PERSPECTIVE FROM THE 19^TH HOLE: This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus use an image from my favorite sport, golf. Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all of my professional positions, including as a Congressional press secretary in Washington, D.C., an Oregon state government manager in Salem and Portland, press secretary for Oregon’s last Republican governor (Vic Atiyeh), and a private sector lobbyist. This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.

If I was still a hospital and health insurance lobbyist, “this” debacle would make more than a little irritated.

What the “this?” As reported by KGW-TV, a story chronicles an unbelievable screw up on the part of all parts of the health care establishment.

Here are excerpts of the story.

“LA CENTER, Wash. — Ryan Hansen knew something was wrong. The 15-year old felt dizzy, his heart raced and his hip hurt when he walked. So his mother took Ryan to an urgent care in Vancouver. An advice nurse agreed that something was very wrong. Ryan needed to get to the emergency room immediately.

“Ryan’s mother, Jamie Hansen, rushed her son to PeaceHealth Southwest Medical Center. After a battery of tests, emergency room physicians surmised Ryan had some type of infection attacking his heart.

“The doctors at PeaceHealth warned they couldn’t provide the specialty pediatric care Ryan needed so they immediately ordered an ambulance to take him across the river to Randall Children’s Hospital at Legacy Emanuel in Portland.

“Before loading into the ambulance, Ryan’s mother asked the hospital staff about insurance. She knew PeaceHealth in Vancouver was in-network, but worried Randall in Portland was not covered by her health insurer.

“After a week at Randall, including four days in the pediatric intensive care unit, Ryan made a full recovery. He was sent home.

“A few weeks later the first hospital bill arrived: $112,387.

“Hansen’s insurer, LifeWise Health Plan of Washington, provided little relief. After processing the claims, Hansen said LifeWise offered to pay $15,396 – just a small portion of the total hospital bill.”

This looks like what it is – all health care establishment entities pointing figures at others, not taking responsibility for various mis-communication, or worse, outright lies.

Hansen’s case is a telling example of how powerless patients can be in the complex world of medical billing. Hospitals don’t tell patients how much they charge. Patients don’t know how much insurers will pay until they get their bills.

LifeWise and Legacy blame one another for the hefty bill, leaving the Hansen family caught in financial crosshairs.

Washington Insurance Commission Mike Kreidler has now gotten into the act. No susprise there.

“What angers me most about this case,” Kreider told KGW, “is that Ms. Hansen — who knows how the health care insurance system works – still got stuck with huge surprise bills for her son after an emergency.

Kreidler called the practice “balance billing,” which occurs when a healthcare provider bills a patient for the difference between what the patient’s health insurance chooses to reimburse and what the provider chooses to charge.

Kreidler is proposing legislation in Washington that would help protect patients from this type of surprise medical bill.

The issue – and prospective legislation – also could take hold in Oregon as the 2019 legislative session convenes after the first of the year.

As a hospital/health insurance lobbyist, I would prepare for the tough questions, which are more than warranted in response to such situations. I might even try to talk my clients into proposing legislation so as not to be caught in the lee of other proposals.

To me, as a now-retired health care lobbyist in Oregon, I would contend that hospitals and health insurers aren’t all bad, as often is contended by their opponents at the Capitol in Salem. But stories like the one KGW-TV uncovered often resonate for awhile and make it difficult to contend that one’s clients are trying to do the right thing.