STEAM ROOM FOR ANGER

Hospitals can be pretty cool about negotiating costs outside of insurance, at least teaching hospitals. When I was pregnant years ago, my work decided I was a liability because I had a bleeding issue that required a night in the ER. So, no health insurance. I wasn't married, so Now-hubby couldn't cover me on his. When I registered as a clinic patient at the hospital, it was before I lost my job. Later, closer to my due date, one of the workers noticed I wasn't working and said, "Oh, I wish you'd have told us when it happened and we'd have set up a lower cost for you!" It was still a more-or-less manageable amount for us, and I had a fabulous OB-GYN who to this day is one of my all-time favorite doctors, but I liked their willingness to be flexible on costs. And I never got charged extra for a few more ER visits and a boatload of tests and imaging, just the flat agreed amount.

A friend's son, early twenties, had an emergency appendectomy. No insurance. They were making payments on a ridiculous hospital bill when I mentioned they should visit the hospital's billing department and just ask if they could negotiate the bill for a young, uninsured patient. NO PROBLEM, they said, and the bill magically was cut by two-thirds with a very reasonable payment schedule.

It never hurts to ask.

Should I have this insurance issue happen again, I will ask. Good tip! I can't imagine have a whole surgery out of network bill! Mine was just the ER doc, everything else was in-network so it wasn't a real hardship to pay.

I am still expecting to possibly get 1 last collection notice for my portion from 2019! Should they do an end of year dump as they have in the past what I have found was one collector tried, then it would go to a 2nd collector who then offered a settlement of either payment over several months or a lump sum at a reduced cost. At least that has been my experience since I had the good fortune of being diagnosed in Dec. 2017 hitting that years deductible with all the tests, and then the nightmare of waiting for the 2018 insurance information to get pre-approvals for more tests/surgery. Be glad you didn't know me then. I was a raving mad woman. Both my daughter and I called everyday until they finally gave the info. I mean, if your policy is effective Jan 1, you should have the card or at least something by that day. Not 10 days, or 2 weeks later! Now I know better and I don't schedule anything the 1st 2 weeks of January!

Lord knows what I will be offered for next year. I hope it's not too much more. I won't settle for less coverage either, I have the middle of the road plan as the cheaper one has a really high deductible. Doing my best to not let the insurance company dictate my healthcare, but it's happening here. Prolia for example. I can't get it approved so I'll just wait for something to break!? I'm getting a dexa scan next month (you know I have to schedule it after the 2 yr. mark of the last one, or else!). There are wait times as well. I'm still waiting for a phone call to schedule an endoscopy since August. I'm not pushing since I'm doing well and not having any trouble eating or swallowing, but it would be nice to get it in this year since I've reached my deductible. OK, I better stop now. Going for a walk.

I was mulling over BC's health issues with wait times etc. My own thought is that we are a huge land mass with a small population - roughly 5 M. Even Vancouver is not a major city by other countries standards. It is only big when you count the surrounding cities of Burnaby, Coquitlam, New Westminster etc. So we do not have a lot of large hospitals in the Province; the populations don't support that. Until Kelowna got a PET machine a few years ago anyone living in the Interior had to come to Vancouver. A lot of BC towns barely crack 30,000. Many are in the 12,000 range. If you need specialized care or surgery you pretty much have to go to Kelowna, Vancouver or Victoria. That puts a burden on those facilities to be able to accommodate patients from all those small towns. Most of the hospitals down in the Lower Mainland are putting up new buildings and rejuvenating the older ones in order to cover those needs but it takes time.

So yes - there are wait times and the need to prioritize (triage) But I am grateful to have no premiums, no co-pays, no surprise bills. No networks. I can be sent to whatever specialist or facilities warrant it.

I feel so terrible for those who have to duke it out just to get the care they need.

Question for those of you who are a normal weight. When you see a doc filling in for your primary, non cancer doctor or a new nurse for something like a minor injury or infection, are you asked if you are diabetic? I am asked often even though I am not and have never been, this is usually quickly upon seeing me (I am obese) and without even reviewing their files.

I find it rude and bias but want to know if it’s a standard question before I call them on it.

illimae,

I am not overweight and have never been but I am also asked this as it seems to be a routine med screening question. I don’t know why it would be rude or biased as it’s simply an important bit of info for practioners to know. I will say that with respect to weight, those who are overweight are at an increased risk for diabetes so it would be negligent to not ask! But yes, even us thin folks get asked this.

I don't always get asked, but if I do, I say no and give them my most current A1C count. I suppose I will be getting tested for it for the rest of my life. BMI is 27, I'm overweight according to that scale.

I am always flummoxed by any criticism of the Canadian health care system. I have always been able to choose which hospital I want tests done at or which specialist and have never had to wait for anything major. Everything is triaged. If I have to go to emerg I go online to see which hospital is busiest at the time.

I can't imagine having to think of cost when medical issues come up. It is stunning the number of people who struggle financially in the US due to medical things. I think it's nuts. Even those with good health care there usually pay high premiums.

Truthfully I hadn't thought about how lucky we are until coming to this site and hearing about struggles some go through over being denied testing or not being able to afford it. Or having to choose "networks????" It breaks my heart to read those threads.

This isn't a competition or slam but basically me feeling so damn lucky.

exbrnxgrl, in BC right now there are no monthly premiums or deductions. It's all done from taxation.

I saw this recently, comparing taxes in various areas https://ca.talent.com/tax-calculator

USA net pay 41,329 average tax 20.5%

Canada net pay 40,568 average tax 22.0%

so yeah, we pay more, but not like an *insane* amount more, kwim?

Thank you for the responses. I only suspect it because of the eyeing my body look and obvious surprised reaction when I say no. I don't find it at all rude or unnecessary without the “hmm, really?, No, you're sure?" additional comments.

After a previous gyno complaint about a mild ovarian pain and being told that an ultrasound would be “useless because it can't see through all the fat", I've become a little unsure about what is clinical vs criticism.

illimae, I started getting the diabetes question around the time I turned 50 (I'm 60 now), and was asked if I was diabetic by every single one of the multitude of new doctors, nurses, etc. that came with my cancer diagnosis last year. I'm very lean, always have been. My understanding is that it's a standard question for menopausal and post-menopausal women, because menopause can wreak havoc on blood sugar levels, and we are at higher risk (regardless of weight) for developing diabetes.

exbrnxgrl, you are right about the perception of socialism. We’re not a democracy either which is another concept those same people don’t really understand.

I'm on a Medicare Advantage program - socialism at its finest! The only premium is the amount I'd have to pay for Medicare Part B anyway, so slightly over $100. No pharmacy premium, either. I think of that as a tax since I don't see it. There have been several cost decreases since I've had this insurance, and now they've eliminated some of the referrals to make it easier to use. I couldn't afford the supplemental plan premiums, which also require a separate pharmacy plan. It's just a shame a person has to wait until they're old to get on a plan like this. At least the Affordable Care Act has helped a lot of younger folks get insurance they otherwise couldn't, but there are still too many people with no coverage.

Wrenn, I was too stunned to call her on her shitty manner but I did not go back and told my PCP who knew her and referred her, he couldn’t believe it either.

Additionally, her office was on the 19th floor of a building and I’m afraid of heights, I got such an eye roll when I asked her to close the blinds. I think she had a problem from the start.

Good grief illimae! Totally unacceptable. I can’t recall being asked and am at normal weight although I was heavy for many years. (That’s another interesting irony. I spent most of my youth and early adulthood very overweight. At 38 something clicked and I decided I needed to get the weight off. Fast forward eight months after spending a lot of effort on body image and I found the lump. I ended up bald with part of a breast! Ha! Of course, there is a good chance that I found the lump because I lost weight. I’ll never know…)

Moth, thanks for defending our system. I think by the time you factor in the cost of medical coverage which we don’t pay for our tax levels would be pretty comparable. Of course, the one caveat is that we are lulled into a false sense of security in some ways. It was a bit of a shock that there are so many things not covered (like Faslodex and Ibrance) if you don’t have extended health benefits. If I had it to do over again I would have purchased extra coverage years ago.