canada and the U.K. because bashing the Canada and the U.K. healthcare system has become a favorite game for the U.S.  However, ask any Canadian or European citizen, preferably one who has lived in our country, if they would abolish their own system and you’ll hear a resounding “No.”  Invariably they are shocked by our country’s health care system — a profit-making entity that favors the wealthy and healthy.

Lastly, don’t buy the myth that the middle-class or even upper middle-class will be paying taxes to support the “lazy” welfare class. The truth is, we can no longer rely on pensions or life-long employment or any sort of job security. Most of us will be in-between jobs at some point in our lives. Many people will strike out on their own and not have employer-paid health insurance. Many of us will be deemed to have pre-existing conditions that make insurance insanely expensive (if you can get insurance at all).  Finally, without any oversight, you will likely pay for insurance for years and then be denied tests and treatment just when you really need it. Reform isn’t only about helping the uninsured; it is also helping those who currently have jobs and health insurance.

Now I do think that some people should be against reform. Take this quiz and find out where you belong.

1 ) Do you like hearing “how are you going to pay for this” before seeing the doctor or receiving treatment?
Yes or No
 
2 ) Are you in the top 1% earning bracket?
Yes or No
 
3 ) Is your last name Trump or Hilton?
Yes or No
 
4 ) Are you the CEO of a major corporation?
Yes or No
 
If you answer Yes, go ahead and kill any chance of reform. Be sure to celebrate with your fellow CEOs in grand style.  If you answer No, you should write to your representative and make yourself heard in this debate.
 

Negotiating Success And Failure On The Same Day

Last week, I asked my doctor for an additional discount on an upcoming surgery (not covered by insurance).  Today they agreed to the discount. We’ll save an additional $300 on top of a 20% discount. Normally I wouldn’t have asked since they already gave me a discount. However I was holding myself to my Just Ask! negotiations challenge and the upcoming surgery was an additional unforeseen cost.

On the other end of the spectrum, I failed to get a discount at my dentist.  This was my second attempt but they wouldn’t budge.  Even though money magazines and blogs often suggest bargaining on medical costs, I personally haven’t had much success! At most I’ve gotten a 5% discount.  

The difference between my doctor and the dentist is a personal relationship.  We’ve spent quite a bit of money at my doctor over the past year and he knows we’ve been a “cash cow”.  I also believe that he and his nurse do sympathize with our situation on a human level.   In contrast, I don’t really know my dentist.  I’ve been going to the same dental clinic for 6+ years but I’ve seen different dentists and the  majority of the cleaning is done by the hygenist.  When I asked for the discount, I’m talking to a receptionist or billing person who only sees me as one of hundreds of patients.

Free Money Finance had an interesting post and discussion about a reader’s personal experiences with negotiations.  The reader felt like he was less successful than others when it came to getting discounts.  Was he giving the wrong vibe? Was he too nice or too rude? I do think that how you ask makes a big difference.  I have more success if I’m nice and smile.  Sometimes I have to get tougher.  On bigger items like cars, healthcare and salary, I’ve succeeded when I’ve had research to back me up.  Oh, and show confidence at all times!

How about you? Have you noticed a pattern of success and/or  failure in your own negotiations?

Bargaining For Rugs And Healthcare

In the spirit of my “Just Ask!” negotiations challenge, I requested an additional $300 discount for an upcoming medical procedure. In my email, I asked if they could reduce this procedure so that the total is a nice round number (i.e. $2,000 instead of $2,300).  It felt so strange to haggle over medical procedures in the same tone I would use haggling over rug prices in a Turkish bazaar.

Ahh, the sorry state of our U.S. healthcare system…