C’mon, we’ve heard for years that health care isn’t affordable in this country for many.  That may be true.  I guess I’ve been fortunate.

However, why is it that no politician (regardless of party) ever seems to mention the true problem with health care insurance in the US, the games the companies play to avoid paying claims.

The experts will tell you, always call your insurance company to make sure the doctor, facility, procedure or whatever is covered by your plan. How many calls is that for most people? Sometimes one just doesn’t think it’ll be a problem (ran into a $700 bill because of some missing paperwork on something a couple years ago..would have only been $20 if I’d made a phone call prior)

How about Prescription insurance?  My wife is taking something which has to be preapproved by her doctor.  Now, I need a little help here. If the doctor is writing a prescription, isn’t he/she approving the drug?  Do they have to approve it before writing the prescription?  What it ends up being is a game of our pharmacy faxing our doctor who then must fill something out and fax it to our insurance who will send a letter out a couple of weeks later explaining we are now preapproved and they’ll cover the medication.

Hope that doesn’t happen to people who need something right away. I was told by my insurance customer service (has to be the worst and most unsatisfying job ever) that I could always pay the full amount for the prescription and then file a claim. Told her, no chance I’m going that route. Too many opportunities to make a mistake and give them an excuse to not pay the claim.

So, Mr. President and other elected officials. What can you do about this problem? I’m an educated, reasonably intelligent and sometimes organized person.   I have no idea how people with challenges I’ve been fortunate to not have actually get through all the red tape and receive the treatment they need at the cost they’re insurance should provide them.

One day I’ll start keeping track of how much time I spend on the phone with my health care insurance, or pharmacy or doctor’s office trying to clear things up. Oh, and how much time do I spend a year collecting all my receipts to fax off to be able to claim expenses against my FSA account? Is it really worth the tax savings?

One last thought, how much do all these calls to my insurance company add up to each year? Wouldn’t simplifying the processes reduce that cost and allow the savings to be returned to the customers (or pocketed by the insurance company)?

It’s all about making a buck or saving a buck or…well, isn’t it about staying healthy?  How about keeping your sanity?

So, how about it?  Yes, we can look at ways to improve the availability of healthcare to those without.  But there’s no common ground between the two parties to actually expect any dramatic changes.  So, why not actually help the American people by fixing something which should be fixable.  Just force Insurance companies to get rid of their silly games to be covered.  Or is that too much to ask?

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