Depending on the route, I pass up to three hospitals on my way home from work. Not bad for a commute that clocks in just short of seven miles. Passing by those August steel and glass buildings used to make me feel safe. Now, it just makes me sad.
Just about everyone I know has had an issue of some kind or another with health care. The mother of a friend of mine got hit with a six-figure bill for end-of-life care of her husband — and they were insured. My own stepmother died in a San Diego hospital bed following supposedly uncomplicated neck surgery. A friend who works as a waitress at a four-star restaurant has to spend five hours at County whenever she gets the flu.
I felt pretty lucky. None of this had touched me directly, the faceless bureaucrats of HMO policy had remained faceless, and “denial of coverage” was a phrase only heard by someone else.
About six months ago, my wife and I showed up to the Kaiser Permanente campus in Hollywood for a fertility appointment. I was nervous. A month prior, we had decided against getting a dog “since it was too much work.” Our two cats — who require little more than being watered and fed — would have been overjoyed. That assumes, of course, they would have been awake to hear the news. But the timing was right, and we were ready.
If you’ve ever been to the Hollywood Kaiser, you may have an inkling of how I felt. The campus takes up several city blocks. There are hundreds, if not thousands, of patients being seen and treated by an army of medical professionals. The place has that institutional smell of disinfectant. The fluorescent lights make you look ill, even if you’re just there for a checkup.
Our appointment, the initial one, was actually termed a “pre-consultation.” I’m not entirely sure what that means, but I can tell you what happened. We were put into a room with a randomly selected second couple to watch a required video, one that would explain the mystery of infertility.
It was laughable. Gauging from the AquaNet-heavy hair, the pantsuits and sweater-vests, the video was old. Old old. It featured various women and men of various ages and races asking dumb questions: “Am I not eating the right foods?” “Why aren’t I pregnant?” I felt stuck in the world’s most boring United Colors of Benetton commercial.
Being in the room with another couple felt odd. More than odd, it felt wrong. And, after the nurse started going through our insurance information, it felt illegal. As we were sitting there, the nurse began going through the other couple’s info. The woman, unfortunately, had coverage that covered but 50% of any infertility treatments. She was better off than her partner, though, who had no insurance whatsoever.
“Cash,” he said. “I pay cash.”
At this point, I began to feel a bit smug. My high-and-mighty position here at the Leader provides pretty good insurance for Donna and me. I had chosen Kaiser (motto: “Great until you get sick”) specifically because of its infertility coverage. Our pervious insurance covered nearly nothing, no small consideration given the tens-of-thousands of dollars procedures and treatments can cost.
At this point, the nurse left to complete more paperwork, or perhaps to start the video anew for another unwilling foursome. Shortly after, the woman’s phone rang, and she stepped outside the room to take the call.
“She’s afraid because of her abortion she can’t get pregnant,” the man said, the door still closing. “I don’t know what she’s worried about. She can get pregnant, obviously.”
Uh . . .
After this, the nurse came back, papers were signed, and we were blessedly shooed out the door. Donna, however, had to go through a series of immunizations, tests and procedures before our first actual consultation with an actual fertility specialist. This took six months. I’ll spare you the details, but it seemed an excessive number of hoops.
On the day of the great consultation, Donna went at it alone. I feel bad about this. She insisted I didn’t need to come, and that it would likely be a repeat of information she already heard.
Too true. She received little to no information from an extremely businesslike doctor, and was quickly shipped off for another round of tests. On the way out, an office worker presented her with a $250 bill, the 50% share of costs. She had no cash, no checks, and declined to put it on her credit card. Fine, the woman said, but no more work until we’re paid in full.
But why the bill in the first place? As of Jan. 1, Kaiser changed our coverage, chopping our infertility coverage from a $25 co-pay to the half-off deal described above. In most other industries, you get a heads-up on the cost of a service. You can decide whether it’s worth it. Medicine does not appear to play by those rules.
The $250 bill is pricey, sure, but isn’t going to break us. The problem, really, is that we can’t really afford the total cost. Do we take out a loan to have a child? Maybe I can change my insurance to one that allows better coverage, but it may be too late then. Time is of the essence in these matters.
Given the arrogance of the health-care industry as a whole during the ongoing debate, Kaiser’s ways are not surprising. It seems the typical response, in fact.
This system is broken. It has shown its cracks to my family, my friends and me. It needs to be fixed, if not for us, perhaps for your children. Or, perhaps, for the children Donna I may never have.
Get in touch DAN EVANS is the editor. He may be reached at (818) 637-3234 or by e-mail at email@example.com.