Health care chaos: Not just a national issue

BY CHAD SKILES

As an international student from Kenya, sophomore Mark Thiong’o experienced one of his more baffling cultural revelations during the Family & Friends Weekend in September. This was not, as one may assume, because of some seemingly bizarre social nomenclature—such as saying “aluminum” with the American accent, something with which Mark has already battled. Oddly enough, his frustration stemmed from how surprisingly hard it was for him—in America, in the year 2009—to fix his chipped tooth.

Mark stopped by to recount the overcomplicated process involved with solving his hardly-complicated problem. “It all started when I was innocently enjoying some pasta”, Mark explained. During our interview, we never deduced how the soft-textured pasta could be responsible for such a thing, but decided to overlook this as a small detail. I could not help but silently hope, for his sake, that the chips and salsa we were enjoying during the conversation would not bring about similar bad luck for my dear friend.

“I knew I was covered through the school, but I wasn’t sure about dental. I called Lisa Perry and she explained that emergencies are always covered.” What sounded like a moment of relief and an easily fixable problem would turn out to be a tooth ache gone awry. “My first thought was, ‘Well, at least I’m covered’, but eventually realized that I wasn’t covered well.”

Mark went to ER to receive treatment on his tooth, but found out that the doctors could only prescribe painkillers. From there, Mark made his way to the friendly neighborhood Walgreens, where the pharmacy was initially satisfied with the insurance card he gave to them, but afterward concluded that Mark was not covered for the medication. “I guess they thought I made my own card of paper or something… like I’m attempting to defraud Walgreens.” Mark ended up covering the cost out of his pocket, setting him back some thirty-five bucks. “The best part is that the out-of pocket cost for the medicine made me overdraft my bank account which resulted in $106 in overdraft charges.” It all began to add up from this point.

Mark had to wait out the weekend semi-toothless until he was able to contact the proper staff from the college to sort out the confusion. From there, he was denied coverage from a dentist’s office where they, again, asked to pay out-of-pocket for a $200 visit. “I was floored. In Kenya, one $200 payment covers all of my health care for an entire year. This one visit was going to cost me that. As much as you dish out with each payment, you wonder why there are still so many outside costs and fees, especially with health issues.”

For some reason, just as in his incident at the now, not-so-friendly neighborhood Walgreens, the dentist’s office initially thought that Mark was covered before telling him that he, in fact, wasn’t. Seeing as how Mark had already over-drafted his bank account, he was in no position to shell out the 200 bucks. Luckily, a phone call to the college sorted out the kinks—mostly. Mark still had to find a way to balance his bank account, find the money for a check-up on his tooth, and psychologically rebound from the poor treatment he was receiving from a first-world country. “I was just surprised to find coverage this bad. I heard things like, ‘We can only cover up to $250 per tooth’ and thought, ‘What? Really?’ … it’s just so compartmentalized.”

After the smoke had cleared, Mark had talked to the right people and finally received compensation for his out-of-pocket payments that he never should have paid in the first place. “I can’t say enough good things about John E. Schoenbauer from Richard J. Horan Agency and Maureen LeBate, who both helped me through the entire process,” he noted.

Reflecting on the whole ordeal, Mark thought to himself, “Geeze, I’m glad all I did was chip my tooth.” This seemed to resonate—what if it had been worse? Mark highlighted a major issue that has been at the forefront of American political action. President Obama has said during many of his recent speeches in support of health care reform that, “In America, you shouldn’t have to go broke just because you got sick.” If this is true—which I think it is—then you certainly shouldn’t go broke for being served a bogus bowl of pasta.

Even so, there are people with problems far worse than a chip in his or her tooth in desperate need of health care; some 46 million Americans do not have health insurance. Perhaps Mark’s tooth fiasco served as a local reminder of how difficult it can be to receive coverage for health care needs. “I think that it’s based on greed in this country, to be honest. I am not as angry with the college, the insurance companies, or even the miscommunication between them. I am most disappointed by the health care system that makes it all possible.” This made the distinction between successful health care systems, which are embedded in a sincere willingness to help sick people, and wrecked health care systems that may have spent too much time trying to get rich off of sick people instead. Alongside of hoping that Mark is able to repair his achy tooth, perhaps we should all be hoping that a hefty policy reform is order to make unjustly long stories (and long articles) like this one a problem of the past.

Short URL: http://www.themountaineer.org/?p=791

Posted by Chad Skiles on Oct 30, 2009 Filed under Health & Well-Being. You can follow any responses to this entry through the RSS 2.0. You can leave a response or trackback to this entry