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Thursday, September 24, 2009

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Andrea

In regards to the last sentence quoted: it makes me think about one of the hospitalizations my son went through. We were still in the process of diagnosing his autoimmune disorder when he coughed one night as we put him to sleep-then started to breathe oddly. We called an ambulance, went to the ER and sat through a series of x-rays that told us that his lungs were "fine." B/c of his history, I wouldn't leave the ER. Finally, the doctors agreed to a cat-scan. When they looked at him in three dimensions they realized immediately that his lung had collapsed. The intervention in a pneumothorax is to insert a chest tube into the pleural wall and re-inflate the lung via vacuum. While the tube is inserted, though, the patient must remain in ICU in a bed attached to a machine that creates the vacuum. Doctors tried to remove chest tube too soon, the lung collapsed a second time. All told, we were in PICU that time for 31 days. My son has very unusual health issues, I do not fault the doctors for the errors that occurred. In retrospect, I realize that certain events HAD TO occur before doctors could legitimately arrive at the proper diagnosis.

However, about 7 days in, we were informed by our insurance company that while the hospital was indeed in our plan, the medical group of pediatricians that worked in ICU had recently withdrawn from our plan because they felt they were not receiving adequate compensation from the insurance company. Thus, every time a pediatrician came to visit us or checked my son's chart, instead of being 100% covered, we were only covered for 80% of reasonable cost. Over the course of a month, the difference between real life and 80% of reasonable cost really added up.

My husband is a state employee. We actually have very good insurance. But that one hospitalization (and my son has had many) still stripped us of our savings (not VAST sums, but all we had) up to that point.

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