Musings about Money

I finally dug into the file for the health insurance Benefits Summary and discovered - we have no lifetime maximum!  "Unlimited benefits for each individual."  Thank You, Lord, and thank you Blue Cross Blue Shield!  I knew we had good insurance, but I still thought we might have a $1 million per person limit or some such.  Joel's bills will quite likely exceed that total, although BCBS might not pay that much; they negotiate down with Preferred Providers, sometimes as much as 50%.

A few weeks ago, an envelope came from Life Links, the Hutchinson helicopter provider that flew Joel to HCMC on the night of the accident.  The bill for almost $30,000 was accompanied by a notice that BCBS had "denied your claim because we are a Non-participating Provider.  They will pay you directly."  They included a whole page of instructions on possibly routes to take if BCBS did not pay us the full amount, and concluded with a reminder that "you are responsible for the full amount."  That caused a few nervous moments, along with questions - "How could they refuse to pay it?  It was an emergency; it wasn't like we had a choice to go with a Participating Provider!" - and gratitude that we actually do have the money to pay that bill if necessary.  But within a week, a check arrived from BCBS for the exact amount.  Once again - we have great insurance!

Because we have the top-of-the-line policy, we (and our employer) have paid a lot in premiums over the years - well over $1000/month since going to work for Gorans Bros.  But even if we've averaged $1000/month for our entire married life, that totals $300,000 - less than the bill for Joel's stay at HCMC, let alone Regency and now Sister Kenny.  As sister-in-law Tanya and I agreed the first week after Joel's accident (and before Steve's accident), that's why we have insurance.  But the ability of BCBS to pay these bills depends on a whole lot of people all paying more in premiums than they take out in claims in order to have enough money left over for Joel.  And to think of all the money that goes into caring for Joel, and that has gone into developing all the procedures and machines that are helping him recover, boggles our minds.  Our American health care system is serving us well, but there isn't enough money in the world for every person in this country to receive this much care.  Fortunately, most people never will need this much care.  It's easy to see the conundrum that we face, however:  how can we afford enough care for everyone?