This is a story about a thing that happened to me. It's not particularly awful, but it's not good either, and it says a lot about what American medicine is like today.
Like Rep. Michele Bachmann, I suffer from regular migraines. They're a curse in my family; my mom has them, my siblings all get them, and several of my aunts and uncles and cousins have them.
One of the most promising new treatments for migraines is botox injections on targeted muscles which are central to the feedback group that creates migraines. I got an appointment at my local pain clinic to be evaluated for botox injections. I've had them before, and had good success, down in Honolulu. Anyways, it took a month to get in, and the doc read me a quick checklist, then declared me a good candidate. She said they would call my insurance company.
A couple of weeks later, I got a call from the pain clinic. Hooray, my treatments are covered! The nurse was quite excited. I've played this game before, though, and I said, "What's my copay?" She had no idea, and she'd call me back.
Another three days. "Well, your copay is 20%, after you fill your deductable." Okay, what's my deductible. "$1000." Okay, how much is 20%? She was confused.
How much are you charging for this procedure? She doesn't know.
Three more days, then a callback.
She has an estimate for me. An estimate? This is a routine outpatient procedure, which uses the exact same materials for every single patient. Anyways, the estimate is $2450. Could be more, could be less. How much more? She doesn't know.
I thanked her, and told her I wouldn't be getting the procedure.
So, to sum up -- private American providers don't know how much they charge for the procedures they do. Insurance companies tell you you're "covered" for a procedure, then charge you a minimum of $1,000. And, in the end, people just don't get care. This is American medicine. And absolutely nothing in Obama's miniscule and incremental health care reform will affect even the tiniest detail in this story.