Tag Archives: Covered California

Can we save Enloe Hospital? Interesting new measure, “Fair Hospital Pricing Act,” heads for 2016 ballot

28 Nov

I know it’s not even Christmas yet but Election 2016 is coming around fast.  Because of low turnout in the last couple  of elections, fewer signatures are required on petitions, and we might expect a record number of measures up for our approval or disapproval.

Reading Dan Walther’s column recently I found this measure posted – “The Fair Healthcare Pricing Act of 2016.” 

http://www.oag.ca.gov/system/files/initiatives/pdfs/15-0101%20%28Affordable%20Healthcare%29.pdf?

What a mind-blower – State data reflect that private hospitals operating in this State, on average, charge patients 325 percent above the actual cost of providing health care, and some private hospitals charge more than 800 percent above the actual cost of the care provided.” 

Furthermore, “patients who are uninsured and underinsured often pay far more than insurers and health care service plans. The result is that unreasonably high hospital charges disproportionately affect uninsured and underinsured individuals and families.”   Yes, contrary to many liberal claims, the uninsured are not leeches, but end up paying more than the insured. 

The first question that enters my mind is, where does Enloe stand here? Closer to the 325 or the 800? 

What I know about Enloe is that 10 years ago they were charging $7,000/hour for ER treatment, and charging for entire hours instead of real time – meaning, if you came in at 11:30 and left at 12:15 you paid for two hours. Rooms were $7500/day, and that’s for half the room, private rooms were more.  I have that ER charge on paper, a total of $15,000 in charges for about a 55 minute visit to the ER.  I got the room charge from a woman in the billing department – I remember how she had a hard time spitting it out, I could tell she was shocked by the price herself. 

That was 10 years ago, I can’t find that information now. You have to go down there, they don’t have a phone number you can call and you won’t find anything on their website. They are very evasive about their pricing, that is, until you wake up from surgery and there’s a hospital rep sitting next to your bed, telling you he or she is there to “help you” figure out how you will pay your bill. A friend of mine is hooked for life – told he had cancer, what could he do? They attached his house, now he will pay that half-million dollar hospital bill on his mortgage for the rest of his life, after having paid his mortgage down to less than $30,000 before the incident. I don’t want to ask him if he feels lucky to be alive as he hauls it out to go to work at 6am, 8 – 10  hours on ladders, pushing 60 years old, knowing he has nothing to leave his kids but bills.

Another friend of mine got a call at work out of town that his father was ill and being taken to Enloe. He was at the hospital within four hours – his dad already owed $17,000 and had not even got a diagnosis of any kind.  The old man wanted to go home, the doctors told my friend they couldn’t tell him anything unless the old man  stayed the night. Whammo – $35,000 by noon the next day.

My husband racked up almost $80,000 in charges over a weekend.

Yeah, I know – anecdotes. Well, I bet you could get similar “anecdotes” from just about anybody who has two dimes to rub together to pay for a doctor. Thanks to Obamacare, my family is no longer welcome at the hospital, we don’t have insurance. There is no more “deal” – in past, if you could pay 10 percent within 30 days, that was it. That’s what the insurance companies pay, but they get a lot longer than 30 days. Now you must have insurance or you can be refused service. You  can’t even get into Immediate Care without your SSN, I don’t care if you’re waving a fistful of hundred dollar bills.  Obamacare is a disaster for the working class.

Here we call it “Covered California,” which is a crack-up after the report I read recently that says nobody is signing up, so California is hardly “covered.” My family was hit for $800/month, with a $12,000 deductible – who would buy that?  We could actually have taken a subsidized plan – The Bronze Plan, which I like to call “The Mr. Shit Plan.” That plan will not even get a person into Enloe, I’d say, you better head for O-ville, stat!

A friend of mine who worked at Enloe Hospital in a higher level position told me CEO Mike Wiltermood, whom he knew personally,  “makes about a million dollars.” He wasn’t exaggerating, that’s the normal compensation package for these people who do nothing to serve the patient. For years I tried to get Wiltermood to tell us his salary – he would not answer, instead attacking my credibility, telling people, “consider the source…“, meaning, me.  Consider the source? Of a question? Why can’t he answer? Cause  he does make “about a million dollars,” that’s not uncommon in a business where the customer is typically charged 325 to 800 percent of the cost of service. That gross overcharge pays Wiltermood’s salary, benefits and pension.  

I have not finished reading “The Fair Pricing Act,” but I will study it. These measures are tricky, it’s essential to read this stuff. It’s also a good idea to check out the people behind it. 

All I could find on Roberta B. Johansen, the woman who sent the initiative to the Attorney General for review, is that she backed “The Economic Recovery Tax Relief Act” in 2005, which, among other things, sought to eliminate tax loop holes for wealthy people and lower state sales tax. I have no idea whether this measure made the ballot, or,  if so, how it did, but that’s something we know about Roberta B. Johansen. She’s also a generous donor to UCSF hospital. 

This will take more snooping, but I think it’s worth it. Like the measure says, “Excessive hospital charges are a leading cause of bankruptcy and financial distress among uninsured and underinsured individuals and families. “

The poor management of Enloe Hospital undermines the health of our community, physically, financially, and spiritually.  We need to take our hospital back, maybe this is one way to do it. 

In loving memory of Dr. and Mrs. Joseph Chiapella.

 

 

 

 

 

 

Let’s just admit it – Obamacare/Covered California is a complete failure and needs to be dumped asap

4 Sep
I found this ad in the News and Review - look at the bottom in tiny writing, "Sorry, no Covered California or medi-cal..." Sorry? Really?

I found this ad in the News and Review – look at the bottom in tiny writing, “Sorry, no Covered California or medi-cal…” Sorry? Really?

 

I’m not attacking the doctor pictured, or even the practice she works for, because I haven’t checked them out – maybe they charge perfectly reasonable prices and give cash discounts like my dentist and oral surgeon have done. 

But if I were paying $800 a month for my Bronze Plan (or, as I like to call it, The Mr. Shit Plan), I’d be pretty PO’d to find out my doctor won’t accept it. That’s just crazy Folks, why do we put up with this crap?   

My husband  and I are in a pretty ridiculous situation. We qualify for Medi-Cal but can’t collect because we own our own house and rentals. We’d have to sell  off all our assets and be dirt poor before we could collect a penny in benefits, and then what? You see the ad above is pretty clear.

So, we could  bump ourselves up to the Bronze Plan – $800/month, $12,000 deductible. If we got sick, we would eat pretty substantially into our savings before we could make any claim – meanwhile, unable to work, how would we pay our mortgage, tax, utility and other bills?

Oh yeah – the ad above says they don’t take the Mr. Shit Plan.

I always thought I’d saved a lot in the bank, until we got our first hospital bill about 8 years ago. A friend had had a similar procedure 10 years earlier, and his hospital bill wasn’t a fraction, he was able to pay it fully out of his savings and walk away a free and healthy man. Now you can’t even get in without insurance, even green cash will  only get you so far, the bills are so outrageous – more than your house is worth oftentimes. Doctors are vultures, they pick you so clean, you don’t have a home to go and die. 

I wonder if she smiles like  that when she tells you your insurance isn’t good enough.

I guess I’m going to send a copy of this ad to Jerry Brown’s office, and ask him what he can do about this before November. I’ll send a copy to Neal Kashkari, his Republic opponent, see if either one of them has an answer.