Let us give thanks...for INSURANCE!

I think one of the first things I said when they told me I had cancer on September 14 was, "OMG, this is going to cost a (bleep!) fortune!" Usually, I love being right. Not so much, this time. The first of the bills have started trickling in, and the figures are downright breathtaking.

"Just tell me a number," Bill said stoically. OK, sweetie: For the initial testing in Knoxville, the pre-op diagnostic tests at UVA, and the one mastectomy surgery (not including the first Sentinel Node Biopsy surgery or the last Implant Reconstruction surgery, and not including any actual physician fees) we're at $61,650.78 as of yesterday. This also doesn't include travel costs, meals, new bras, gauze, prescription drugs at the pharmacy, any chemo, hormonal, or gene-targeted therapies needed after surgery (or perhaps psychological counseling needed after viewing the bills).

Whew. I feel like I need smelling salts or a smack upside the head. If I could drink, I'd open a bottle right now for breakfast.

It's a ridiculous number of course, one that is hard to comprehend, and therefore is rendered meaningless in the world of reality. It might as well be $600,000 or $6 million. It's just a gazillion smackeroos in our frame of reference. Oh well.

There will be insurance picking up the lion's share, there will presumably be "adjustments" made by the hospital based on contractual rates, something that I know happens but don't fully understand. The original numbers never actually get paid, but I don't know where that magical adjustment money goes--it seems to just disappear into the void.

For example, my Knoxville tests were originally $1665 and $239. My insurance paid $257.78 and $97, respectively. I paid $26.84 and $10.78, respectively. The other $1511.60 went into the land of "money we wish we had, so we billed it, but no one will pay it, so we'll forget about it."

I've had this explained to me, by knowledgeable people who work in the medical insurance business, but I still don't get it. Where does that accounting entry go? How do you bill a mythical number that everyone knows you're not going to get, in order to arrive at a number that everyone agrees is the real price? It's like negotiating to buy a car, where the guy has to go talk to his manager before a deal can be struck, and no one knows how much it's going to cost until you sign the papers and the car is yours at whatever it says on the paperwork.

It's a crazy-maker, that's the truth.

So, we shrug our shoulders and write the seemingly minuscule co-payment checks. Maybe it's to get us to the table and breathe a sigh of relief that we're paying anything less than that stunning initial number? Is it meant to help me feel like I just got a bargain on saving my life?

I'm not really worried about this, but I'm fascinated by the absurdity of it. When I was first diagnosed, I pulled a chunk of my Roth IRA money out (allowed for medical expenditures) in anticipation of this very situation. The beauty of the IRA rules is to encourage people to save for retirement while maintaining a "rainy-day" fund if it's needed before retirement. This is my rainy day and thankfully we have it available to spend. Who needs a sacrosanct retirement fund if foregoing cancer treatment would kill you before you ever got to collect it, right?

So, I'm indeed thankful this morning--for my good medical care so far, for a cooperative and helpful insurance company, for money in the bank that will soon be in the coffers of the medical establishment, and yes, even for the Internal Revenue Service for their rules on withdrawing money for medical expenses.

But I still want to know where that adjustment money goes....


Happy Thanksgiving to all. This is my very favorite holiday, mostly because of my mother's and Aunt Kay's cooking and that fact that it was my father's favorite too. Anytime you can gather family & friends, ponder freedom & history, and then add the celebratory ingesting of massive amounts of food, you've got a winning party in my book. Bill and I are doing it this year as "just the two of us." We're going to Morristown to eat with all the seniors at the Ryan's Buffet, an upscale strap-on-the-feedbag kind of place. No cooking or dishes for me this year, which is a little sad, but oh-so-convenient. It is what works for us this year. Next year, we'll start some new tradition and think back to this time, hopefully with no regrets or sadness, being thankful that we got through this time with cheer.