By Michael Olenick, a regular contributor on Naked Capitalism. You can follow him on Twitter at @michael_olenick
Receptionist: Beegbaux Medical Clinic, can I help you?
Newly Insured: Hi. I have a new Obamacare policy and I’d like to schedule a visit.
Receptionist: Who is your insurance with?
Newly Insured: A company called Corporate Welfare Assurance Company. You’ve seen their ads on TV, “The President’s giving you CWAP so sign up”
Duh: don’t you read the news? This is a respectable medical clinic: we don’t take CWAP here.
Newly Insured: I pay 18% of my gross salary for quality affordable healthcare. I’ve had a strange looking growth for ten months but after scheduling an appointment under my old plan my last insurance company dropped me before I could show up.
Receptionist: All that is very interesting and I can relate – despite working in a medical office I have ACA CWAP insurance myself — but there’s nothing I can do. Bye. [Click sound]
[Cut to a montage of various receptionists for each line]
Receptionist 2: No, we don’t take the President’s CWAP.
Receptionist 3: We tried working with CWAP insurance but they kept threatening to drop us from their network if we demanded to be paid, and eventually did so. Sorry.
Receptionist 4: We’re out of network for CWAP but if you’d pay us $150 we’ll look at you.
Receptionist 5: For a regular doctor visit? Nope. Sorry. But…
Newly Insured: [Cutting her off] Trying to use CWAP is a hopeless pain in the ass.
Receptionist 5: Well, if it’s a screening colonoscopy you’re looking for you should have said so. CWAP covers those if you’re over 50 though you have to pay more if during the procedure the doctor finds anything and fixes it.
Newly Insured: I’m still pretty young and .. wait; who said anything about a colonoscopy? I just want a doctor.
Receptionist 5: Well, let me look at the menu of items covered… Are you into wine?
Newly Insured: Uh, yeah, I guess. I usually have a glass of wine with dinner.
Receptionist 5: Great! CWAP covers residential substance abuse treatment. Pack a bag, leave the bottle behind, and we’ll have you enrolled this evening.
Newly Insured: I don’t think it’s a good idea to try giving up alcohol while trying to navigate this CWAP.
Receptionist 5: Hmm. Well then how about a syphilis test? If you were a woman I could offer you tests for syphilis, chlamydia, gonorrhea, hepatitis, a urinary tract infection and HPV but you’re a man so it’s one Bad Blood test for you.
Newly Insured: Bad blood test?
Receptionist 5: That means syphilis. It’s from a list of slang terms for venereal diseases that the CDC created at this web address: http://www.cdc.gov/std/healthcomm/HPVGenPub2004ApD.pdf
Newly Insured: Wouldn’t it make more sense to test anybody willing be tested for venereal disease since curing one man or woman prevents infection from spreading?
Receptionist 5: Look – this is all philosophically interesting, and I’m trying to work with you and all, but I’m not the one who defined what this CWAP covers. My job is to sell procedures and it doesn’t sound like you want one, which they’ve told me to tell you is like totally irresponsible, but don’t waste my time. [Play sound of phone clicking down.]
Receptionist 6: Yes – we’ll take your CWAP. Our next appointment is in two months. Is that acceptable?
Newly Insured: Really!
Receptionist 6: Really what? Two months? That seems to annoy some people. Tough. Honestly we’ve lost a lot of patients lately or it’d be 3-4 months.
Lost them because they obtained superior health insurance and went to high end clinics at training hospitals?
Receptionist 6: No, lost them because they died. I mean we’re not like a high-cost clinic where bankers, oil sheiks, drug dealers, and shadier types like the owners of government-hired foreclosure review consultancies can just whip out a brief case and pay cash. But there are doctors and nurses here.
Newly Insured: I wasn’t questioning: I’m just happy to hear you have an opening: I’ll take it! Who is my doctor?
Receptionist 6: Dr. Frank. He’s one of my favorites here! He used to be in a rock band then, while playing a gig on an island somewhere he caught something from a groupie and wandered into a local medical school. He loved the place and dated the Dean for awhile – Frank has great taste like that ‘cause, not to brag, but he’s dating me now, well, and a few others here but, like, whatever, they’ll go away — and, oh yeah, eventually they gave him an MD.
Newly Insured: But he is a doctor? Licensed in the US? He knows what he’s doing?
Receptionist 6: Oh yeah. He’s great. CWAP actually gave him an award for the lowest cost of care out of any doctor in the whole state. CWAP sends him all sorts of goodies. Soon he’ll be training stodgier doctors, with more boring backgrounds. Frank’s suggested a training cruise: I’m hoping he’ll bring me with.
Newly Insured: Does he have a specialty?
Receptionist 6: He convinces people with cancer to skip treatment. “Die high and happy,” that’s Frank’s motto, his contribution to modern medicine as he likes to call it. If you’re gonna’ go you may as well die a little sooner — flying on top of the world — rather than puking and bald, right? It’s not like we live forever.
Newly Insured: I guess, though if death is avoidable I’d rather put it off a few years. Anyway I suppose he’s a start. OK; we’re scheduled. I’ll see you in four months.
Receptionist 6: Wait, I forgot something…. Oh yeah, I’m supposed to tell you to remember that your visit is under the deductible so it will cost at $200 and more if tests are needed and, like, since you’re seeing Frank, and he owns the lab, tests are always needed.
Newly Insured: But that’s more than it cost for the clinic that didn’t take CWAP!
Receptionist 6: Yeah, but it counts towards your deductible so if anything is really wrong, assuming that you pay us another $6,000 of so, your CWAP will be worth something. Unless of course it takes until the end of the year to reach $6,000, then you’ll have to start counting your CWAP all over again.
Newly Insured: You know I can fly to Europe, pay a top quality doctor, and receive quite a bit of treatment all for less than $6,000, plane ticket included?
Receptionist 6: Au Revoir. Want company?
This would be funny if it was not real. On Monday there was an article in the NYTimes about the way specialist Doctors rip people off. It would have been even more fun if the writers of this piece had read that and then incorporated some of that nonsense in this skit. I am reading ‘Lords of Finance’ and think it is only now (after 23 years in this country) that I am really understanding the kind of country America has, is and will always be. A nation where greed has contrived to always shine the light on money grubbing Shylocks and speculative flesh eating parasites sprinkled here and there with some true genius entrepreneurs – ALL of whom are PERMANENTLY captured by the money men on Wall Street. It is not for nothing that Coolidge remarked ‘they hired the money, didn’t they?’ in response to writing down WWI debt of the allies. He may or may not have said that but it is irrelevant.
The interesting thing about Obamacare is that anything is possible. It is so complicated, so full of strange details written into the law by lobbyists, hidden catch-22’s, lots of wiggly language that can be interpreted in this or that way by armies of hungry-for-fees-lawyers hired by the medical industry. This has invited an already corrupt industry to become corrupt in a more Byzantine manner.
People are just going to have to find out for themselves how “healthcare” insurance works or, more to the point, doesn’t.
Only then will they be willing to demand a better alternative.
That’s my story and I’m sticking to it.
Great work. This skit is a reminder (as if we need one) that here in the US nothing really matters except having money, and not having it. Remarkably, parents waste most people’s entire childhood telling them that money doesn’t matter. Schools tell them the same thing. They get out into the world and discover, ‘holy shit, money matters!’ Of course, if you try to tell anybody that money matters they immediately write you off as a worthless, selfish, greedy bastard, who cares nothing about anybody else. Can someone please explain this?
The quickest way to hamster away thoughts about the consequences of not having money is shame, ridicule, etc.
In fact, that’s the mechanism most used to suppress any idea that may produce uncomfortable feelings.
Personally I like the Chinese way of looking at it: mo cheng, mo meng (and I’m brutalizing the pronunciation)
No money, No life.
They are not wrong! ….Money doesn’t make you happy, but you need enough not to be unhappy.
In the U.S. money is the ultimate arbiter of all value–it has taken the place of God and religion even for the so-called “religious.” Culture cannot survive if that fact were generally known–it would be too discouraging to live that way so we pretend that is not a fact. And we pretend to our children that other values like fairness, concern for others, sharing and so on are important or more important than money and wealth. We don’t collectively believe it, but in the American tradition of denial, we assert it is true just as we vociferously declared the U.S. was the land of the free despite Jim Crow, that we were fighting the Vietnam (insert any war) to give freedom and dignity to the Vietnamese and so on. If we told our children the truth they would be even more discouraged than they are so we fill them full of optimistic illusions for their own good.
laughing through my tears…
Is this a slight against ObamaCare or against insurers? Or are they indistinguishable?
Its both. Insurers aren’t the only problem and are something of a red herring when compared to the Hospital Cartels.
It demonstrates ACA is lipstick on a pig in many ways because much what is written is indistinguishable from difficulties encountered prior to ACA.
Who carried this?
Hi run – Who carried what? This piece? It was written specifically for NC. It’d be fun if somebody who knows how to do these things would find actors and record it into a skit.
Benedict: I think it’s fair to say they’re the same. Rather than “winning” the latest battle like they usually do, then walking away and waiting for the question about public healthcare policy to show up again, insurance companies instead took over those functions of the government. This , fuses themselves to the bureaucracy at the DNA level, giving them more control to maintain the status quo as healthcare costs rise even further out of control.
Our President’s goal for healthcare reform is to “bend the cost curve,” an uninspiring and near meaningless goal. The US healthcare industry will exceed $3 trillion (20% of GDP) this year. Numerous studies have acknowledged that less than half of that amount is actual healthcare. In fact, most studies agree there is at least $1 trillion in waste, inefficiency and fraud – why isn’t that the target? Nothing in the ACA does anything to eliminate that waste and inefficiency. Nothing.
By allowing the “industry” the opportunity to write this Law, the participants simply enriched and protected themselves. The result will be higher costs and additional taxes – not affordable healthcare.
If you call five times each to your health insurance company, your health provider network, your PCP office, HHS, HCA and DSHS, you will get 30 different answers to the same question. If you go to the websites of all those entities you get even more different answers or dead links.
The two most common comments I received on phone calls were, “oh, yeah, we’re totally swamped with calls” and “oh, the stories I could tell you about how confused everyone is, both internal and external, would take a week”.
My favorite comment from my health insurance CSR, “make an appointment and see if they accept the insurance; the truth will tell when the rubber meets the road”.
I feel like I’m facing an abstraction of Dirty Harry asking me, “do you feel lucky punk, well do you?”
I was born in the USA, the country that prides itself as a shining light in the wilderness for the rest of the world. Worked for a renewable energy company in Canada for three years.
Company accountant: Have you signed up for you Care Card yet?
Me: Um, no I just started work last week.
Accountant: You are in a civilized country now. We don’t permit our residents to go without access to health care.
As a temporary resident my Care Card was exactly the same color as the in one in the wallet of the richest man in the province.
And by the way I never had a co-pay bill for any service in Canada, and certainly not a co-pay plus deductible charge that is more than the total cost of the procedure in other countries as it is in every hospital I’ve encountered in the USA.
And furthermore I never waited in an assembly line to see a doctor like happens in the US, with its doctor/patient ration only 1/7 that of Cuba.
Amazing what a country can afford if it doesn’t have to support an imperial army as large as that of the entire rest of the world.
Don’t fall for the myth the USA can’t afford good healthcare for everyone. You have the universities to train good medical staff and legions of capable people who would re-train given the opportunity. You have enough underutilized labor and resources to make all the facilities, you have the demand.
Money is just an abstract construct used to manage power relationships within society there’s never a real shortage of it.
What’s lacking is the political will to make good things happen….. Why?……Because the bloated vested interests at the top end of society use all their money, power and influence to protect their own positions and prevent them happening.
Last week I came across my 84-yearold mother-in-law still in bed at 9.30am white-faced, wheezing badly and hardly able to breath, and sure she was dying. An emergency call brought us a helicopter ambulance and four paramedics within half-an-hour (we live more than two hours from town), and within half-an-hour after that she was in hospital with a diagnosis of pneunomia.
Four days later after intervenous anti-biotics and a bucket-load of other treatments she was very much better and discharged with a month’s supply of medication.
As this was in New Zealand with a national Health Service the only cost to us was our petrol for the trip into town to collect her.
Sorry I couldn’t make that any more amusing.
That’s because It’s not really very funny, if you are on the wrong end of a user pays, free market healthcare solution you just stop wheezing and die.
You would however be consoled by the knowledge the “hardworking” citizenry has been relieved the burden of supporting another lazy, feckless scrounger.