Just when you thought this thread had died a quiet, painless death....
Just in case any of you are curious, an update: I'm now in out patient physical therapy (thanks to my HMO, it only took five weeks to get it started), and I'm making steady progress. My infection is long gone, so now I don't need any pain medication and my general sense of well-being is loads better. Even though my ortho is ecstatic about my progress, I am still fully disabled and he doesn't make any speculations about when that status will change. As for the Europe trip, I asked him on three separate occasions if I could go and he never gave me an answer, so I'm adopting the "don't ask, don't tell" policy and going. I kind of got the impression that's where he was going with the issue as well.
As for the other part of this saga, I want to spread some bad publicity about a truly deserving entity.
The kid who hit me and his family had a small insurance policy ($100,000 liability limit), and my lawyer and the three others I've discussed this with agree that it's an exercise in futility to try to get anything else from them, as they have no assets to speak of, and I'm not that keen on booting them out of their house. From the start, their insurance provider has offered to settle this case for the full liability limit, and we have accepted their offer. In steps Palomar Pomerado Hospital, where I was first taken and spent my first nine days. In the interest of what they refer to as "balanced billing", they have attached a lien to my settlement, even though I have health insurance, and my insurance has already paid them their
negotiated amount. Their argument is that, since they have to negotiate with the insurance company, they should be entitled to at least a portion of my settlement to offset their loss (the amount they are trying to get is approx. $33,900).
Common knowledge: Health care providers in this country artificially inflate
their prices in the knowledge they will negotiate down with insurance companies, and add superfluous charges to the bill, also with that in mind. It has also been revealed that the real goal behind these liens is to offset the losses incurred by treating indigent patients(who, incidentally, receive better care than I do with my HMO!). Palomar Hospital's own lawyer
agreed to release the settlement provided we hold in trust the maximum amount they can steal....uh, I mean, recover from my settlement, pending two U.S. Supreme Court decisions affecting the legality of these liens. Palomar Hospital has subsequently rescinded that agreement, continuing to deny me access to my settlement. They are trying to pressure me into agreeing to turn over money to them before the Court decisions come down in case the decisions come out against them (and then they get squat).
Their lawyers also acknowledged to my lawyer that my need to be compensated for lost wages, my lost job, and my material loss, let alone pain and suffering, outweighs Palomar Hospital's desire for more compensation.
To me this is a case of blatant double-dipping and outright greed. I, by being insured, have tried to do the right thing in having that coverage, and now they want to be paid twice from me to cover someone else who doesn't have my level of self-responsibility, for whatever reason.
To address their reasoning, if their negotiated prices aren't profitable enough for them, maybe they need to find themselves better negotiators!
My lawyer has advised me that, instead of going into someone's office with a chainsaw and cutting their desk in half(my idea), to go one step further. If Palomar Hospital continues to pursue this stalling, we will go to a local TV news consumer advocate (we're thinking Turko, for you SD locals) with this story.
Last week Dick Gephart(sp?) suggested that President Bush take that tax cut and buy everyone health insurance. Doesn't seem so far fetched in light of the above, does it?
BTW, I've always
, and continue to be, a staunch advocate of single-payor health insurance. Health insurance companies are not in the business of taking care of you and me. They are in the business of making a profit. And now it seems health care providers are following suit.
Thanks, I feel a little better now.