Home > Gwinnett > Rick Badie / My Opinion > Archives > 2008 > May > 11 > Entry
DEL.ICIO.USPaying Twice
The Atlanta Journal-Constitution
She was at the hospital to stay by her sick son’s side, but Louise Beers was pretty sick herself.
She’d been battling a lingering viral bronchial infection for a week or so.
“I thought my chest would explode,” the 67-year-old Duluth woman told me. “I had to wear a mask to sit by my son’s bed.”
Beers primary doctor had been treating her with meds, but she was slow to improve. He suggested that Beers have a chest X-ray while at Piedmont Hospital to visit her son. The results were alarming.
She was admitted into Piedmont on Feb. 26 for an overnight stay. She received breathing treatments and insulin.
When Beers learned that she’d be staying, she had her daughter go home and get four other medications that she takes daily. But she wasn’t allowed to take her personal stash of pills. Instead, the nurses ordered the same medicines from the hospital pharmacy.
Beers didn’t have too much of a problem with that - till she got the bill.
“I have to pay $175.48 for what Medicare would have paid no more than $10 or $15 dollars for!” she wrote in an e-mail. “Were you aware that this is going on?”
Well, no, but Piedmont spokeswoman Diana Lewis explained why she couldn’t take the medicine brought from home. It’s a safety issue. Any reputable hospital, she said, would never let a patient ingest meds that came from home.
“It puts the patient at risk,” Lewis said. “There’s no way for the nurse to be sure about the dosages. She’s not a pharmacist.”
I explained Beers’ unhappiness with her prescription bill. She, in return, turned to Joseph Ware, who handles patient financial services for Piedmont. My phone rang 30 minutes later.
“Medicare has a list of drugs that they consider ‘self-administrable’ that they will not pay for if administered to an outpatient [covered by Medicare],” Lewis said. “[Beers] was an outpatient.”
Beers, who spent 30 years training insurance agents, has no issue with the hospital. Her son, who’d already had two heart operations, fought for his life in the cardiac ICU at Piedmont Hospital. He suffered from a torn aorta, the same condition that killed actor John Ritter.
“My son is alive because of Piedmont,” Beers told me. “A number of times we almost lost him. He’s doing much better. And I was very sick. Piedmont is a wonderful place.”
When the bill for the medicine arrived in the mail, she contacted Medicare. A customer service rep told her what Lewis had explained to me - that the provider doesn’t pay for certain drugs when administered to outpatients. Lewis of Piedmont told me to have Beers contact the hospital. Ware, of the patient finances department, can help her file an appeal.
Beers plans to.
“I am caught between the proverbial rock and a hard place,” she said. “I have no complaints about my treatment at Piedmont, but this just needles me. If I am having to pay this horrendous amount, everybody else must have to pay, too. I wonder how many people get caught up in this.”
Me too.
Rick Badie’s column appears on Sundays, Tuesdays and Thursdays. Contact him at 770-263-3875 or e-mail: rbadie@ajc.com.
Permalink | Comments (16) | Post your comment | Categories: Rick Badie
Comments
By Sandy_G
May 11, 2008 8:25 PM | Link to this
If the current convuluted rules and regulations of government run health insurance such as Medicare sounds unfair and illogical, just imagine government-run, socialized medical care with the rules being made by our current crop of congressmen and women.
By Bruce Wilcox
May 11, 2008 8:55 PM | Link to this
Many and it is a safety issue for the hosptial. Who knows what doctor is prescribing what drug’s for what condition? It could be Rush with a back pain.
If her primary doctor is prescribing that many drugs for a bronchial infection I’d begin to wonder?
Whenever I have had to go to the hospital, not in an emergency of course, most of my doctors would contact the doctor and see just what meds I needed for my stay.
But let’s be honest, Piedmont only takes certain types of insurance, maybe she hadn’t gotten pre-approved by her insurance company to have her condition treated by Piedmont. If you get sick make sure it has been pre-approved.
Louise Beers is very lucky to have insurance, it is either 45 or 48 million in this contry that have no insurance. Sorry Ms. Beers, but in this country it is profit that drives the health system, not the patients.
Ever wonder why the United States of America is ranked number 32 in health care in the world? Something to think about, next to oil, the health care industry and the drug companies are next next in profit.
By Louise Beers
May 11, 2008 11:26 PM | Link to this
In response to a couple of comments made by Mr. Wilcox, my doctor did not prescribe the medications in question for the bronchial infection. I have numerous other health problems, and the meds, which I must take every day, were for those conditions. Secondly, while I understand that I am fortunate to have Medicare insurance at this stage in my life, I also pay for Medicare Part B, Medicare Part D (for presecritions) and an additional insurance policy for charges not paid by Medicare, if approved. I don’t want you to think I am walking around with my hand out; I just want to pay the same amount for the meds that insurance would have paid, had the meds been approved by Medicare. Seems fair to me…. Louise Beers
By LT5000
May 12, 2008 9:33 AM | Link to this
$175.00 dollars is a horrendous amount? And worth an article?
Another Badie article for the trash heap.
Bruce, of course, has to tie in Big Oil and Health Care with no mention of lawyers. Yawn, channeling Abbie Hoffman again.
Perhaps Brucie should read the real health care statistics before he parrots the Obama talking points on insurance coverage. The “40 million uninsured” is pure crap. That is people uninsured at any one time. In fact, the average time people are uninsured in about 6 months.
85% of people have insurance.
http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur200706.pdf
How many times a year does Brucie need to go to the hospital to get those “foreign objects” removed?
LT5000
By Bruce Wilcox
May 12, 2008 12:07 PM | Link to this
LT read your articles before popping them up, In 2006, the percentage of uninsured persons at the time of the interview was 14.8% (43.6 million) for persons of all ages, 16.8% (43.3 million) for persons under the age of 65 years, 19.8% (36.5 million) for persons aged 18–64 years, and 9.3% (6.8 million) for children under the age of 18 years (Tables 1 and 2). The percentage of people under age 65 who were uninsured at the time of the interview increased significantly between 2005 and 2006.
Plus this includes private and government run insurance.
By Bruce Wilcox
May 12, 2008 12:17 PM | Link to this
Louise Beers I don’t disagree with you, but that isn’t the way the health industry works. But as I said above, “Sorry Ms. Beers, but in this country it is profit that drives the health system, not the patients.”
By LT5000
May 12, 2008 12:24 PM | Link to this
For Brucie, who apparently can’t read.
Data from 2006 also revealed that 11.8% (30.5 million) of persons under age 65 (14.5% of adults and 5.2% of children) had been uninsured for more than a year.
Yes Brucie, that’s 30 million without insurance for more than a year. 30% below you ignorant 45 million claim.
Based on data from the 2006 NHIS, Hispanic persons were considerably more likely than non-Hispanic white persons, non-Hispanic black persons, and non-Hispanic Asian persons to be uninsured at the time of interview.
Hmmm, they included illegals and non citizens in the survey. That could easily add up to another 10 million easy. All of a sudden, 45 million turns into 20 million. Then add in the people who don’t think they need health insurance and the numbers get a lot smaller.
Did something get in your eye at the Inserection video booth?
LT5000
By Cindy
May 12, 2008 12:57 PM | Link to this
LT,
Why are you so angry today? How’s it going?
Cindy
By Bruce Wilcox
May 12, 2008 2:39 PM | Link to this
“The percentage of people under age 65 who were uninsured at the time of the interview increased significantly between 2005 and 2006.”, it is now 2008, using what little common sense you can muster, would the stat above indicate it should increase or decrease?
Want to stop using old figures and start using ones that are relevent.
By Bruce Wilcox
May 12, 2008 2:52 PM | Link to this
Two things, there are a large number of people over 65 that have no insurance. If you insist on ols stats, try these…
Key Findings from the New Census Data
The number of people without health insurance was 46.6 million in 2005, compared to 45.3 million in 2004, and 41.2 million in 2001 (see table below).
The percentage of Americans without insurance rose to 15.9 percent in 2005, higher than the 15.6 percent level in 2004 and much higher than the 14.9 percent level in 2001.
The percentage of Americans who are uninsured rose largely because the percentage of people with employer-sponsored coverage continued to decline, as it has in the past several years.
The percentage of children under 18 who are uninsured rose from 10.8 percent in 2004 to 11.2 percent in 2005, while the number of uninsured children climbed from 7.9 million in 2004 to 8.3 million in 2005, an increase of 360,000.
http://www.cbpp.org/8-29-06health.htm
By LT5000
May 12, 2008 2:52 PM | Link to this
Brucie,
Bruce, I am using the most recent facts and figures.
The numbers of uninsured drop dramatically when you count the people who have not had health insurance for over a year.
They drop even further when you take illegals out of the equations.
And further yet when you take out people who could afford health insurance, but choose not to pay for it.
These are facts Brucie, not some “45 million” claim you pulled out of your syphilis infected rear.
Quit being an Obama puppet, even though I’m sure you would love to sit on his lap.
LT5000
By Justin
May 12, 2008 4:32 PM | Link to this
LT5000, you are sure beginning to sound like a latent homosexual. To continue making the jabs relating to it just furthers the suspicion that you are. Just wanted to let you know the perception you are exuding.
By LT5000
May 13, 2008 8:10 AM | Link to this
Justin,
I don’t suffer fools lightly. Add yourself to the list.
LT5000
By Cindy
May 13, 2008 9:34 AM | Link to this
List?
By Hitting too close to home
May 13, 2008 10:18 AM | Link to this
Justin - LT’s reaction make it seem like you hit a bit too close to home.
By Agitatter
May 14, 2008 8:10 PM | Link to this
LunaTic 5000. More nonsense? Shut down you computer, go outside and breath some air. You really need help