Pain equals PA reality

By Staff Writer
September 11, 2003

Cecelia Francisco

The stomach pain I had throughout the night was so excruciating that I was unable to sleep. Going through the expected routine of taking antacids and seeing the food I ate earlier being regurgitated in the toilet I began to wonder if this pain was something more serious. At 3 a.m. I awoke my father and we proceeded to drive over to the emergency room. After explaining over and over to many healthcare people what and where the pain was, I was seen by the doctor. The doctor took a sample of my blood so they could get it analyzed. The doctor advised me that I would need a MRI of my abdominal area. After further evaluation the doctors concluded that my appendix was about to burst.

Three months after the appendectomy I still have great pain. Fortunately, it is not from the surgery, which was a complete success. Rather the medical bills continue to arrive from all sources. Our insurance carrier should pay for most of these bills but initially this was in doubt. The reason we pay insurance companies money is so in times of need they will reimburse the cost of our medical fees. The insurance companies are dropping the ball concerning the medical bills and these problems need to be addressed. Through my own experience it seems they regularly fail to pay the necessary amount and instead cause my parents wasted time in calling and fighting about the bill.

In the long run the insurance company will pay for most of the medical bill. Unfortunately, looking at the amount of time my parents have taken calling and explaining the insurance company’s role in the bill is quite annoying. As a person who has gone through several other operations and have seen this done to my parents over and over again, I can say the insurance companies continually fail to initially pay their necessary part. The service of the insurance company can be deemed irresponsible and at times unfair.

It becomes a frustrating time when the insurance company dictates how long a person receives medical coverage in a hospital. In past surgeries, I have been quickly shuffled out of the hospital rotation. These surgeries were for a bronchial cleft cyst and instead of allowing me to stay another day, the doctors suggested I go home with a tube connected to a drain. This would collect blood and any other substance that were to come from the area. Now for the appendectomy, I did everything in my power to demonstrate the necessary requirements to get discharged, but I am more concerned about the people who don’t have adequate coverage and receive quick treatment. The hospital should not be an “assembly line” but rather each individual should receive personal care. If there is a problem with people who receive coverage from an insurance company then we should all be worried about those people who do not receive any help because they could become us.

The state needs to become more involved with these insurance companies. Malpractice suits are happening so often that almost all hospitals are charging for everything and at times it is the reason good doctors are leaving Pennsylvania. Insurance companies are affecting the practice of medicine and that is not right. I have heard doctors complain about the malpractice suits and understand their frustrations with lawyers and frivolous lawsuits while hearing lawyers blaming doctors who should be trying to oust the irresponsible practitioners.

The problem is too huge and needs to be expanded upon but from a former patient’s view it is very upsetting that insurance companies do not put the interests of the patient first. The insurance companies who carry the liability costs of the doctors raise their premiums resulting in sometimes the inevitable. The inevitable being that the doctor will leave that state which Pennsylvania has seen time and time again. Why then aren’t the insurance companies paying their fair share of our fees when they increase the cost of their coverage? There needs to be a solution and more awareness concerning this issue because when all the best doctors are gone we will be left with inferior medical help. If this distressing issue continues we as a whole should be fearful that the only “qualified” people left to operate on us are those who can claim they have seen all the episodes of ER.

Posted to the web by Cecelia Francisco

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