I always think about how complicated things like taxes and healthcare are here, and I wonder.. does it really have to take so long? When I hear of how quickly people do taxes in other western, developed countries, particularly those in Europe, I think about how they probably laugh at us when they hear that so many Americans don’t even do their own taxes, that instead, they hire tax accountants to do this for them. I also think about how other western countries laugh at the state of our healthcare system — how expensive it is and little we actually get out of it.

Let’s think about this: I made a doctor’s appointment for this morning primarily for an annual physical with a primary care physician, but because I told them I had questions about my cold, which has unfortunately included violent coughing fits, they labeled my visit an “office visit” instead of an “annual physical,” which means that I had to pay a $20 copay. All because I had a couple questions, really? Annual physicals have no copay with primary care physicians; illness/office visits do. I made sure with the office receptionist that all my blood work taken should be coded as “annual physical” and NOT as “illness” — yes, because this is something you need to verbatim say, otherwise, your insurance will bill this as reactive/medical treatment, and then I’d have to pay out of pocket expenses. Then, as the lab technician was drawing my blood, I asked her if I could find out my blood type. What was her response? “Well, evaluating your blood for blood type is not considered ‘preventive,’ so we’d need to bill your insurance for that, and then you’d have an out of pocket expense that you could apply to to your deductible.”

I don’t even get to know my own blood type and need them to charge for that, as well? Doesn’t that automatically come up when they draw my blood?!

The lab technician didn’t even give me as much of a smile. She was dead serious.

The doctor I saw today, who was pretty unengaging and didn’t seem to have the greatest bedside manner, was forgettable. She said they’d only use my blood for the bare-bones preventive tests, so this would not include vitamin levels or blood sugar, as those were considered not preventive and would be reactive.

So… if my blood sugar were super high or super low, and we identified that during a test,  that would then have negative ramifications on my health. So then, in what reasonably intelligent mind would you not call that preventive medicine? The doctor shook her head. “It’s just the way the insurance works, and we want to make sure you aren’t getting charged for anything that isn’t fully necessary. So, remember to take a vitamin D supplement.”

It’s just the way the insurance works.

Thanks for the great explanation, doc.

Now, I’m even more crystal clear about the sorry and pathetic state of healthcare in this system. And if I, a privileged white-collar professional working at a tech company, have issues with what is getting billed and not getting billed, how do others far less fortunate than me feel getting nickeled and dimed for every little test or exam? It’s no wonder some people rather just be sick and avoid the doctor at all costs. It’s because of crap like this.