Stop the Insanity: Health Insurance Horror Stories

Stop the Insanity
Health Insurance Horror Stories

Last time in “Stop the Insanity,” I went off about calling your health insurance company.

Today I want to talk about something even worse.

The horrors of actually trying to use your health insurance.

Meet my cousin, Charlie. Some years ago, working at a construction site in upstate New York, he shot a nail through his left thumb.

He went to the ER, got it cleaned up and bandaged, and was told to contact a good hand surgeon, right away.

No problem, he thought. He had solid health coverage. He paid an arm and a leg for it. All he needed to fix was a finger.

But he couldn’t find a single surgeon willing to help him.

He called dozens of clinics and hospitals, across three counties.

He even visited some—to plead his case in person.

No dice.

One surgeon was retiring. Another was on indefinite vacation. Some were booked out for weeks. Some didn’t take his insurance. Some did, but wouldn’t accept his worker’s comp—or said they’d reached their workers’ comp “quota” for the month, whatever that meant.

Meanwhile, Charlie’s thumb kept getting worse.

It got so bad, he had to visit a different ER.

The doctor took one look at it. And gasped.

The first emergency room should never have let him walk out the door with a hand injury that bad, he said. Now, the best hand surgeon in the world couldn’t repair his thumb completely.

Charlie asked what he should do.

The doctor offered a wild piece of advice.

Call the first ER. Explain their mistake. And threaten to sue.

“They’ll get you into hand surgery that same day,” he promised.

Wouldn’t you know it. They did.

If my cousin’s story makes your blood boil, good. Mine too.

But if you think Charlie’s experience is in any way unique, you’re wrong.

That second ER doc, though—he knew how to play the game. Maybe the secret to getting good healthcare is working in the healthcare industry?

Wrong again.

Here’s another story. About some employees at one of the finest, most respected medical institutions in the world.

Turns out, they get treated like trash by their corporate insurance company just like all the rest of us.

The situation’s gotten so awful, some have filed complaints with state and federal authorities. It’s becoming a real scandal.

They’ve said it takes months to get even basic appointments.

It can be impossible to find in-network doctors taking new patients.

Their insurance provider’s website is glitchy and full of errors.

They pay sky-high premiums but still get surprise bills all the time.

And they’re forced to spend hours and hours on the phone, fighting with clueless insurance reps.

Talk about adding insult to medical injury.

If folks like these have to deal with this shit, what hope do the rest of us have?

I’ll end with one final story. It’ll set your teeth on edge.

At least it did mine.

While I was waiting to go into dental surgery a few years ago, I overheard the patient ahead of me telling the office manager she needed to go find an ATM.

I didn’t think anything of it—until it was my turn to pay.

Emerging from surgery, still in a fog of anesthesia, I approached the front desk. I took out my credit card.

“We have a new policy, Mr. Patterson,” the office manager said. “We add a 5% credit card surcharge to every payment—unless you pay in cash.”

The total bill was a few thousand dollars.

Who the hell carries that kind of money around? I sure don’t.

Look, I know our healthcare system is crazy complicated. And I don’t claim to know how to fix it.

But there have to be some smart solutions out there. That don’t involve threatening hospitals with lawsuits, or humiliating healthcare workers, or paying for oral surgery with a stack of hundreds.

That reminds me.

I have a dentist appointment next week.

Guess I better stop by the bank.

—James Patterson

For more of my “Stop the Insanity” essays, please visit my Substack.