Category Archives: healthcare

I Have A Steaming Cup of STFU For HCA/Centennial


Oh, God. It’s worse than we thought. I just heard two stories from people in my same insurance group that are as bad if not worse — both involving emergency care. One at Vanderbilt hospital.

Let me repeat: we all have excellent insurance. We have an HRA which pays 100% of the deductible. I’m not out one penny and the hospitals aren’t footing the bill for anyone. You will get your money from us. Leave us the fuck alone.

It appears the entire hospital system is trying to harass and bully fully insured patients into paying more/sooner. Hey fellas, if you have a beef about payment, take it up with AHIP. Patients shouldn’t be put in the middle of this.

More suckitude from the “best healthcare system in the world.” Baaah. I don’t know why we have to put up with this bullshit.


Dear HCA/Centennial: I am beyond tired of you dicking me around on payment for a goddamn mammogram. You do this every year. The creative lengths you go to wrest payment from me, the patient, instead of waiting for BlueCross-BlueShield to pay you, as they do every year, has grown old.

You will get your money. You always get your money. You have never not gotten your money. I have top-notch insurance for a reason, one of them being so I don’t have to deal with some hospital billing office calling and sending me invoices when they haven’t even given my insurance company sufficient time to process payment. I’m just sick of it.

So this year I go in for services at the end of May, they billed insurance on June 3, and they sent me a bill on June 8. That’s barely time for BlueCross-BlueShield to receive the bill, let alone process it. I called the billing office and they apologized saying it was “a mistake” and I “shouldn’t have been sent a bill this soon.” Gee, ya think?

Thing is, a similar thing happened last year. I blogged about it here. That time it wasn’t “a mistake” but an “option.” I could pay now “if I wanted to” and have HCA pay me back when they got their payment from the insurance company.

Why the fuck would I want to do that?

Let me add, a neighbor of mine was in a horrific bicycle accident last year and got a whole bunch of diagnostic imaging services at HCA-Centennial. He told me they got the same “pay us now, if you want to” harassing phone calls. Followed by bills they knew they didn’t have to pay because it was covered by insurance. They wanted to know what that was about, too. They thought it was weird, too. It’s not just me.

You guys have to cut this out. It’s obnoxious and unnecessary. I”m sick of it.

I’m going to call my doctor and ask if someone else does mammograms in Nashville so I don’t have to deal with it anymore. I’m done with you people.


Filed under health insurance, healthcare

I Don’t Understand This

Can one of my readers in the healthcare field please explain to me what “consumer-based lab testing” is? AHIP (America’s Health Insurance Plans) is holding its annual convention in Nashville right now and one of our local biz rags gave a brief rundown of what they’re discussing. “Consumer-based lab testing” came up and it sounds all shiny-sparkly-free-markety-“let’s all shop for our healthcare”-y. And I’m just trying to understand who this is for:

“Without consumer engagement, there is no pressure for prices to go down,” said Elizabeth Holmes, founder and CEO of Theranos.

Theranos, which Holmes founded in 2003 and has former Sen. Bill Frist as a board member, offers accessible and affordable lab testing, with transparent prices available on the company’s website. Holmes likened consumer-based lab testing to at-home pregnancy tests, and said by making lab testing more accessible, early detection becomes possible for patients who are not a part of the existing health care system.

“When prices are transparent and consumers are informed, competition flourishes,” Holmes said.

What the fuck does this mean? If you’re not part of the existing health care system, it’s because you’re either too poor (but not so poor as to qualify for Medicaid), or else you’re one of those young fools who thinks they’re invincible. So you’re gonna, what, get a blood test or a PAP smear or funny lump biopsied by “shopping around” for your labwork? Without a doctor’s referral? I don’t get it. Who’s taking the sample? If it’s a PAP or a biopsy, you need to see a doctor. So I’m just confused who would be “shopping around” for their labwork.

And is cost really the only issue when it comes to who is analyzing your lab work? Or even the most important issue? Isn’t accuracy kind of important, too? Even more important than cost? I mean, I can divine your labwork by gazing into a crystal ball and I’ll do it for $5. Don’t think I’d get many takers.

Or is she saying this is for people who are in the healthcare system? So that when I get my annual PAP smear or have a funny lump biopsied, I’m going to have to shop around and tell my doctor which lab I want processing my test sample? Like I have time for this? Like “consumer choice” is something I have time to deal with in my life? (And yes, I’ve already been down this road with Bill Frist and his infatuation with “shopping” for healthcare). Because again, cost is the only thing I’m supposed to care about?

Please tell me what I’m missing here. I swear to Goddess, Republican infatuation with “shopping” is so far removed from the way most of us navigate our daily lives. I do not want to shop for this shit. Who would? What consumers want, and deserve, is the absolute best healthcare, when they need it, without having to go bankrupt. Always and forever. That’s not shopping, that’s fixing our fucked up system.


Filed under health insurance, healthcare

My Annual Healthcare Rant

It’s time for me to get my annual mammogram at the for-profit HCA/Centennial, which means it’s time for my annual rant about our for-profit healthcare system. I blogged about my experience last year, in which I was offered an opportunity to pay for the service out of pocket upfront, at no discernible benefit to me because it’s all going to be paid by my insurance anyway.

So this year I got the same “give me my money” phone call, which they laughably call “pre-registration.” I give them my name and address and other contact info (which they already have because it’s in their system) and then I get the rigamarole about how much the service will cost — this time she’s clear to say it’s “because my insurance hasn’t been verified.” Last year, they just told me the service would be $150. So I’m glad they’re at least clarifying the insurance angle. But still, I’m supposed to do what, exactly, with this information? Start selling off the family heirlooms? I have insurance, mammograms are covered, now go away, please.

And then 24 hours later I get yet another phone call from the same person who “pre-registered” me yesterday, to say my insurance has been verified. Which you’d think would be good news, but in HCA Land, it’s actually another opportunity for them to try to get my money. For a 20% discount, I can pay now! Yes, that’s actually the deal I was offered. I can pay for the service at 20% off now, or I can do nothing and my insurance company will pay the full price (repriced, but whatevs). I mean, my insurance pays 100%.

I mean, seriously, people? WTF? Why not just lower your prices 20% and then we can all reap the reward of lower insurance premiums?

I cannot believe this is going on.

Mr. Beale is furious. He wants to know, if I do pay now at the 20% discount, and then BlueCross/BlueShield remimburses at 100%, who gets that extra 20%? HCA?


Filed under HCA, health insurance, healthcare, Nashville

Republicans, Make Up Your Damn Minds, Already



Sen. Rand Paul’s letter to Harry Reid about blocking Surgeon General nominee Dr. Murthy over gun control:


Full text at the link. My trolls who keep trying to blame Democrats for the stuff Republicans are doing can go fuck themselves.


Proving yet again that there is literally nothing President Obama can do to please Republicans, Sen. Lamar Alexander is not happy with President Obama’s pick for “Ebola Czar.” (Keep in mind, the hissy fits/impeachment threats conservatives had over Obama’s so-called “Czars” in the first place make their current call for an Ebola Czar especially hypocritical):

“I had in mind a cabinet-level official with the skills of a four-star general or admiral who had a broad public health background and would be accountable to Congress. That kind of action would give Americans confidence about our government’s response to Ebola.”

Hmm … someone like, maybe, the Surgeon General we don’t have because the Republicans are too scared of the gun lobby to approve Dr. Vivek H. Murthy?

Honestly, I truly believe that President Obama could personally develop a cure for Ebola, cancer, and stupidity all in one tasty, affordable treat — but the GOP would complain that it’s gluten-free.


Filed under healthcare, Republican Party, Sen. Lamar Alexander

Who You Gonna Call, America?

Healthcare professionals nearly universally agree that implementing a travel ban for Ebola-affected countries in West Africa is not just a bad idea, it’s a bad idea that will backfire.

Republicans, the same people who have weird notions about the earth’s climate, have bizarre ideas about how the female body works, believe in fringe conspiracy theories like Agenda 21, and other jaw-droppingly stupid things, disagree.

So, who are you going to listen to, America? When it comes to public health and public safety, are you going to listen to the healthcare experts, or are you going to listen to the crazy people who think there are aborted fetuses in your can of Coca-Cola?

I despair for this country sometimes. I really do.


Filed under healthcare


Interesting piece in The New Yorker about our relatively sanguine response to the flu, which kills thousands, vs ebola, which has sickened three people:

[…] As we know, the flu can be deadly—according to the Centers for Disease Control and Prevention, the average annual death toll from influenza between 1976 and 2007 was more than twenty-three thousand. And unlike Ebola and EV-D68, for which there are no vaccines or real treatments, flu can almost always be prevented, or at least mitigated, if you get a flu shot. Stoking public concern about the flu could actually do some good, by encouraging people to get vaccinated. Instead, the media cover EV-D68 and Ebola as if they’re massive threats to our well-being even though they likely aren’t, and even though the average person can do little to prevent them anyway.


At work here is the curiously divergent and inconsistent way most of us think about risk. As a myriad of studies have shown, we tend to underestimate the risk of common perils and overestimate the risk of novel events. We fret about dying in a terrorist attack or a plane crash, but don’t spend much time worrying about dying in a car accident. We pay more attention to the danger of Ebola than to the far more relevant danger of flu, or of obesity or heart disease. It’s as if, in certain circumstances, the more frequently something kills, the less anxiety-producing we find it. We know that more than thirty thousand people are going to die on our roads this year, and we’ve accommodated ourselves to this number because it’s about the same every year. Control, too, matters: most of us think that whether we’re killed in a car accident or die of heart disease is under our control (as, to some degree, it is). As a result, we fear such outcomes less than those that can strike us out of the blue.

These attitudes toward risk are irrational, but they’re also understandable. The real problem is that irrational fears often shape public behavior and public policy. They lead us to over-invest in theatre (such as airport screenings for Ebola) and to neglect simple solutions (such as getting a flu shot). If Americans learned that we were facing the outbreak of a new disease that was going to do what the flu will do in the next few months, the press would be banging the drums about vaccination. Instead, it’s yesterday’s news.

Meanwhile, on the opposite end of the response spectrum, comes this disturbing news:

The Dallas hospital that treated Texas Ebola patient Thomas Eric Duncan didn’t have appropriate protective gear and reportedly left him in a room with other patients for “several hours” before ultimately putting him in isolation, exposing at least 76 people.

Yesterday, Centers for Disease Control Director Thomas Frieden acknowledged that Texas Health Presbyterian Hospital workers weren’t provided full-body biohazard suits until three days after Duncan was admitted (they now reportedly have 12).

According to National Nurses United—speaking on behalf of the Dallas nurses—the hospital had no protocols in place to handle the virus. Nurses involved in treating Duncan say he was left in a public area and a nurse supervisor “faced resistance from other hospital authorities,” when she requested he be placed in isolation.

It looks like the very last people who should be in a panic about ebola are the ones in full freak-out mode, while the front-line folks who should be the most engaged are saying, “meh, whatevs.” Seriously? You had one job, Texas. If this is how they deal with ebola, I’d hate to think how they handle something like influenza. I have to wonder why a CDC team wasn’t immediately deployed to that Dallas hospital and basically took it over the moment Duncan was admitted. I’m sure there are a myriad of reasons, including budget limitations and administrative limitations.

But you know, remember when Texas was all “we wanna secede,” and “that Tenth Amendment rawks” and “hey self-deport, you diseased illegal immigrants” and stuff? Yeah, that’s some world-class irony right there. Again: you had one job, Texas.

I was going to get my flu shot last weekend but, believe it or not, I was too sick to go. Some kind of sinus infection-y thing going around. As far as I know, I’ve already contracted the flu. But I’m better now and am getting a flu shot this weekend.

Get your flu shots, especially if you live in Texas. At the very least, it will keep you out of the hospitals that are apparently operated by incompetents who don’t know how to implement known common-sense protocols to contain a rare infectious disease.


Filed under healthcare

Two Americas, Addict/New Mom Edition

Two Americas. In one America, we arrest new mothers whose newborns test positive for drugs and charge them with assault (even though in this case, the drug our new mother used is not covered under the law through which she was charged. Weird, that.)

In another America, affluent moms hire “sobriety coaches” to help them stay clean and sober:

Once consigned to Hollywood entourages to keep celebrities on the straight and narrow (and out of rehab), sobriety coaches, also known as sober companions and recovery therapists, are being hired by well-heeled mothers from the Upper East Side to the beachfront homes of Boca Raton, Fla.

Blame the rigors of being an urban mother. “Raising kids is stressful to begin with,” said Mary Karr, the best-selling writer who lives in Greenwich Village, who related her grueling recovery in her 2009 memoir “Lit: A Memoir.” “The new supermoms have to be thin and rich and successful, so there’s all this extra stress,” she said. “It’s loathsome.”

“Addiction is a disease of isolation,” added Ms. Karr, 59, who has a 28-year-old son (she starts “Lit” with an open letter to him). “I would have loved to have someone come over and help me not get drunk.”

It’s not just the extra glasses of pinot or rosé. Cosmopolitan mothers these days are also reaching for Adderall (the multitasker’s best friend), Percocet (the antidote to the taxing trifecta of marriage, children and career) and Ambien (that bedtime staple), not to mention a cocktail of other drugs that high-strung mothers also have at their disposal.

And by the time these mothers realize they need help, they don’t exactly have the time or wherewithal to check into rehab or attend 12-step meetings. In addition, they want more privacy, the better to avoid the judgment and stigma that mothers with addiction face.

It is worth noting that the story of Mallory Loyola appeared in the news section of TV station WBIR. Mary Karr’s story appeared in the “Fashion & Style” section of the Sunday New York Times.

In one America an addicted mom is arrested and charged with assault, held on $2,000 bond, with her picture plastered all over the news. In another America well-heeled moms who “don’t have time” for rehab and 12-step meetings and need to avoid the stigma of drug addiction to preserve their social status hire “sobriety coaches” to hold their hands and tell them it’s okay to be stressed-out about having to be thin and beautiful. Such an impossible standard, who can blame them for reaching for the Percocet now and then? Poor things.

I honestly do not want to hear from another one of these Special Snowflakes who melt under the stress of their privileged lives. If Mallory Loyola has to have her face plastered across the news and now has a criminal record and is charged with assault, then so should Tamara Mellon, Mary Karr, “Jeanne” the anonymous Fortune 500 marketing exec, and all the rest. Alternately, if Jeanne et. al. get the compassion, understanding and personal attention that comes from hiring a coach, then why shouldn’t Mallory Loyola?

Says “Jeanne The Fortune 500 marketing exec”:

“I was my daughter’s age when my dad came out as an alcoholic,” said Jeanne, a marketing executive, who spent her youth going to Alateen, an offshoot of A.A. meetings for teenage family members. “I never thought that would be me,” she said. Rehab was not a viable option. “What working mom can be away for 30 to 60 days?” she added. “And how would I explain it?”

So she hired Natasha Silver Bell, 38, a sobriety coach on the Upper East Side, who is a divorced mother and former addict. Jeanne has been seeing Ms. Silver Bell once a week for the last four months, paying roughly $2o0 for an hour sit-down session, which also grants calling or texting privileges. “I liked that I could do it without disrupting my schedule,” Jeanne said.

And yet, we expect the Mallory Loyolas of the country to make time for it, explain it, etc., nor do we afford them the anonymity and privacy that Jeanne so cherishes.

Forgive me if this injustice rubs me the wrong way.


Filed under healthcare, Tennessee