Exasperated Man Versus the Machine

One Man's Fight Against Healthcare Absurdity

The older I get, the more I find myself interested in the details of my health insurance (strange how that works). Over the years, I have written about several exasperating experiences with our modern healthcare system, but this past week I have taken my exasperation to a new level--activism.

What fomented my newfound exasperation was the news that the State Treasurer in North Carolina, who oversees the state employee health insurance plan, decided to make our local healthcare system, Atrium Health, a non-preferred provider. This meant my plan would no longer pay for visits to specialists in Atrium Health (nowadays you have to use specialists for seemingly everything) unless I hit a $5000 deductible, at which point our plan would pay out a whopping 30% coinsurance above the deductible, meaning to afford an X-ray for my kidney stones I would need to sell a kidney.

Instead of using Atrium, the new plan wants us to change providers to a preferred provider, Novant or UNC Health. Beyond the hassle of changing doctors and getting in somewhere new, the problem here is that Atrium owns the only two hospitals in the county, and nearly all our local providers and specialists are in the Atrium system.

Atrium Provider in Kings Mountain, NC

So we are more or less being forced by financial necessity to change doctors and travel to Charlotte for basic care. I’m not an expert in healthcare policy, but that seems like a counterproductive policy for encouraging preventative care. Do they know how hard it is to get rural men to go to doctors in the first place? And now they’re expecting us to proactively venture to the city? (Furthermore, as a society, do we really want a bunch of men puttering about in pickup trucks on busy city streets?--talk about a recipe for a healthcare disaster).

As a seasoned government employee, I’m used to being slapped in the face by cuts to benefits, but this felt like a kick in the teeth. So I decided to channel my incredulity into phone calls and emails. I contacted the State Employees Association of North Carolina, and they encouraged me to send emails to my local elected officials, which I did, and I even left a message with the administrative assistant for the State Treasurer. I was actually surprised when I later got a call back from one of the State Treasurer’s staffers. He tried to explain to me that if there were no preferred providers in my county, I could still use “access” providers, a type of mid-tier provider between preferred and non-preferred. I tried to explain to him, using my dulcet tones of exasperation, that there are hardly any access providers here either.

“Atrium is the only game in town!!!!” I erupted.

“Oh,” he responded, “I didn’t know that. I will relay your concerns to the treasurer,” at which point I apologized for my dulcet tones of exasperation.

After sending off my volley of emails and calls, I decided to let things be, knowing I had voiced my opposition, and I didn’t want to have an aneurism by thinking about how much it would cost to have an aneurism. So a few days later, I was even more surprised when the following email popped up in my inbox.

PARTIAL VICTORY!!!!! EXASPERATED MAN TRIUMPHS!!!!

Kudos to Ted Alexander, our state senator representing Cleveland County. I’m not sure what he did or said, but apparently his dulcet tones had some effect. Atrium Cleveland will now be considered an “access” provider, meaning we can keep our local doctors and old copays without having to hit a $5000 deductible first.

Since the exception is only for Atrium providers in Cleveland County, folks in lots of other counties who use Atrium will still be in the same absurd situation. Again, I’m not an expert in healthcare policy, but anybody who thought it was a good idea for the state’s largest health insurance plan to make the state’s largest healthcare system a non-preferred provider probably isn’t either. Serenity now.

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What is your craziest healthcare experience?