Having just posted the previous item, it occurs to me that I have a horror story of my own.
Some years ago a raccoon got into the house through a cat door, and bit me on the hand as I was wrestling it into a trash can. Since any coon abroad in daylight is likely to be sick I shot the animal and put its head in the freezer till the animal control officer could collect it. The day afterward I got a call from the health department to tell me that the coon’s brain had tested positive for rabies.
My primary care physician sent me to the emergency room to begin the three-week course of shots. That was the end of it, I figured. But then I got a bill for close to $3,000. Anthem Blue Cross Blue Shield was refusing to pay on grounds that I should have gone to my primary care physician for the shots.
And the adventure began — the hideous experience that everyone screwed by the private sector is forced to suffer. Cable companies, power companies, phone companies, you name it. The endless phone trees leading nowhere. The stalling. The promises to call you back that are never kept. The repeating each time of the same story to a different agent. The refusal on grounds of “company policy,” presented as something authored by God before which mortals are, alas, powerless.
Logic, as Professor Higgins told Colonel Pickering, was never even tried: “But my primary care physician is the one who sent me to the emergency room.” “I understand, sir, but all shots must by given by your primary care physician.” “But he didn’t even have the shots.” “I’m sorry, sir, it’s company policy.”
I took my problem to the doctor who ran the emergency room, a man I play poker with. “Those sons of bitches,” he said. “This is the kind of shit they always pull.”
He told me that no doctor in our part of the state keeps rabies vaccine in the office. It’s enormously expensive and goes bad quickly, and a doctor may go years without having a call for it. So the emergency room serves as the sole repository for the whole area.
“Blue Cross says they’re rejecting my whole claim because the ER charges more to give shots,” I said. Bullshit said the ER, and got on the phone to my primary care physician. The difference in cost for administering all the shots turned to be something like $25, total.
Back to the phone tree. I offered to pay the $25 difference, but of course this was against company policy. I could, however, take my case to our appeals board. May I have their address, then? Certainly, sir, and thank you for calling Anthem Blue Cross/Blue Shield of Connecticut.
And so I filed the appeal, and weeks passed, then months. At last the appeal was rejected. I then appealed the rejection, more or less as follows:
I do not have $3,000 to send you. I can get it, though, if you’re sure you want me to. The way I get money is by writing stuff and selling it to things like newspapers and magazines. The people who read my stuff may not know much about medicine, but there is one thing that each and every one of them knows.
This is that a human being infected with rabies who is not treated in time will die in one hundred percent of the cases. In fact such a human being just did, that young Connecticut girl who was bitten by a rabid rat while she was sleeping and didn’t realize it until the symptoms showed up.
You will recall, as will everybody in the state, that this girl died a slow and agonizing death, at a cost to her insurance company that must have run to hundreds of thousands of dollars. The exact figure may even be in your own files.
To assist you in considering this matter, I enclose a list of my published articles and books.
Yours sincerely, etc .
This time the logic of my argument proved to be powerful enough for even an insurance company to grasp. The check, eventually, did indeed turn out to be in the mail.