Letter writer: Insurance issues cloud hospital stay

Graphic by Lori Deaton

During a recent hospitalization [at Mission/St. Joseph Hospital], I was disappointed that the focus of my care appeared to be centered around insurance requirements as opposed to my health status. For example, the transfer from observation status to in-patient status was determined by insurance guidelines instead of a complete assessment of my physical condition. My physician, as well as a hospital insurance representative, discussed insurance issues with me throughout my stay.

From a patient’s perspective, it is very difficult to intelligently discuss insurance issues while on mind-altering medications and struggling to breathe. I question why there was any need to discuss insurance. I have insurance, and the hospital has all of my insurance information documented in their records.

Another concerning issue was the physical condition of my room and the hospital. It was filthy! Considering the fact that hospital-acquired infections are a serious reality, environmental service should be a top priority.

I am urging all of us to encourage politicians to put health care on their agendas. These issues should be a top priority item for all legislators at the state and federal level. Please do not vote for any candidate who is not concerned with health care reform. Our health care system is only going to get worse.

— Anne Catherine Gibbons
Asheville

Editor’s note: A response from Mission Health President and CEO Ronald A. Paulus appears in the letter, “Mission Health Offers Apology and Explanation” in this issue.

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41 thoughts on “Letter writer: Insurance issues cloud hospital stay

  1. Val

    I grew up on the Canadian single payer health care system; then military medicine; and now the VA; all forms of “socialist medicine”; I would easily choose this over our for profit scam system here in Murica.
    I was also a healthcare provider relying on insurance reimbursement to make a living….
    For profit healthcare is an oxymoron; and Health Care insurance is an absolute scam. What kind of sense does it make to pay a for profit healthcare insurance company whose primary purpose is to maximize profits; who’s shareholders are much more important than the clients/patients they are to be servicing…?
    complete scam!

    • Lulz

      LOL, so you’d go on waiting list and hope to be treated before death? When your ideology supersedes integrity and even your own health to the point that you would die for it willingly to promote the lie it is, you have issues. In no way should the VA, or the other systems as scandalous as they are, be used as a basis of preference, Especially considering that they are mired in controversy and corruption on top of costing lives. Unbelievable.

      • Val

        Is the VA mired in as much scandal as our for profit healthcare system was; so that the government had to intercede and create Obamacare? … obviously not a much better system, but at least 50 million more people are eligible for affordable healthcare…. what good is healthcare when it’s not attainable or affordable? Id much rather have to wait for affordable healthcare than not had any health care at all, because I can’t afford it ….And what’s more corrupt; a for profit insurance company CEO making 60 mill in bonuses? for-profit healthcare insurance that pays their insurance sales people more than they do the doctors that treat the patients/ customers they’re supposed to insure? Again; i’ve been in all models of healthcare and I was even a provider in for-profit healthcare …. Health insurance is an absolute scam!

        • Lulz

          LOL, gee you don’t suppose a non-profit health system that pays very little taxes and has been allowed to acquire vast amounts of property and become a MONOPOLY has anything to do with it? Of course not. That’s like bordering on reality on top of pointing fingers at the local government cronies who have ran the show for decades now lulz.

      • luther blissett

        “you’d go on waiting list and hope to be treated before death?”

        The US has an infinitely-long waiting list for those who can’t afford to see a doctor. Nowhere in Canada — nowhere in the developed world — do people line up at 4am to receive pro bono care. And a huge majority of those eligible for VA care do not want those services privatized. The main problem there is recruitment, staff retention and funding, because if you want to be a very rich doctor who only sees rich people, there is a much more obvious path in the US than if you want to make a decent living and serve the public.

        But this is a distraction from the subject of the letter: the ever-expanding “not for profit” Mission Health has a bad habit of sending billing agents to rifle through your pockets for insurance, and credit cards once it’s clear you won’t die on your gurney.

        Still, it’s nice to see Ron Paulus show up with his MBA jargon and buck-passing. Perhaps he’ll comment on how Mission staff complain of being worked into the ground to cover the cost of all those shiny new buildings?

        • Richard B.

          So Luther, are you a former or current Mission employee? Do you or have you ever worked? MBA jargon and buck-passing?
          If you are not a disgruntled employee, which is fine, then you are a fraud who spouts about stuff of which you know little about.

          • luther blissett

            It’s nice that Doctor Ron MD MBA has his paid defenders monitoring threads. A good reminder of where power lies in Asheville.

            Exact quote: “We’re working unpaid overtime and have to rush through consultations to pay for the new building.”

    • The Real World

      It is not helpful to present this topic simplistically. It is a complex issue. And it’s disingenuous to infer a country, ANY country, has created the magic solution; none has. The good news is thee are many existing systems we can evaluate to help come up with a plan that reasonably works for the USA.

      I would prefer one where healthcare providers have at least some vested interest in outcomes. An example: my internist is okay but having met with her 3 times I could discern she wasn’t that invested in my situation. She’s a Doc with the Mission Health System and is paid a salary. I’m just one cog in the wheel and as long as she shows up for work and doesn’t commit malpractice, she gets paid her salary. No biggie to her if I leave that practice, she has no investment in it.

      Contrast that to a specialist I went to. He was one of the 3 owners of that private practice. He took more time, listened more closely and I knew why. It’s the difference of having your name, reputation and money invested in a business and definitely being concerned that it survives and thrives. Which naturally would cause him to be more interested in patient outcomes.

      Meanwhile, as Lulz says, in countries of single-payer design you often have to get on waiting lists for tests, treatments or surgeries. One nurse I know in the USA told me that her uncle in England had an eye condition that he needed treatment for. It wasn’t immediately critical so he was scheduled for 9 months later. She said by the time his turn came that procedure was no longer appropriate because his condition had worsened past its effectiveness!! This is not uncommon and is why so many Canadians frequent US hospitals in the northern border states and pay cash for tests and surgeries.

      All is not well in single-payer systems and anyone who tries to say so is either clueless or lying. It’s those darn FACTS again …. why do they always have to get in the way of the dream?

      • Val

        U are veering off topic…
        What good is the best health care in the world; if it’s unaffordable!!? Yes; we (the US) might have the best doctors, hospitals, and treatment options; but few people have access, and even fewer for-profit healthcare insurances are willing to pay for those services.
        Why are you 2 ignoring the fact that an insurance company’s sole purpose is to maximize profits which creates a clear conflict of interest with the best interest of ones health care…?

        • Negrodamus

          That’s why Obamacare is a failure: it’s not affordable. People are simply going without ‘healthcare’ because they can’t afford the much higher deductibles on top of the much higher premiums. They’d rather pay the penalty. Consequently the whole system is crashing because it’s really only affordable for unhealthy people or those who are heavily subsidized.

          • Lulz

            But Val does make a point. O-care had the blessing of the insurance companies. And they deserve the literal flogging they’re getting.

            The bigger issue here is the corporate takeover of America in collusion with the Fed. In more areas than just health care.

          • Val

            Just because people are choosing to pay the penalty over the coverage doesn’t mean it’s unaffordable.
            And the solution to what u deem a dilemma; is socialized healthcare.

          • Negrodamus

            But that’s why many are not participating: they can’t afford it. The cost/benefit ratio is too high.

            The solution is to reform the entire medical system, which is the 2nd or 3rd leading cause of death in the US.

          • Lulz

            LOL, the solution is to break up the corporate system that has zero competition because of the government. Sheesh. Mission could give a rats behind about serving people here because where else are they going to go? Why would you expect bureaucrats to be any different?

          • luther blissett

            “it’s not affordable.”

            That’s because GOP governors like Pat McCrony have prevented Medicaid expansion, and because the GOP-led Congress has let important components of the ACA lapse — specifically risk corridor payments to balance out exchange risk pools — while grandstanding on “repeal and replace” when they have no replacement. It’s also partly because large hospital chains have tried to strongarm insurers, which is why Carolinas HealthCare is facing an antitrust investigation right now.

        • The Real World

          No, I am right on topic. The incentive and vested interest (or lack thereof) a health care provider has is often indicative of the care received. I gave a clear example and having grown up in the USA, I could provide many, many more of Doctors with their own practices that I rec’d better care from than since they have significantly become part of big companies and just paid a salary.
          Seriously, stop and think, how do you think healthcare became so superior in America? Incentive matters, it always has.

          Nevertheless, if you had tried to comprehend my comments accurately you would realize I was not encouraging a return to the prior way of doing things. It had some significant flaws. But, the idea that we should adopt the programs that other countries have without understanding their serious pitfalls is just plain stupid.

          And, indeed, you seem to be very unaware of what is happening in Obamacare-land. It is sinking quickly. For 2017, there will be ONE insurer in NC — Blue Cross! Can’t wait to see what those premiums are going to be. http://www.forbes.com/sites/katherinerestrepo/2016/09/01/slim-pickings-for-north-carolina-obamacare-policyholders-in-2017/#572294e2c085

          Strive for better Val, it’s always worth the effort.

          • Val

            Not suggesting incentive doesn’t Matter; although if the incentives arent there, because for profit insurance companies arent adequately reimbursing providers for providing care; due to the fact that their motives are profit driven. The less they pay a provider the less incentive there is for that provider to provide the very best adequate care; which is a topic u aren’t countering…. there’s a difference between for-profit healthcare and for-profit insurance.

      • luther blissett

        “It’s the difference of having your name, reputation and money invested in a business”

        Trouble is, as Atul Gawande noted, there are too many ways to make lots of money that aren’t tied to patient health. Plenty of doctors are more like property investors. Some habitually generate referrals for implicit or explicit kickbacks.

        http://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum

        As Gawande points out, Mayo Clinic physicians are salaried, but their promotions are driven by patient outcomes, not their ability to maximize revenue.

  2. Deplorable Infidel

    Donald Trump is the only candidate EVER to proclaim that health insurance needs to be sold across state lines which will
    make system much more competitive. Makes sense to me and it’s about the only thing I like about Trump …

    • luther blissett

      a) it’s been part of the GOP platform for the past decade
      b) it sets up a situation where one state can gut its insurance regulations to offer cheap policies with paltry coverage and no recourse, just as South Dakota lured credit card companies by abolishing caps on interest rates. Instead of competition, you’ll get a race to the bottom: buy an insurance policy from, say, Idaho, and the small print will say you have to appeal any rejected claims to the Idaho commissioner of insurance, who will have no incentive to rule in your favor.

  3. Val

    Obama care was designed to to fail from the beginning; which will push us to a single-payer or socialize model….
    It was one way to work around the Republican-controlled system..
    And I’m all for it

    • Lulz

      LOL, no it won’t. You can’t enslave people to a government that by your admittance screwed them over. Nor can you control them via health care. The pendulum is swinging back. All it takes is to see through the LIES OF THE LEFT of which you admit to. And that’s why people like you are a scourge to liberty.

    • Lulz

      LOL, which I appreciate your actually honesty for once. After all, the con of the leftist is one of utter destruction of freedom and liberty. People with your ideology who lie and have to attain power via fraud and under false premises is why the government, that is now nothing more than the enforcer of the democrat party, needs to be given a serious cleansing. And those who share your ideology within it rooted out.

    • The Real World

      I figure you are right about all of that. And failing, it is.

      But, here’s the public service announcement I’d like to make to everyone. It will be nowhere close to “free” as many like to say. ( Pls send a memo to “Everything is Free Bernie” about this annoying little FACT). If we go the typical ‘socialist’ route……folks, you will want to save your money because there will be times that you either fear, or do not want, the waiting time you’ll be slotted for care. And if you want to jump the line — cool cash will be required to do it (or a supplemental insurance plan you pay for yourself).

      And all of that will be on top of whatever happens to your income tax obligation. Healthcare overall will be more costly to US taxpayers than in Europe because we are a nation of self-inflicted overweight, junk food-eating, couch sitting, Diabetes and heart disease-addled death wishers. Yea, it’s really that bad. Fly to any European city and spend 2 days walking around. You’ll see they look nothing like half of American citizens. Save your money!

      • Lulz

        LOL, you omit some points here. Illegals come here for freebies including food subsidies. The liars on the left will allow them to live their lives any way they see fit as long as they continue to breed huge families while others finance it as their numbers dwindle. You and I and the rest will of course be held to other standards. And in the end, will be sent to the death house faster because of being white. The evil, and this is evil, needs to not only be outed for what it really is but those that propagate it to shown what they really are.

        • luther blissett

          “Illegals come here for freebies including food subsidies.”

          Who’s picking your produce and slaughtering livestock, bitter white nationalist?

          The illegal immigrant workforce provides an ongoing subsidy to old white people. It keeps their food cheap and their Social Security checks coming.

    • boatrocker

      It is called the Affordable Health Care Act.
      Obamacare is what the party of NO calls it.

  4. Val

    I’m curious; why do the vast majority of industrialized nation have some sort of socialized medicine; whether it’s single payer or government run? Isn’t there some credibility to that fact as being a more sustainable system? Or does the ignorant American mentality play out; “if it’s our way, it must be the best!”….! Sadly we see this propaganda prevail over and over again

  5. The Real World

    Most of those nations are more financially socialized overall. Or they were, until that didn’t work out too well. See the UK, Eastern Europe and the majority of Scandanavian countries now have elected center-right governments. They will likely continue with taxpayer-funded healthcare even if quality of care declines because it is very difficult to change enormous embedded systems, as we have seen recently in the USA.

    My parents imparted some good lessons that have stood the test of time. An important one is: know WHY you doing something …… and the very last reason ought to be, “because that’s what everyone else is doing”. “What if they’re stupid or chumps, my father would ask, then what does that make you.” Which is why it irked me to no end to hear clueless Bernie tout all his free shit because that’s what all the other countries do! He would provide no substantiating data and never mentioned even having been to a Scandanavian country. Where do we get these people? You had to be low IQ to buy his pie-in-the-sky shtick.

    I have 2 questions: 1) why are so many of you inclined to give up your freedom so easily? (To allow a massive bureaucracy even more control over YOUR life, your choice of Doctors, treatments and with even more money taken from your earnings to pay for the care of illegal immigrants or people who self-abuse?) 2) Do you imagine that you could easily get your freedom back if all the happy talk doesn’t pan out with a taxpayer-funded system? (Happy talk like we heard a few years ago: your healthcare costs will go down, you can keep your Doctor, ETC)

    • Negrodamus

      “why are so many of you inclined to give up your freedom so easily?”

      Progressives don’t like real freedom. Reality conflicts with their worldview on so many levels, so they prefer social frameworks that maintain their illusions and safe spaces where they don’t have to be bothered with reality.

      • The Real World

        You are probably more right than wrong with your reality vs the dream thesis.

        I’m going to share a couple more real-world stories about socialized healthcare so that the English guy with the bad eyes example isn’t deemed an exception.

        An Irish friend, here in the USA, told me of her 21 yr old niece in Ireland who was having alot of uncomfortable abdominal cramping (probably female stuff). She got checked by a Doc, it didn’t qualify as an emergency so she was scheduled for an ultrasound 3 months out. Problem was it was painful and very much bothering her. After about 1 month, my friend and the girls Mother decide to chip in for the $600 required to jump the line early for her ultrasound.

        Like I said before, save your money and buck-up to the discomfort (and fear) while deciding whether to wait your turn or spend upfront money to get treated sooner.

        Second story is MUCH worse: visiting New Zealand about 10 years ago and got into a long conversation with the owner of the B&B where I was staying. She shared a story of her sisters family. About 35 years prior, when her nephew was 3 yrs old, he’s running around the garden and happened to trip and fall. When he went down he hit a jagged piece of wire from that thin, short garden fencing to keep rabbits out. The wire piece went into his nose. They took him to their nearby local Doc and he fished out what he could but told them, “you need to go to the hospital for an x-ray because I’m not sure I got it all.” So, they go to the hospital and explain injury, kid get examined and they deem it all looks clear and no x-ray is needed. The parents insisted the primary Doc, who saw the injury first, said it should be done. Nope, the Govt-paid hospital Doc wouldn’t authorize it.

        Guess what? For the miniscule cost of a &^%$#? x-ray, that boy would have had a normal life. Turns out there still WAS a wire piece in his nasal cavity and it eventually worked it’s way to his brain and damaged it to the point that he would never be able to work a job or have a real life. He has lived with his parents for his entire 38 years and will always. Atrocious! But, there’s more — NZ laws are such that you can’t sue the Doc or hospital; the govt decides what the monetary damages ought to be. She said it’s rare anybody gets more than $100,000 or so, which is what he got. Yep, you read that right. His life destroyed to save $50 on a &^%$# x-ray and only 100K provided to help him live since he can’t earn. I asked why the parents didn’t pay out-of-pocket for the x-ray and she replied, a bit embarrassed, “they just didn’t think of that as an option. It was always the case that you just go with what the Doc says and what the Govt provides.” Which is another entire angle about what happens when you let the bureaucracy own your brain and have control over your well-being. Chew on that awhile.

    • luther blissett

      “why are so many of you inclined to give up your freedom so easily?”

      Here’s a sewing kit and a bottle of Everclear: enjoy your freedom to perform surgery on yourself!

      • The Real World

        You put forth some interesting commentary at times. But then, you post some nonsensical childishness like that and ding your valuable comments. ????

        • luther blissett

          Well, you say some idiotic things that seem to call for flippant responses.

          Health care is by definition a domain where individuals cede their personal freedom: they are asking a professional with skill and experience to pass judgment on their health. And sometimes they won’t accept that judgment, and will seek a second and third and fourth opinion until they find a doctor that tells them what they want to hear.

          At some point, a functional health care system has to step in and deal with vanity and delusion.

          • The Real World

            “Health care is by definition a domain where individuals cede their personal freedom” — you couldn’t be any more incorrect about that. So that explains the inane chatter.

          • luther blissett

            “you couldn’t be any more incorrect about that”

            So, you think you know better than your doctors? Gotcha.

            Really, take that bottle of Everclear and sewing kit and look up how to remove your appendix on Google.

          • The Real World

            luther – there are many fine doctors in this world and there are also plenty of inept, even downright scary, ones. See above story about New Zealand doc who denied a simple, inexpensive x-ray ….true brilliance and the horrendous outcome was of no consequence to him. The govt paid the meager settlement.

            I have no doubt that single-payer is coming to the USA. But, as I’ve said numerous times, save your money b/c you’ll likely want to buy a supplemental insurance policy b/c the basic standard of care will be sub-par. If you all would do some simple research instead of buying whatever pipe dream the fool politicians are selling, you’d understand that. Hello — the ACA is a perfect case in point. Imploding as we speak but you won’t hear Obama taking responsibility for it.

          • The Real World

            luther – please see the 2 articles posted below. It’s good to be informed!

  6. val

    AGAIN!!
    Is there some rhyme to the reason that ALL industrialized nations (except the US) has socialized healthcare!!? is there no credibility to that fact!!???

    • The Real World

      Val – check this out:

      It was one of the more macabre stories to emerge out of socialist Venezuela — and served as a metaphor for the final days of the rotting regime.

      In a hospital morgue, a bloated corpse exploded.

      The morgue’s barely functioning cooling system was to blame – hardly a surprise in the oil-rich yet impoverished nation whose health-care system has collapsed under the socialist government. Decomposing for two days in the tropical heat, the corpse finally exploded in a spray of toxic fluids and gasses. The ghastly incident earlier this month necessitated the partial evacuation of the hospital, University Hospital Antonio Patricio de Alcalá, located in Cumaná — a city of 825,000 in eastern Venezuela. Patients in nearby rooms and corridors were sickened to their stomachs by the stench.

      “It’s not the first time that a body exploded,” a hospital employee told a Venezuelan media outlet. “It has already occurred two times since the middle of September.”
      http://www.frontpagemag.com/fpm/264530/corpses-exploding-decrepit-venezuelan-hospitals-david-paulin#.WAeN2me_7s0.email

    • The Real World

      Val – article today in Washington Post: Europe’s morality crisis: Euthanizing the mentally ill
      ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
      Excerpts: Once prohibited — indeed, unthinkable — the euthanasia of people with mental illnesses or cognitive disorders, including dementia, is now a common occurrence in Belgium and the Netherlands. Belgium legalized euthanasia in 2002 for patients suffering “unbearably” from any “untreatable” medical condition, terminal or non-terminal, including psychiatric ones.

      As the Belgian opponents of the practice put it in their open letter: “We see that some who were first declared incurable, eventually abandon euthanasia because new prospects showed up. In a paradoxical way, this proves that the disease cannot be called incurable.”

      Obviously. But the commission report breezily responds, “illness, especially if it is psychic, should not be an obstacle to making a decision on the basis of rational reasoning,” subject to a careful physician’s approval.

      This, regarding a Belgian medical system that over the past two years administered lethal injections upon the request of five non-terminally ill people with schizophrenia, five with autism, eight with bipolar disorder and 29 with dementia — an increasingly common condition in the aging Western world — as well as 39 with depression, according to the report.
      https://www.washingtonpost.com/opinions/europes-morality-crisis-euthanizing-the-mentally-ill/2016/10/19/c75faaca-961c-11e6-bc79-af1cd3d2984b_story.html?utm_term=.64b73ec99c5a#comments
      ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

      I put these articles forward because rational people prefer to make informed decisions and politicians will rarely mention the downside to whatever they propose. Actually, they generally fabricate quite a bit. Obamacare is a glaring case-in-point.

      There are positive aspects to socialized healthcare and there most definitely are negative ones. Wouldn’t you rather know the negatives in order to mitigate or avoid them? Seriously……don’t believe politicians! Do your own research to confirm the realities of what they promise.

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