Learning from Illness 9 – Health Insurance Hype

Once the fear of ‘something really serious’ had passed and I had strong painkillers to ward off any future discomfort, the whole nature of dealing with the disease became easier. It was simply a gall bladder problem, so aside from an operation which needed to be negotiated, there was little to inconvenience me.

I didn’t want to spend a long time on painkillers, however, because of the risk of getting to like them too much. And, I suppose, there’s a part of me that when faced with these situations wants to get them over with as soon as possible.

I had for many years kept up payments to the VHI – even when the household budget was stretched and it seemed like an unnecessary expense. I suppose my logic – like a lot of people’s – was that I wasn’t paying for this year as much as future years. That’s a twisted logic in itself as VHI have only introduced penalties for new members recently, but this was one of the realities of being ill (as opposed to the theory) that I came up against.

The theory is that you need to have health insurance. The reality is that health insurance is a scam that benefits the hospitals and the insurance industry. If I had simply saved the money I had put into VHI over the years, I would have saved a massive amount of money and had plenty to pay for my health expenses. But the first step was getting a surgeon who would perform the surgery.

Now the one thing the VHI had done was to mislead me on the type and amount of health insurance I actually had, and their used-car salesperson technique actually ended up benefiting me, though I think we’d all agree, this is not the best way to run a health service.

As a freelance journalist and communications consultant, I don’t have a regular income, and with health insurance rising each year, I began to question whether or not I could afford it. Thankfully, a VHI salesperson called me to offer me a ‘deal’. He asked if it really bothered me if I had a private room, or whether I would be happy to to be a semi-private room or ward.

As it turns out, I had no preference in this regard and plumped for the semi-private room at the cheaper price. What I didn’t realise, what the salesperson didn’t tell me was that this effectively took away the one thing that people pay for when they purchase health insurance – their ability to skip the queue.

How this works, of course is that if you have insurance for a private room in a private hospital, you simply go to see the surgeon who operates on you as soon as they have a room free, which is almost always. And I did this – thinking that I had access to services based on the fact that I had been paying into VHI for over 20 years.

Normally, if I had had no insurance, I would go on a public list at this stage and wait however long for an appointment with a surgeon. That could take months. Instead, because I thought I had insurance cover, I paid the €150 upfront to see a general surgeon.

The surgeon was a man in his fifties who was very re-assuring. He explained how they did the operation and how it was all done with tubes and cameras. It’s called a Cholecystectomy and it’s a routine thing, he assured me. Only about 10% of cases have any complications and that’s usually in cases where the gall bladder is inflamed. In my case, with a few days or a week of antibiotic treatment, the gall bladder should be fine and removing it a doddle.

In fact, he had a spot which had just opened up on his next surgery day which was two days away and he asked me if I’d be prepared to get it done then? “No problem,” I thought. No time like the present.

Secretly, I was delighted. The sooner the better. Get it over with. I’d be well-recovered and back working before Christmas. We agreed all the details and I signed the consent forms and his secretary got me to fill in a few forms and I went home – all ready to return the day after the following day for surgery.

That lasted for a day. The following day the consultant’s secretary phoned me to tell me that she had checked with VHI and I didn’t have cover for the private hospital, which meant they couldn’t do the surgery. Well, unless I paid. Since I had been following that route so far, I inquired how much that would be? €1,000 a night. Which is nice. If I had €1,000 to blow on one night, I’d imagine that the Four Seasons down the road would be willing to accommodate me and maybe throw in dinner, but it’s a moot point as I don’t have that kind of money.

So, having seen the consultant, paid my VHI for 20 years and knowing exactly what I needed to get done, I was heading back onto a public waiting list to wait for an undetermined time until I could have this operation. It all seemed very…inefficient.

But here’s the thing. I didn’t have to wait that long. Because I’d already had the appointment with the surgeon, I was merely waiting for the operation. And guess what, I was called for my operation within two weeks.

Nobody had told me that once you see the surgeon you are far more likely to get on his public list. I don’t know if I displaced anyone, but I can’t know for sure. I was lined up for an operation  – which was supposed to take months of waiting – within a matter of weeks, and all for a few hundred euro. The health service work in mysterious ways.

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