My oldest daughter got sick last Saturday. By Sunday she was running a high fever, and her eyes were swollen and red. I took her to Urgent Care, where she was diagnosed with strep.
Sunday night I purchased an individual insurance plan, mindful that my husband’s contract work would render us ineligible for Medicaid.
By Wednesday, her fever had dipped below 102 only once, and her eyes were so red she looked strange. I called her pediatrician’s office and begged for an appointment. She’s only six. She wasn’t eating or drinking.
They told me that, since I didn’t have proof of insurance coverage, I’d have to wait 48 business hours until their financial counselor could call me back.
I said I’d pay cash, pay for the entire visit up-front, but she needed to be seen today, and by a doctor with a greater interest in her health than an urgent care physician. The woman on the phone said she was sorry.
I’m not proud – I started to cry, and was transferred to the physician’s nurse, who was concerned enough by my daughter’s condition that she made me an appointment and had the financial counselor call me back within minutes. On Wednesday I paid a $100 deposit to the pediatrician’s office, another $100 deposit to a pediatric ophthalmologist, and $110 for an inch-high bottle of eye drops. Our health plan has a $5000/family deductible, so the actual bills for these visits will be our responsibility. But what concerns me is the runaround I got in trying to make an appointment.
Having health insurance makes things easier for most of us, but there are people who choose not to buy it because they prefer to pay as they need care, and don’t anticipate visiting the doctor often. Lack of insurance shouldn’t automatically indicate an inability to pay. A $100 deposit for self-paying patients is steep, but it isn’t unfair… a 48-hour wait in the case of a sick child, is.
Obviously there are other options – walk-in clinics like the CVS MinuteClinic, urgent care, the emergency room… But she’d been turned away from the MinuteClinic the previous weekend, as she was too sick to be treated there. The urgent care doctor failed to diagnose the problem with her eyes, assuring me the swelling and redness was caused by her fever even though I questioned him several times, so I hated to take her back to a place where the goal is to stabilize each patient and move him or her out as quickly as possible.
What do you think? Should physicians be able to pre-screen patients for their ability to pay? Is a $100 deposit fair? Unfair? Weigh in with a comment.
Comments
I think it is insane that they wouldn't see you if you offered to pay in cash for the visit! A sick child is a sick child no matter what.
We've thought about dropping my husband's health coverage before b/c in our 4.5 year marriage he's been to a doctor ONCE and paying $100 for that visit is a whole lot less than what we've paid for insurance the last 4 years. It's just the whole "what ifs" that get us. What if he were in an accident and seriously injured? What if he were really sick. What if he were diagnosed with something awful like cancer. All of those are horrifying of course, but IF they happened and we had to pay out of pocket we'd be screwed.
No answers. Just thoughts.
I think our social welfare system is sick. In every single way. Physicians shouldn't be able to pre-screen... if a patient needs care, care for them. To leave a 6 yr old to wait for 48 hours is almost unimaginable. If what you are left with is a $100 deposit to secure care, I don't like it, but at least they are not refusing care. It is all totally unfair.
I know socialism is almost a four letter word to some, but I truly believe that we should care for each other as a society. I lived in Norway for the better part of a year and even though I was not a citizen, when I got sick, I was seen by a physician, no questions asked and no bills paid. It was like medical nirvana. I didn't wait for two hours, I didn't have to answer a half a million questions. I was treated like a human being and not a pay check. I paid out of pocket for the medicine prescribed, but that was it.
Reform, and major reform at that, is the answer. No question about that from me.
I think it is crazy that you had to beg to get your very sick daughter an appointment. I was just complaining this past week about how I had to beg my own doctor for an appointment. The nurse on the phone trying to decide if I was sick enough to deserve one. Come on! We are paying them right? Insured or not, the bill comes to us. And an adult is one thing, but a child is another.
It is a symptom of the problems with a for-profit healthcare system that your financial situation was more important than your daughter's health. The "what-ifs" concerning her condition are numerous: what if she had something serious enough to be life-threatening in that 48 hours? The doctor's office should NOT be screening patients over the phone, especially not the receptionist! The fact that too many people have to use the ER for what should be routine care is a direct result of policies like this. And as painful as it may have been to pay $100 up front, going to the ER would have been much more expensive. It's probably not an unreasonable amount, but it's sad that insurance companies have the bargaining power to pay less, and individuals don't.
Not fair, not fair, not fair. You would think that we as a society would have progressed past this type of thinking by now. I have high hopes for the next four years even though that's probably unreasonable. Hang in there.
It is completely and totally wrong for a doctor to screen patients in need for their financial/insurance status before deigning to treat them. What happened to the Hippocratic Oath???
Doctors should be there to treat the sick and they should allow for situations where the patient's need is more important than the treatment cost. I am so sorry you experienced this.
It may be time to find a new pediatrician, at the very least, make sure the doctor is aware of the steps you were asked to take, if you haven't already done so. 48 hours might be a reasonable request for a well child visit, but not in the event of illness. It may be a training issue. Otherwise it would force me to question the integrity of the doctor.
Jen, I don't think it is fair physicians be able to pre-screen patients for their ability to pay.
Jodie: please do not drop your husband's health coverage. I am speaking from experience. My husband is the most healthy guy I know. I added him in my dependent health coverage base on the "what if" factor. Well, last year he went to see our family doctor because he feels that his nose is block and can't breath easy. ENT found out he has a tumor, turn out to be cancer. Long story short, he went thru nasal tumor surgery, chemotherapy, radiation, etc and on his way to fully recover. Without health coverage, we might have to file for bankrupt!
Very sad state of affairs with our health insurance in this country. So sorry you are having to deal with all this.
Honestly, I don't know what Scotland does now, but when I lived there for a time as a girl, all children had free healthcare, and good healthcare to. The doctors even made house visits. I still remember a doctor in my sister's room when she was very sick. My mom still says that was one of her favorite parts about living abroad.
First off, I agree with Viv, I think it might be time to find a new doctor.
What exactly were they going to do -run your credit history like you were taking out a loan? Give me a break.
I can understand wanting to make sure they get paid, but there has to be a better way. Unless that was a rogue receptionist, it sounds like your current doctor isn't in the business of people.
Wow, that is insane! I had no idea it worked like that! My father is a doctor who worked regularly in a free-clinic in our hometown, but I guess I never realized the need before. I think that kind of treatment is wrong and unfair. Especially where children are involved. Just my two cents.
Having recently switched insurance companies and having to deal with all the paperwork/questions that come along with that, I can tell you that our insurance procedures are seriously flawed! I'm sorry that you are going through all this with your kids! Prayers for healthy kids coming your way.
Fair/unfair is not the question here. More like humane/inhumane...or civilized/barbaric...
I think if you had mentioned up front that you would pay cash it may have been different. They may have just assumed that it was a cold and that you would want to wait the mere (in their eyes) 48hrs so you wouldn't need to pay out of pocket. Who knows what they were really thinking. Of course the times I didn't have proof of coverage my Dr. just asked me repetedly if I was sure I wanted my son to have the shots and said I could go to the clinic if I needed to. I assured him that we had the insurance and that I would get it cleared up. I do love our Ped though and he was jsut making sure we would not have to pay ourselves. Any other time when we were between insurances, they simply billed me after the fact. Oh and if they do bill you after the fact, wait before paying, call them up and ASK for a cash discount. They took 10% off the bill for me or would have taken monthly installments. And as horrible as it sounds if you can't pay right away, they will keep sending the bill until it actually says "Last notice before sending to creditor".
I guess I can see why they would want a deposit, but it seems like any doctor's office would also have compassion and when you are dealing with children, it is a whole different ball-game. I hope the kids get better soon and that you don't have any other trips to the doctor or urgent care!
Mis adventures in the land of the uninsured. Did you not get the memo that our heatlh care system is broken?
Physicians are not the issue, but rather a product of what society has done to them. Did you know that they can be sued both by the insurance company and the patient if they accept monies from someone how is already covered by a carrier or charges rates that are below Medicare established rules. Did you know that they are "stiffed" on a daily bases from pateints who write bad checks after they repair lacerations, provide medications and shots? The public needs to understand that they too must pay for supplies such as: staff, lights, paper, computers, insurance for their staff, medications, postage, rent, electric etc. etc., at what point does one stop? How many times a day does one expect to do "charity" work? Has anyone ever gone into a food store and say, hey I have no money, but I am hungry, can you just give me a loaf of bread and some milk & eggs?
Doesn't the electric company shut your water off if you don't pay the bills?
Anyway, I think the problem surrounds that the public is not full cognizant of all the ramifications in our health care system. Hospital ERs must see all comers regardless of abiltiy to pay. Believe me that don't do that out of the goodness of their heart, the law states that if you recieve Medicare fundings, then you must see all comers.
That is quite different from one accepting Medicare. So what I think is that the public needs some education on our health care system, once this occurs, then perhaps we can better the current state of affairs.
I too am among the uninsured/underinsured - your recent experience with your daughter is very scary, I wish her a speedy recovery
Deposit is fair but a waiting period before being seen? Absolutely not. Should they be able to screen out patients without insurance? No. I really don't think they should be able to do that at all. What's that creed? "First do no harm."
This is horrifying. We struggle to get by on my husband's salary but at least it comes with health insurance. Health insurance that I will never, ever take for granted.
Thank you for sharing your story so people are more motivated to fight for a better health care system.
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