Of Cattle and Colonoscopies

As farm animals go, cattle have it pretty good. Most of them roam free and forage in green pastures before they’re loaded in a trailer, paraded through a series of chutes and gates, and admitted to a feedlot to finish out their days.  If I had to be a farm animal in our modern food system, I’d rather be a beef cow than a broiler or hog. 

As Americans, most of us have it pretty good too. We live out our lives in freedom in a land of abundance before we get loaded in an ambulance, paraded through a series of elevators, hallways, and doors, and admitted to a hospital or healthcare facility to finish out our days. I don’t think I’ve ever commiserated so much with livestock as I have in the last few months during my brief encounters with our healthcare system. I’ve now experienced being funneled through hallways and into offices and operating rooms, all while being bombarded with waivers and forms and nonsensical medical verbiage. The whole process is both dizzyingly efficient and dazzlingly obtuse. Indeed, the only other system that comes close to rivaling both the industrial efficiency and purposeful obfuscation of our farm system is probably our healthcare system.

Indeed, I’m pretty used to various makes and models of manure, but the stench wafting off of hospital bills is pure bs. A few months ago, I had an endoscopy and colonoscopy done at a hospital outpatient center. I was promptly greeted at 5:30 A.M. with a friendly hello from the receptionist who then cheerily tells me that, according to their estimates of my insurance coverage, my portion to pay for the facility fee is only $730. It could be worse I think, so I pay it and go about my business of trying to contain my bowels. And that’s where they get you. You’ve already committed to drinking a gallon of laxative, so you’re going to pay up. The problem is they’re not going to pay you back for overcharging (turns out, my facility fee copay should have been $80–their estimate was merely off by 900%) unless you descend into the worse version of yourself, the frustrated version that finally snaps and yells at customer service reps on the phone. That is what it takes to claw back money from them, if you ever notice you’ve been overcharged in the first place. I bet most people just prepay the facility fee and never realize they’ve been overcharged because the whole billing and insurance process is so confusing and convoluted. 

The only reason I even noticed was because Thomas just happened to need a routine procedure done this week. When I checked out how much was left to meet our deductible, I realized that something was off between what my insurance company applied to my deductible and what I had paid for the procedure. This led to many hours trying to decipher invoices and claims and medical codes, hours of my life I’ll never get back, even if I ever get money back. After a heated conversation with the billing department on the phone, they finally agreed that they had innocently overcharged me and would promptly refund me. 

The problem is there is nothing innocent about this. In fact, Thomas’s procedure was at another outpatient center under the operation of the same hospital system, which is the only hospital system in this area. Again, we arrive at 5:30 A.M. and a receptionist promptly greets us. Within minutes of sitting down in the waiting room, a billing clerk whisks us away to an office to try to convince us to prepay our portion of the facility fee, which this time they say is $2800. Never did the clerk say that paying upfront is optional, at least until Natalie firmly refused to pay, stating we wouldn’t pay until they ran it through our insurance and billed us. At which point, the clerk told us that was perfectly okay and sent us on our way back to the waiting room, where I watched her reemerge several times to take other arriving patients back to her office, where undoubtedly she tried to extract prepayment. There is no doubt in my mind that this hospital system is systematically overcharging people and pocketing the money of the folks who don’t realize it. How they get away with it is beyond me. 

All this is to say, I’m really grateful for all the healthcare professionals who work in the hospitals and doctor offices, even if the system itself is broken. The doctors and nurses all seemed to try their best to provide personal and friendly care, though I’m sure they’re likely under quotas to see more patients and do more procedures, to run more cattle through the cattle chute.

And I’m not sure what the answer is. Maybe there isn’t one. Just be aware that if you or your loved ones have a procedure scheduled, you aren’t required to pay upfront, even if they make it seem otherwise.