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Coverage caps

There’s a law in Florida called the Baker Act; a law which gives law enforcement and medical professionals the authority to hold people with mental illness – specifically those who show signs of being a danger to others or themselves.

There are few (if any) public facilities to provide this emergency care, so patients are cared for in private facilities… usually a floor set aside at the local hospital (the so called “psych ward”).

Since these institutions often are not publicly funded, “Baker Acted” patients are expected to pay for their care. Since most health insurance policies in the U.S. have unconscionable caps on the number of days covered in a 12 month period, and because mental illness can require extended periods of hospitalization, patients usually pay through the nose.

Because patients without coverage can not easily bargain as a group for the prices paid, patients without coverage usually pay more than insurance companies (for the same services). In fact, hospitals have been known to make up financial losses from insurance contracts with the fees charged to the uninsured.

As it happens, someone close to me is in the hospital, and she used up her hospitalization coverage (which only covered a percentage of the cost anyway) earlier this year. If I’m not mistaken, the bill submitted to insurance earlier this year was in excess of $60,000.

Imagine you had a really good job, with what was considered above average health benefits. Imagine what your finances would look like after paying 20% of a 60k hospital bill, plus 100% of what ever happens from here on out (which looks to be worse this time). Then ask yourself if you still like our health care system as it is.

With all the stress that undoubtedly accumulates in direct proportion to the accumulation of medical bills, it’s a wonder anyone recovers from a hospital stay.

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