Health care Hell

I am a healthy 25-year-old woman and when I got bronchitis in January I learned how awful health care in America is. As a former copy editor for a daily newspaper in New Mexico I worked nights usually until after 12 a.m. As I was finishing work one night I started to feel very unwell (muscle pains, headache). I went home and got an awful coughing fit and coughed up some bloody sputum. Naturally, I was scared, but I wasn't certain that my problem required immediate care. I called the local hospital hoping to speak with a doctor or nurse about my symptoms and hopefully gauge the severity of what I was feeling. They were unwilling to advise me -- perhaps they are required by law not to do so -- but if someone had just been able to tell me that my symptoms likely meant I had bronchitis, perhaps my fear of the unknown would not have propelled me to go to the hospital in the first place. The first inadequacy of our health care system is the inability to reach someone knowledgeable at an hour that doesn't fall between 9 and 5. Why not just wait until the morning most people ask? "What guarantee is there that someone will even be able to see me in the morning?", I say. So I went to the hospital, which is contracted with my insurance plan through a PPO. Unfortunately, not every doctor in the hospital is in my plan network. I had assumed, foolishly, that the doctors in a hospital that is contracted with my PPO would also, logically I feel, be contracted with my PPO. One hospital, one network. But that was not the case. I had an insurance claims rep explain it to me in hopes that it might be recorded on the phone and the sheer ridiculousness of the notion would be documented. The conversation went something like this:

Me: So you are contracted with the hospital but not the doctors in the hospital?
Rep: Yes.
Me: So depending on which doctor I saw in the hospital with which you are contracted I could or could not be covered?
Rep: Yes.
Me: That doesn't make sense.
Rep: That's the way our health care system works.

The increased fragmentation of our health care system, where hospitals but not the doctors who work in them can be contracted with a PPO, is crazy. The rep also told me that is why you have to call your insurance provider before you see any doctor in the hospital (with which they are contracted) to make sure that doctor is really in network. Imagine if I had been in a dire emergency.