Last spring as bundles of winter clothing were packed away, I noticed a small mole that had ridden on one shoulder for many years had suddenly grown into a brown, bubbly toasted marshmallow with black splotches. I phoned the doctor.
It turned out to be a seborrheic keratosis, a fancy name for a skin disorder. The doctor said it was probably benign but should be tested just in case.
The office visit was $50. The growth appeared to have a blood supply and may not be easy to remove, the doctor said, so another appointment would be necessary (another $50, plus the cost to shave or remove it for biopsy). Add to that the laboratory fee of several hundred dollars. You know the drill.
Through one of my part-time jobs I had recently acquired something resembling healthcare coverage. The premium was a tenth of my income. Office visits were covered at five per year; most everything else involved a steep deductible and co-payments.
The doctor’s office person said she had never heard of the insurance company and refused to submit the bill for me. I mailed the bill to the insurance company myself. Then I waited for reimbursement.
After more than a month I called the insurance company in the Carolinas. The stranger on the phone asked what the diagnosis had been. She said no diagnosis code had been on the doctor’s bill. I told her the diagnosis. But despite her nosy question, she said she herself could not write the code down -- it had to come from the doctor’s office. Why hadn't they called the doctor's office? Well we sent you a letter. But I had never received it.
I called the doctor’s office and left a message. Nobody ever returned the call.
I copied the doctor’s bill and looked up the code on the internet -- 702.1 -- and wrote it on the bill. Then I mailed it to the insurance company. A couple weeks later I received the $50 check. Then I wrote to them canceling the policy. One-tenth of my monthly income looks just as good in my pocket as theirs.
About a month later, after taking a hot bath I felt a slight twinge on my shoulder. I looked, and saw the growth had disappeared completely. It had fallen off in the tub and gone down the drain. No bleeding, no pain.
I would gladly pay one-tenth of my income or more into a medical savings account, or something like it. But to pay a middle man is inefficient. I want my money to go directly to my doctor. And my medical information is between me and my doctor, not to be disclosed to a stranger who cares not about my well-being but about her business’s bottom line. That’s baloney. Insurance is not health care. Insurance locks too many people out of affordable health care. We are free to create a better way.