Wednesday, September 30, 2009

The Waiting Room

There were 24 people inside the waiting room of a clinic in a moderately sketchy section of the city where the southern fringes of Hollywood meet the northern border of Koreatown. I sat among them for three hours this afternoon and in between chapters of The Omnivore's Dilemma, and outlining a piece for PokerNews I watched them. A lot. There really wasn't much else to do as I waited until 3:30 p.m. to be seen for my 12:45 appointment. All of us had one thing in common-- we had no health insurance.

Number of women: 22

Number of men: 2

Number of flamingly gay men: 1

Number of women carrying Louis Vuitton purses: 2

Number of women carrying Chanel totes : 1

Retail price of a Chanel 2.55: $2,250

Number of students from Hollywood High School: 5

How many of those students were passing the time by doing homework?: 0

How many textbooks were in their backpacks?: 0

Really?: Not a one.

How do I know they were from Hollywood High School? The student IDs around their necks.

Number of people reading books in the room: 3

Ethnicities of people reading books: White, Filipino, Asian

Number of people using texting devices and/or cell phones: 15

How many of those devices were iPhones? 11

Bad television shows that played out during my wait time: Some sort of talk show, Are You Smarter than a Fifth Grader?, and Divorce Court.

People who were playing along with Are You Smarter than a Fifth Grader? 4

Number of them who are smarter than a fifth grader: 1

Number of phone calls the actress sitting next to me received from her agent: at least 10

Number of auditions she missed while waiting for her 1:30 "appointment": seemingly one really important one

Total time spent in waiting room: 2 hours, 46 minutes

Total bill for a year's supply of birth control: $769.00

Number of times I said "fuck" out loud after being presented with the bill: at least 3

So that breaks down to... what exactly?: $2.11 a day to not burden myself, my boyfriend and society-at-large with a child. Which actually is a lot cheaper than actually having one.

Silver lining: At least I was home by 4:20.


John G. Hartness said...

Total cost for a year's supply of birth control for my wife with Blue Cross/Blue Shield - $600. Not a ton of difference except for the time spent in the waiting room. I suppose. Not like I go with her or anything.

Pauly said...

Ditto what Falstaff said.

For the record, I'll be picking up half the tab but I didn't have to s it through waiting room hell.

Betty Underground said...

Dr. Pauly, you are a good man! The last boyfriend I had who offered to do that was in HIGH SCHOOL. Wait, not that I was having sex in high school. Or before the age of 16 in a state with a statutory rape law.

Irongirl01 said...

I remember the days of a $5 monthly copay with my HMO. it was even cheaper when i went thru planned parenthood in my twenties (sliding scale based on income ) last time i used bcp's I paid $27+/month even with insurance that was 2006. so your paying a little more then 2x that. My solution was finding a guy who shoots blanks!!!

Butch Howard said...

California: Self-medicate your 4:20 habit in nice free-market style, but pile on the BS to dispense a non-narcotic, mostly harmless, hormone supplement.

(And I'll grant that the rest of the country is even more restrictive in that they don't even allow the freedom for the 4:20 service call, but at least they are being equally restrictive in a way).

Calculating total cost of birth control in the plan we use (United Health Care) is a bit tricky, I think. Just looking at the prescription service it costs $120 because we have a $10 per month fee for most drugs.

However, I think you have to include part of the premium into the number to get the real cost and I also think you have to include both the part I pay and the part of the premium paid by the employer (since that would likely be part of my salary if they were not paying it toward insurance for me). So now you have to decide what part of the $1200/month premium goes toward the prescription service. If we use roughly what Medicare charges (because I cannot find something that says exactly what my policy charges) then about $25 per month per person of the premium goes to the prescriptions. Whether we use them or not. In our case we do.

Now we have, just for the Wife, some portion of $25 a month, plus the $10 copay. How much of the $25 to use? Well, if she was of perfect heath we would have to use all of it. Since she is not we get to spread it over the other prescriptions. So it ends up being a range of prices from $120/yr to $420/yr depending on how many other drugs she has to buy. We'll pick something in the middle: $270.

Plus a checkup once a year. So add in a $20 copay for that and some portion of the other $1100/month premium. $275/month we pay for the Wife whether she is sick, has an accident, or not. Let's say half of that is insurance and half is for medical care benefits (don't know the actual split). So about $1650 for the year to cover the Wife for medical benefits, most of which is her one visit a year, but sometimes two so call it half each.

$825 for the doctor visit out of the premiums, plus the $20 copay, plus $270 for the prescription benefits, and we get a typical cost for the birth control of $1115.

Now I will grant that if we had a really sucky year, with a car wreck or some bad disease, all this calculation for the birth control pills would skew to the very low ends of all the ranges.

My point, poorly made I think, is that we are all paying too much for a simple dose of hormones. Would that we had more freedom both in the drug regulation and in the markets for medical care so that prices would come to reasonable levels and we could make our own rational choices on when we need a dose and when we need a waste a day to get a doctor's advice about it.

Until then, good grief, get some insurance and medical coverage. You're over 30 now, right? Past the age where you can safely risk being without. lists several ranging from $100-$300 a month for a 30-yo female in the LA zipcodes.

change100 said...

Believe it or not, I've actually been shopping for Health Insurance plans. Not a single plan approaching my price range covers the type of BC I use.

The insurance I might be able to afford should I continue to work as steadily as I am now is a plan with a $5,000 annual deductible where your prescription costs don't even count against it.

So if I do end up buying insurance and have a catastrophic accident, I should probably not go bankrupt. Probably. But as for everything else, I'll probably be just as screwed as I am now with long waits and high prices.

lj said...

great post, as usual.

Dawn Summers said...

How could you tell what was in their backpacks?