Haggling For Healthcare
This morning, as I left an excellent physical therapy session at University Hospital, I felt so happy that I have assembled a great team of therapists! Yesterday I had acupuncture followed by a brachial plexus session. This morning, in spite of limited function and range of motion, I felt great as I went to PT!
Waking up pain-free is a big deal and should not be taken for granted.
In May 2025, my family physician told me that I was boringly healthy. Approximately four weeks later, all of that changed. I was someone who was completely disinterested in healthcare and insurance, except for numbers on a budget spreadsheet when I was the Director of a Metropark system.
That has changed.
My dear wife just got a notice that the cost of her supplemental healthcare coverage was going up 80% this year. There may or may not be alternatives. In addition to the ever-changing and evolving costs and the myriad of details involved with managing insurance, there is the issue of the quality of service.
Northeastern Ohio is globally recognized for its healthcare providers—both University Hospital and the Cleveland Clinic are world-renowned. That being said, while both have remarkable attributes, in other regards, they miss the mark. The process of “therapeutic recovery” has been an interesting adventure. First of all, I was surprised to find my therapy was divided into two categories: physical therapy and occupational therapy. One would intuitively think that physical therapy would apply to all manner of physical motion and activity, and occupational therapy would apply to lifestyle and managing fundamental daily activities. I had no idea that physical therapy stopped somewhere along the arm and occupational therapy took over from that point down to the hand.
This begs the question: Is the elbow "no man’s land?"
My experience with the Cleveland Clinic occupational therapy program has been excellent; however, my experience with their physical therapy program has been very disappointing—and please remember, I was looking for a therapeutic team. I have seen somewhere in the neighborhood of 12 different physical therapists associated with the Cleveland Clinic. I would say three were great; the rest were somewhat indifferent caregivers or clinical at best. Ultimately, I gave up on the Clinic because I felt the Clinic had given up on me.
In June, I received an order for extended PT from my Clinic shoulder doctor. At my next scheduled PT session, I was told I was done with physical therapy. It seemed my age was a factor, as well as my score on the quantitative measurements the Clinic uses. This survey, by the way, did not account for the diversity of my injuries.
So I had to “shop around.” Shopping for healthcare providers and practitioners is a procedure that I never expected to deal with, and I’ve never had any practical experience with. I had no choice, as my hope of a collaborative therapy team approach to my recovery was dashed apart by what I perceive as a quantitative versus qualitative approach in the Clinic’s physical therapy department. This forced me to shop around to build a comprehensive team. Hence the title for this essay: “Haggling For Healthcare.”
I am in a relatively luxurious position of not worrying excessively about healthcare costs; however, navigating through my insurance programs and the billing procedures from hospitals and caregivers has been concerning. Last year, for example, I had two helicopter rides. Both of those were billed in the neighborhood of $70,000. I have no idea what my total healthcare expenditures were for 2025, but it had to be a staggering number.
Looking back to the date of my crash, I’ve received some remarkable, lifesaving care. I’ve made remarkable progress, and I'm still alive. That being said, in addition to the mental and physical demands of healing, I have been appalled at some of my experiences. I found myself thinking: We all need personal advocates to help us navigate through the bureaucracy of our contemporary healthcare system. Then an internal voice screamed:
“No… no, we don’t!”
We don't need another layer of bureaucracy. What we need is a simpler, more compassionate system. We do not need a system so layered with bureaucracy that it gets bogged down by economically driven networks, procedural quotas, and quantitative measures that strip away caregiving compassion and qualitative recovery.
An old woman in a market negotiating with vendors comes to mind. To quote Mick Jagger from the opening lyric in Mother’s Little Helper: “What a drag it is getting old.”
Especially when you have to haggle just to heal!