Just prior to summer, my intern informed me he had received an opportunity to interview at Google. Asking for my advice, I told him to, “Go for it.” We went through pro’s and con’s, the fact he may have to ditch his girlfriend should she not find Seattle appealing, and whether he liked Seattle’s Best or Starbucks. (Seems like one on every corner). Inquiring of how to prepare, I told him, “Drink four of your favorite beers in 30 minutes and watch Fantasia backward.” In all seriousness, “There are lots of websites with tons of sample questions out there. Maybe they’ll ask how you would decipher a provider’s ‘Explanation of Benefits (EOB).“
An EOB is a health insurance provider statement describing the costs it will cover for the medical care you’ve received. In reality, it’s a ‘swindle sheet.’ I received my EOB (or lack thereof) for February’s tumor surgery this past Saturday. I envision the EOB creator found the most niche way of paraphrasing just how beautiful one’s benefits are while simultaneously informing how much is not covered.
“Greetings, Member. Had you had no insurance, the original cost of this surgery would be over $5 grand. However, since you chose a physician and surgical center under contract, and the fact you chose to check yourself out versus staying overnight, we’ll knock off $2 grand.
Costs were calculated based upon the full moon cycle during the week your surgery was performed, the associated gravitational pull, multiplied by the total square miles of depleted water in the California basin, then divided by the remaining number of brine shrimp in the artic. In summary, we’re covering half. Therefore, your estimated costs are $1,500.
Thank you for allowing us to be of service. Remember, we believe you’re special, but so are we.”
The exact cost was $1,540, for there was a forty-dollar copay.
The American Bar Association claims healthcare is a human right. Understanding the EOB is not. Having worked in healthcare since 2006, there’s no rhyme or reason for the EOB. The average ‘Joe‘ can’t make sense out of it. The facility would better serve by saying we’re ‘f•••ing you’ for half the bill. ‘Being F’d‘ is something the average ‘Joe‘ understands. Just once I would love a Trump supporter to hand Trump an EOB and ask him to explain it. But here’s the catch, Trump has promised that repeal will end with “a beautiful picture” – a beauty that ends upon receiving the EOB.
Here’s what I wish the hospital said:
“We’re sinking our tentacles into your a••, and we’re going to drain your bank account of every possible dime. And, if that isn’t enough, we’re going to drain the gas from the car used to drive here. We understand you’ll have to push the vehicle upon departure. However, on the positive side, your physical therapy gets off to a great start.”
Next time you receive an EOB, remember that top administrators at U.S. hospitals are paid exceptionally well. CEOs make $400,000 to $500,000 a year, not including benefits (such as stock options). Administrative expenses eat up as much as 25 percent of total hospital expenses we pay (much higher than in other countries). For all the chatter and talk about free healthcare, no single candidate has explained how they will prevent the average ‘Joe‘ from getting tentacled up the a••. Neither GOP, Democrat, Socialist, nor Independent has been able to state how they would turn the good ship ‘Healthcare‘ around.
I’m fortunate. I can pay the bill. Millions can’t. And spiritually speaking, I believe in healthcare reform, but we need a robust framework, not a ninety-second campaign pitch. The average ‘Joe’s‘ of the world demands it.