A Personal Experience: Health Law, Health Care and Me

In September I had began to feel pretty rough, so bad that I actually went to the doctor. It was determined that I had a gallstone pancreatitis caused by a gallbladder with stones (of course) and my gallbladder needed to come out. Having had no prior abdominal surgery my surgeon was happy that I had a “virgin belly”, a pretty funny term.

I know that my health insurance went up significantly last year and significantly again this year. Thank you President Obama for a real piece of work. Insurance now seems to rely on age rather than experience as previously done and I’m afraid that my rates now greatly exceed my age many, many times over. I understand that some families are paying in the $1500 to $2000 range per month. Those are medium to higher range plans but the deductibles and copays for lower range plans can be very significant; I have seen as much as a $10,000.00 deductible.

I am in the process of trying to sort out my bills and making sure that my providers have considered my gap insurance. I received a bill from the hospital, one for my CT, one for the emergency room doctor who I don’t think I really needed to see because I was told to go to the ER to be admitted; we already knew what was going on. I received a bill from the surgeon, one from the anesthesiologist and last but not least the hospitalist. The deductibles added up to a few thousand dollars but they had not considered the gap insurance so I will see what happens. I have had to become my own advocate to make sure that these entities stay on top of my insurances. Do you remember when your doctor admitted you and came to see you in the hospital? Now the hospitalist drives the process and they don’t know anything about you until they walk in your room and flip open your chart. The first one that I saw I got to tell him I was having surgery in a few hours and he charged me for that! When my surgery was over the surgeon came by and said I could go home that afternoon but the hospitalist who didn’t come by again that day did not discharge me so I stayed an extra night and another hospitalist came by the next morning and released me. The hospitalist drives the system. I don’t question the abilities of the hospitalist but they don’t know me and in a follow up visit my surgeon told me the hospitalist allowed me to go back to work sooner than he would have allowed.

With all of the new regulations on health care providers no wonder the cost has gone up. This wonderful technology has greatly improved health care delivery but it obviously has a price. New Medicare payment models for certain sections of the health care industry are now in a trial phase. Basically those that are more efficient in the delivery of health care will be paid more. While efficiency includes fewer hospital returns for treatment of an already treated condition I’m guessing there is also pressure to further decrease the length of stay; my experience shows that conflicts with using hospitalists. Health care is becoming a balancing act with the survival of independent clinics that provide top-notch specialty services and trying to not be absorbed by large hospital systems that look at the bottom line rather than the services that have been provided to the community.

It has become evident with the number of health insurance companies dropping out of the marketplace that the goal of the Obama administration was to become a one-payer system, i.e. the government. Remember the phrase, “I’m from the government and I’m here to help you”? I don’t know where Blue Cross, Humana, Viva and the others will fit into this unless it’s as a secondary insurance, gap insurance and a Medicare supplement. The goal of progressives is to follow a European style government that we figured out two hundred and forty years ago does not work well for Americans. When my wife and I were in the Republic of Ireland ten years ago and listening to Sky News the rage that day was over a twenty something year old woman that died while waiting on some type of scan that was scheduled six months away under her socialized medicine program. Those that can afford it do a private pay in the afternoons after doctors have completed their government obligations. We can only pray that a Trump administration will really get a grip on what Obama’s administration has complicated.

The heroes of my health care were the employees that I know have suffered from literally little or no raises and increasing health insurance premiums. I think about the nurse in the ER that got me a food tray after I had missed lunch and been there for hours. I think about the nurse in the holding area after I left the ER while waiting on a room. I laid on a small stretcher that my feet hung off for a few hours but the nurse did everything she could to make me comfortable. I think about the nursing assistant that took me to my room telling me about a gentleman that she spoke to and how he worked two shifts at different places to care for his family. The nurses that cared for me on the floor were equally great and made sure I had everything that I needed. I think about the very nice young man that rolled me to surgery and though very busy respectfully and reverently waited while one of my pastors prayed with my wife and me. These employees of the local hospital were great and I really appreciated them. I hope that the hospital values these employees as I did.

I pray that each of you have a blessed Hanukkah or Christmas and for Christians to think about a loving God that sent His Son to earth in the form of a baby to grow and teach us about our loving God and to finally give over his life as a sacrifice for those that will call on the name of Jesus for salvation.

This article is informative only and not meant to be all inclusive. Additionally this article does not serve as legal advice to the reader and does not constitute an attorney- client relationship. The reader should seek counsel from their attorney should any questions exist.

"No representation is made that the quality of legal services performed is greater than the quality of legal services performed by other lawyers."

Mailing address: Ronald A. Holtsford, Esq. • Ronald A. Holtsford, LLC • 7956 Vaughn Road, Box #124 • Montgomery, AL 36116 • (334) 220-3700

raholtsford@aol.com­