We are getting ready to bring Joel home from the hospital, and it brings up all kinds of questions. He's taking ten different medications. Because of low appetite, most of his food intake flows through his "G-tube," and consists of cans of Two-Cal, a product containing "corn syrup solids, sodium and calcium caseinates," and dozens of other ingredients, mostly vitamins and minerals.
We have cooked and eaten a healthier diet, stressing whole grains and minimal processing, since our marriage, primarily because of Pete's research following his colon cancer before I met him. We know this Two-Cal can't compete with real food, and in fact, the doctors and nurses continually stress the importance of Joel forcing himself to eat even if he lacks hunger. So I asked the nurse what we could put through the tube in terms of real food puréed or blended. Nope, she replied, too much chance of clogging the tube and causing infection.
We will face a dilemma daily - how much do we try to "treat" Joel with alternative foods or home remedies, and how much do we try to duplicate the hospital environment? We have great respect and gratitude for the medical personnel who have kept Joel alive and brought him this far, but we know also that they operate under constraints of licensing and insurance coverage and liability that prevent them from giving him some benefits, and cause them to give him extra treatments that aren't necessary or maybe even helpful.
In the emergency room after David's ambulance delivery, the nurse scrubbed my stomach in preparation for a shot of Pitocin, ignoring my protests ("It's just routine") until the doctor came in and concurred, "No, she doesn't need Pitocin, she's going to breast feed." The one-size-fits-all routines don't fit all. Prayer, discernment and medical advice will help us do the best we can for Joel.
Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts
Monday, November 11, 2013
Wednesday, September 4, 2013
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?
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?
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