Insured, but Still Owing $109K for a Heart Attack
My father had a heart attack 4 months ago, and he’s been in and out of the ICU for 3 of those months. Everyone likes to think “oh, I’m insured. I’ll be fine.”  But let me tell you, you won’t be fine. 3 months of ICU at Robert Wood Johnson was billed for $4Mn. BCBS-NJ only paid out $750k. The headache begins there- from a personal financial standpoint, and Tri-party incentive standpoint. Ignoring the difference of $3.25Mn “owed” to the hospital (technically, this $4Mn is an exaggerated number by RWJ to recoup as much as they can), the insurance company is essentially denying basic&#x2F;reasonable services. The doctors have been fighting with insurance to get him to an LTACH, but the most they’ll pay for is a nursing home.<p>Insurance is a business. They aren’t looking out for you, or your loved ones. I hate to sound cynical, but boy, these past 4 months have shown me the deepest, ugliest side of commerce that inevitably results from aligning incentives with profits.