America is getting milked...

I had a very disturbing wake up call this weekend when on Friday we received a bill from the fertility specialist we had seen four months prior.

My wife and I have been trying for a baby for five years, and when we moved to Lubbock for a new job, and to finally have health insurance again, we decided to try to find out why we had gone through three very saddening and unexplainable miscarriages.

Now I am quite a bit older than my wife, but I also have an eleven year old daughter from a previous marriage. On the advise of a colleague, who also had a difficult time conceiving a child with his wife, (they finally after the second in-vitro fertilization, had twins) we went to a specialist at Texas Tech University (TTU), for an initial consultation (after a referral from my wife’s gynecologist who helped us through our last miscarriage). So my wife got an appointment to see this specialist in January of this year.

A month later my wife got the results from lab tests determining that she had a chromosomal translocation, in other words it explained the miscarriages, and also suggested a very low chance for pregnancy and a pretty high risk for bearing a child with a birth defect. What was interesting about that was that when she initially saw the physician who diagnosed the chromosomal issue, the nurse told her that a fee of $90 (saying we had a 40% discount) would cover the visit (remember we have insurance right?)

We were then referred to a reproductive medicine specialist at TTU.

We made an appointment and saw him in sometime in April. He was a very affable gentleman, chit chatted about his degrees and accomplishments a lot, was a very direct and knowledgeable man with a clear empathy for the situations that most of his patients present with. I liked him, and in all honesty would have stayed with my wife longer, but being a health care professional myself, I had joined my wife more for moral support, and was in a situation where I had to leave early to get to back to work.

Before leaving he suggested that I have blood drawn to rule out any sort on genetic incompatibility I might have (again- I am a proven father). I was fine with it- did the blood draw, and went off to work.

We kind of slowed down on the whole "reproductive medicine" process because we knew it would cost around $10,000 for just one attempt at in-vitro- with no guarantees, and as well we had passed the first hurdle and at least we knew we had a problem. We decided our second step would be to see how well my genetic emissaries measured up in terms of motility and general health. In other words, a sperm test.

Meanwhile we got some sort of lab result that said that as far as the genetics go- I was fine.

So let’s fast forward to August and some three to four months later.

It wasn’t until this Friday that my wife found out that the balance of the bill with specialist number 1 (remember the original $90 with a 40% discount) was NOW an additional $1400.

As well. We got a bill for $400 or so for the visit with Specialist number 2 for the 2 hours or so we spent with him. I can live with that. Attorneys charge on the average of $200 per hour, so a potential avenue to have our own children was certainly worth at least that level of compensation.

The Kicker was the next bill in the queue, a certain Dr. "W" whom neither my wife or I ever saw, had just billed us for $8,600 rounding out the days total of newly acquired economic burden to $9,000 plus the $1,400. Basically the full bill for doing an in-vitro fertilization.

Well it was too late to call anybody the day we got this – so we had to wait until Monday to clear up whatever this mess was- it had to be a mistake.

Well with initial stabs at it, my wife was told we had had a baby in January. So that is where the charges must have come from- and happy days (how ironic- we were actually glad it was a mistake- but remember that the whole reason we were in this mess was because we were trying to have a baby). There is something wrong with the dimension of fear a financial glitch can have on a family.

After 5 years of being uninsured, I had finally gotten health insurance again, and then 6 months after getting it, not needing it, I had to start paying for it out of pocket again because my company decided that it was either that or fire somebody. Dr. "J" assured me that whatever route we took, would be one covered by my insurance policy that by this time I had paid $4000 to in premiums, but hadn’t gotten past my $1500 deductible for "catastrophic coverage".

So back to the $10,000 question. My wife has spent hours this past week talking to nurses, billing supervisors, secretaries, and god knows who else, constantly getting reassurances ranging from- "Oh we keep admonishing Dr. "J" to let patients know how much the tests cost", to "this is what the test costs", to "there is something wrong with your insurance (United Health Care) this week- they always accept these charges, but this week you are the second person to be declined" and don’t forget, the "you had a baby in January- which explains the charges" story.

Now the real kicker here is that Dr "J" actually took the time to call our house and he got me on the phone. It was hard to get a word in edge wise, but it seemed he was very irritated with his nursing staff for dispensing incorrect information, kept telling me that he had not ordered this expensive ($7,600) "Fish" blood test ("Fish be an acronym for whatever genetic anomaly fact finding blood testing that was engaged), and that some doctor whom he refers his patients to automatically orders these tests as long as it is understood that they are covered by insurance, and "by the way- what is wrong with your insurance?", and he went back to how upset he was with this doctor, and that he should have let him know, and how he could have sent me to an agency that only charges $500 for the same test- that if he finds out insurance doesn’t cover- that is the route he takes, and "what was wrong with your insurance?".

Now the funny thing about the insurance rejection and the "this is the second time this has happened this week" story- is the fact that the doctor appointments were 4 and 8 months ago respectively. I am pretty sure the claims were filed quite awhile before this week.

Now according to Dr. "J"- he corrects a wrong within 5 minutes of knowing about it, and to be perfectly honest? I believe him. He was on the phone talking to me- actually- talking AT me, in a very demonstrative effort to clear whatever wrong idea had been manifested. He assured me that it might take a few weeks, but that it could be fixed and that I would probably have to pay less. $500 sounded like the dollar amount he was getting to.

He was upset and nervous. Reproductive specialist’s don’t just call their patients in a panic.

So now it was a $500 dollar test (none of which anybody had advised me of), and who knows where the $1400 dollar charge (that nobody had advised my wife of) was going to go?

What I can’t believe is Dr. "W" charging that kind of money for a blood test. And even further, that anybody in ANY field (not just medicine) could send someone out to get that sort of test before informing them of the fact that they are about to incur a $10,000 debt.

Being fleeced is what this was. An opportunity to milk someone with insurance, and a decent paying job, a quick way to throw down a "bill for services", and should that not be paid in a timely fashion, totally destroy a family’s credit.

Please remember, this test was ordered on a whim. I wasn’t the patient. I had accompanied my wife to support her on a very sensitive fertility issue- I am a proven father, and under what basis could that sort of test be ordered? How can you not inform a client that the test you just ordered for him- costs almost $8,000? I wasn’t vetted. There was no credit check. Just a bill for $10,000 when it was finally done.

Clearly Dr. "J" was aware of the fee- regardless of who the payer was. It was definitely a fee they are used assessing to people that have insurance, meager means- or in some instances, are well prepared to pay. Either way, if you can’t have kids, there are options. You will pay and bleed for you inability to reproduce.

It hurts to not be able to have children. But that isn’t a problem that we wanted to or need to share. But what becomes excruciatingly painful here is to find yourself becoming a milked cow at the expense of your genetics.

This was wrong on a lot of levels, and it needs to stop...