Today’s Word: Subrogation

If you’re insured it’s a cost without a benefit.

For those wondering, I’m not cured yet. I am still hobbled by pain in my leg caused by a pinched nerve. It is being pinched by a herniated disk.

Sounds (and is) complex!

The busted parts are in my back. The pain is in my leg. I’m still having difficulty coming to grips with that.

I’ve seen three doctors, had an X-ray and an MRI. I’ve also had two epidurals–all the fun getting an injection in your spine should be!

My journey has not ended.

The medical bills have started to dribble in. I will have a significant responsibility just with my co-pays and deductibles.

Without insurance… well I just can’t imagine.

I am appreciative of my employer’s insurance plan, but this is just one more reason we need a national single payer insurance system&#185.

Costs from an illness like mine can easily grow beyond anyone’s ability to pay. How many thousands of dollars have you put away for a random rainy day? I am thankful this will not be my problem, but I get it.

My main concern is getting better. As I’ve discovered, pain is no fun.

I am hoping my insurance company wants me well too, but I know that’s not their only concern. For instance it would be great for them if they didn’t have to pay my claim. That’s the reason for the letter I got today.

The letter has my insurance company’s name and logo on the top. They didn’t send it. It comes from “a leading independent provider of outsourced insurance subrogation, claims recovery and cost containment solutions for the healthcare payor and property and casualty industries.”

“Subrogation,” that’s the operative word. Subrogation means my insurance company would like to find someone else responsible for paying my bill. If my pain was caused by an auto injury or some on-the-job accident the cost wouldn’t be their responsibility.

I cannot blame insurance companies for exploring this option. No one… no company wants to pay a cent more than they owe! Mitt Romney’s, “I pay all the taxes owed. And not a penny more,” works here too.

Here’s the problem, subrogation isn’t free. Sure individual insurance companies will save money on individual claims, but subrogation itself costs. Subrogation doesn’t reduce how much money is paid, only who pays it. It could save my insurance companies money.

Oh, cmon, who’s kidding whom? My boss and I pay for subrogation. It’s part of my insurance bill and it provides no coverage or care.

If you’re insured it’s a cost without a benefit.

I called the subrogation company tonight. “Unusually high call volume,” so I tried their website. I went back to the phone after I realized all the options on their webform were aimed at finding my pain was caused by an accident or injury someone else could pay for. The questions were written in a way that made it difficult for me to answer honestly.

My phone call lasted under five minutes. Case for subrogation closed.

I wish the woman on the other side would have said, “I hope you feel better,” as we parted. It isn’t part of her concern.

I’ve come to the conclusion most people opposing single payer healthcare have had little interaction with today’s for profit system. If we had national healthcare this defensive cost would disappear and the money could be spent on getting people well… or lower premiums.

&#185 – Go ahead, call it socialized medicine. That’s fine with me.

15 thoughts on “Today’s Word: Subrogation”

  1. Administrative costs for “private” insurance are massively higher than for government plans, and then you have this cannibalistic subrogation that adds even more costs. Plus, the whole system is much more confusing to everyone, and of course it is rationed (as all insurance must be – but this is rationed by mostly profit-motivated CEOs). If you look at statistics for how satisfied patients are, they are much more satisfied overall in countries that have “socialized” plans.

    You are in enough pain even with an expensive private plan – I’m sure you can imagine the fate of the poor guy who just got downsized and lost his insurance. Something needs to be done.

  2. Geoff you are right on the money, we are worse than most 3rd world countries when it comes to healthcare. Those that cannot afford to go to a doctor, simply don’t go until they absolutely have to. By that time, the cost is more than triple. Most of the time, the bill doesn’t get paid. We need a national healthcare so everyone can get the medical attention they need.
    For me it doesn’t matter, I have terrific health insurance…but I am not selfish and I would love to see everyone have it.

  3. I know it’s tough to understand how something in your back can cause so much pain in your leg. I had cancer in my spine that broke two vertebra and caused a few more to be removed. I am fused from L2-T11. I have a constant pain on the outside of my left hip and sometimes near my groin. It can get worse if I have to climb stairs or walk more than a mile or two on uneven ground. There are ways to work around the pain, there are ways to dull the pain, but I haven’t been able to get rid of it. I have tried traditional medicine, physical therapy, acupuncture, massage, noninflammatory diet, nerve block injections, yoga, reiki, and a bunch of other things. I am in the process of trying to get another opinion about this pain. The usual answer get is that I am ‘lucky’ to be walking around with my injury and illness take some more Cymbalta cause you are depressed about your pain.
    I feel ‘lucky’ because I had ‘good’ insurance. My debt or ‘my responsibility’ for my hospitalizations and treatment was around #20,000 during the first year. I had to get a part time job and make payments for the last four years to get that part of my illness/injury straightened out.
    I shudder to think what someone with no insurance would do. It’s just a mess out there and I am not sure what can be done to help people.
    Good Luck and I hope you can find some answers.

  4. The reason folks don’t want socialized medicine is because they want THE BEST – whether or not they can afford it.

    An email friend in Vienna and I once got to talking about health care. I thought they had a great system. All your basic medical needs were taken care off. However, that mean you were treated in a hospital ward, no tv, basic food, etc. If you wanted a semi-private room, tv, gourmet meals, etc – then you bought insurance that covered the extras.

    It strikes me as a very reasonable system.

  5. A dear friend was the staunchest conservative I ever met. However, he always used to say this country needed ‘socialized medicine’. He used to do a lot of work in Scotland and always marveled at how they could just go to the doctor when they were hurt/sick. Yes, if you wanted elective surgery, you had to wait and you had to pay. Makes sense to me.

    If we can’t have single payer, how about just getting what the Congress has? And at their cost.

  6. Geoff, in case you do not see this on facebook, I am really sorry to hear you are not getting any relief with all the treatment you have had. It was my experience that the drs offer to do evasive and non-evasive procedures AFTER you complete the series of 3 epidurals. Ask a nerve dr specialist what treatment they can offer you after the 3rd epidural if it doesn’t work and start thinking about your decision. Its a process you go through. I highly recommend the Dr Goodrich & Dr Bloomgarden group of drs in New Haven. Check them out. Each dr has their own solutions. Don’t give up. Miss you on the air!!!

  7. Geoff, you will continue to get these lovely notes as time goes on. I had them for years-same company. I guess they could not believe that my pain was not caused by an auto accident.

  8. I was without insurance when I suffered a major heart attack. We had to fight and fight for assistance to no avail. We got turned down because on the day I had the attack we had 900.00 in our savings which put us out for aide. Finally had to file bankruptcy – only then we were offered lesser bills. Even then we could not pay them. The cost of my bills was nearly 300,000.00!

  9. A few weeks ago I saw a program on 60 minutes. It was about refilling herniated disc’s with a jelly and saving the patient from surgery. It was amazing to watch the video..I googled “refilling herniated disc texas”. It is still in the trial phase and the patient feedback is astounding. This might not help patients right now, but the future is looking good. I though you would enjoy the segment. Healing energy to you.

  10. So sorry you are enduring this. About insurance–if you had none, or only catastrophic, you would have been told to take Ibuprofin in large amounts, and sent to a PT for two weeks, then told to continued the exercises at home forever. Different rules for people with different levels of insurance.

  11. While we are on this topic, can I just say, how co pays are bull sh– I
    Actually tell my providers that they are bs. I have gotten to a point where I have
    Stopped paying them. I am not going to pay $10/$15 for my doctor to have a pizza party
    At the end of the week. People STOP paying your co pays!!!!!

  12. No offense to any of the above but why do you worry about medical bills.? If you don’t have the money then just don’t pay it-screw them. Yea yea I know it’s not the right thing to do but who cares, they make enough money.

  13. I agree with you entirely on the health insurance front. Sorry you are not progessing more swiftly in your recovery.

  14. I am self employed and have just a basic
    major medical plan for us, I used to have a great
    Plan but it was so much per month it kept going
    up to where it was almost 5 times what I am
    paying now. The funny thing is all the doctors
    and hospitals assign with the insurance companys
    and they write off a portion , but if you have no
    insurance they write off nothing. Seems crazy too

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