2265 North Clybourn Avenue    Chicago, IL 60614    P: 773.296.6700     F: 773.296.1131

Knowledge Base

Welcome to our extensive library of articles on health concerns and conditions, alternative therapies, nutrition, nutritional supplements, and much more. Acupuncture / Traditional Chinese Medicine Aging Allergies & Food Sensitivities Alternative Therapies Big Pharma Evils Bone Health Candida (Yeast) and Parasites Cardiovascular Health Case Studies Chiropractic & Physical Medicine Dermatology Digestion Diseases Ear, Nose & Throat Environmental Sensitivities Eye Care Fibromyalgia & Chronic Fatigue Fitness & Exercise Health Insurance Issues Healthy Lifestyle Immune System Inflammation Integrative Medicine Lyme Disease & Morgellon's Disease Meditation & Spirituality Men's Health Mental Health Nutrition, Nutritional Supplements, Vitamins, & Herbal Remedies Pain Management Respiratory Health Seminars Sexual Health Testimonials Thyroid, Adrenal, & Sex Hormone Issues Urinary Conditions Weight Issues Women's Health Workshops

Franz Kafka and Health Insurance

Posted 11/02/2010

I visited the ancient city of Prague in the Czech Republic a couple of weeks ago, where the novelist Franz Kafka, now considered one of the most influential writers of the 20th century, has grown into a local cultural hero.

Being a dead hero might be the best option given what else fate might have had in store for Kafka had he not died rather young in 1924. A few years later, the Nazis would have gassed him at Auschwitz (as they did his sisters), and after the war the communists would have sent him to Siberia as a “decadent bourgeoisie.”

So as I moseyed through the Kafka Museum, gathering along the way my Kafka T-shirts, cups, and tote bags and pondering his stories and novels, I couldn’t help but notice a parallel between his themes and our health and disability insurance.

A recurring Kafka theme is the helplessness of the individual against an endlessly complex bureaucracy set in buildings with long corridors and closed doors and staffed by vaguely threatening, always unhelpful, clerks. The protagonist is always told “nothing can be done” and to “come back tomorrow.” To get a feel for this nightmare,
you could read one of Kafka’s two great novels, The Trial or The Castle , or simply watch Tony Perkins and Orson Wells in the masterful 1962 film “The Trial.”

Every day I hear sentences from patients concerning health insurance that could be quotes from Kafka:
• “They’re never really rude, but they’re never helpful.”
• “They never return my calls.”
• “The person I speak to one day always disappears when I call back.”
• “I get directed to nonexistent connections.”
• “I’m told they lost my paperwork.”
• “They claim I wasn’t covered when I was sick.”
• “I’m not in their system.”

And believe me, it’s not just private insurers. Medicare, Medicaid, and the VA system are just as bad, just as inept, unhelpful, and vaguely threatening.

Physicians, as you may know, face Kafkaesque barriers when they try to collect for professional services honestly rendered. Claims are endlessly delayed, paperwork “lost,” definitions of what is “covered” and “non-covered” changed randomly, all with one single-minded purpose: the insurance company keeping as much money as it can for itself.

With such a gloomy picture (and, by the way, there are no happy endings in Kafka– ever), what might both patients and physicians do?

Most physicians now simply join large group practices and let the group’s own billing bureaucracy fight the bureaucracy of the insurance industry in US healthcare’s version of The Hundred Years War. In a slow but steady trend, especially in larger cities, individual primary care physicians are simply opting out of all insurance billing, becoming “cash only.” At the end of your office visit, you pay in full for your services and are given a completed insurance form for you to submit to your insurer, with the attitude “it’s your insurance–you deal with them.” (Actually the success rate is better when you submit than when the doctor does).

A second trend is the conversion of primary care offices to “concierge practices.” In this system, you pay your physician a fixed amount of money every month, usually around $150, and for this, by keeping his or her practice relatively small, you get 24/7 access to your doctor, a next-day appointment if needed, and other niceties available to the well-off. You’re given a completed insurance form after every visit, which allows you to get some of your money back. Lab work and hospitalizations are covered by your regular insurance.

Clearly, this system is for the financially secure. The word “concierge” alone should tell you that (they’re also called boutique practices).

I’ve watched four neighboring primary care practices go “concierge” during the past few weeks, and there’s now a private company that guides a physician through the conversion process, taking a percentage of the profits for its work.

This to me is a most worrisome trend, and let me assure you WholeHealth Chicago is not going this route. With a serious shortage of primary care physicians, it’s more than unfortunate that the remaining few might be available only to the wealthy.

What can you do to avoid the endless corridors, closed doors, and telephone menus filled with “prompts”? (Kafka would have loved those.)

• Avoid the entire system as much as possible by keeping yourself healthy. You (the patient) will not need any of us (doctors) if you very consciously eat a healthful diet, keep your weight under control, regularly exercise, and avoid risky lifestyle choices (like smoking and excess alcohol).

• Learn to take care of minor health problems yourself. Most illnesses are short-lived, self-limiting, and need no medical intervention. If you develop a condition that might require an antibiotic, such as a bladder infection, use one of the mini-clinics at a Walgreen’s or CVS and pay cash. They’re far less expensive than doctor’s offices.

• Use alternative medicine. Chiropractic, traditional Chinese medicine, and herbal medicine are all less costly than conventional Western medicine.

• Learn the phrase “Do I really need that?” when talking to health care providers about expensive tests, prescription drugs, surgical procedures, and even alternative therapies like endless chiropractic or acupuncture sessions.

• Shop around. An MRI of the spine costs about $2500 at Northwestern and about $350 at one of those free-standing MRI centers. Often, the smaller centers even have better equipment. Here are two sources for investigating local costs: The Artists’ Health Insurance Resource Center and LesliesList.

• If you’re essentially healthy, the only health insurance you really need is Major Medical or Catastrophic. Both cover only emergency room treatment and hospitalization (either of which could bankrupt you in days). Health insurance companies rarely promote these policies because they don’t generate much revenue. They’d rather sell you pricey “cover everything” policies because people rarely use them. I wrote about these in an earlier health tip.

In sum, if you want to avoid the endless corridors and closed doors of your own personal Kafka healthcare novel, your very best bet is to…

Leave a Comment


  1. Addie says:

    This is a really helpful newsletter with great advice –especially taking care of minor health problems by yourself. Another help for these issues I found in Wayne Dyer’s book Pulling Your Own Strings, not a spiritual advice book but an earlier book on asssertiveness. In it he describes how employees of bureaucracies are not there to help the complainant/customer/client/patient. They’re there to get rid of you. Overworked, overwhelmed, usually underpaid, according to Dyer, these employees use all kinds of tricks to get rid of you. Armed with this knowledge, it’s easier to learn how to be persistent, to demand attention without anger, and to reach the person you need to speak to. I highly recommend Dyer’s book.

  2. mary jennings says:

    Dr. E,

    Once again, an outstanding article, which I have sent to my email buddies. BUT this is something that needs to get to a much wider audience. Have you considered submitting it to the Tribune, Huffington Post and maybe send a copy to the White House. Thank you for your timely and wise words!

    Mary and John Jennings

1 Pings/Trackbacks for "Franz Kafka and Health Insurance"
  1. […] As I flipped through my new booklet, encountering phrases like “you must,” “you should,”  “if you miss your deadline,” “restrictions,” and “you can appeal,” I couldn’t help but think again of Franz Kafka’s chilling novel The Trial, to which I’ve referred in the past when discussing our health care system. […]

Join our Newsletter

Get health recommendations, delicious and time-saving recipes, medical news, supplement reviews, birthday discounts, and more!

BIRTHDAY

Health Tips

Dr. Edelberg’s Health Tips contain concise bits of advice, medical news, nutritional supplement and pharmaceutical updates, and stress relief ideas. With every Health Tip, you’ll also receive an easy, delicious, and healthful recipe.

When you sign up to receive Health Tips, you can look forward to Dr. Edelberg’s smart and very current observations arriving in your in-box weekly. They’re packed with helpful information and are often slightly irreverent. One of the most common responses to the tips is “I wish my doctor talked to me like this!”

Quick Connect

Get One Click Access to our

patient-portal

The Knowledge Base

Patient education is an integral part of our practice. Here you will find a comprehensive collection of staff articles, descriptions of therapies and nutritional supplements, information addressing your health concerns, and the latest research on nutritional supplements and alternative therapies.

Join our Newsletter

Get health recommendations, delicious and time-saving recipes, medical news, supplement reviews, birthday discounts, and more!

BIRTHDAY

Upcoming Workshops

*Yoga Therapy for Digestive Health
1-3 pm Saturday, April 1

In this workshop you will:

  • Discover how biological and environmental factors shape the health of your gastrointestinal system.
  • Learn specific breathing techniques to reduce stress and feel more grounded in your body.
  • Practice yoga postures that soothe, detox, and ground the entire GI system.
  • Practice a mindful eating exercise (on gluten-free, dairy-free, and sugar-free foods) to explore your relationship to food and cultivate fulfillment.

Registration
Insurance-eligible for WholeHealth Chicago patients.
$50 registration for self-pay or those new to WholeHealth Chicago.
Space is limited and registration is required. Register by calling (773) 296-6700.
More>>

Questions? Please email Renee here.

 

*An Introduction to Healing Touch
Thursday, April 6, 9:30-11:00 am
Would you like to find relief from pain and anxiety without medicine?
Are you interested in addressing the root cause of your symptoms and health concerns?
Would you like to explore ways to navigate life transitions and find more focus, creativity,

Introduction to Healing Touch offers:
-an overview of energy medicine
-specific methods that can be administered to others and utilized for self care
-support for health and well being in body, mind, and spirit

$25 Registration Fee; sign up online or call WholeHealth Chicago at 773-296-6700

Katie Oberlin, HTCP/I
Healing Touch Certified Practitioner/Instructor
More>>

 

*Awakened Body, Quiet Mind
An innovative workshop series for relieving mind/body stress and tapping into your true power and natural health.

Four Group Sessions with Meghan Roekle, PsyD.

Four meetings using a unique combination of embodiment meditation and mental inquiry for deep healing.

Fridays from 6:00-8:00pm beginning April 13th.  Register online or call 773-296-6700
More>>

*April Lyme Academy: Restorative Yoga for Lyme Disease
April 18th 5:30pm-7pm
Join WholeHealth Chicago’s Yoga Therapist Renee Zambo to learn breath work that combats brain fog as well as movements to reduce pain and tension. These gentle movements can be done seated, laying down, or even in your bed at home, and will leave you feeling lighter and more content.

Registration is open to patients of Dr. Kelley and pre-registration is required. Please call WholeHealth Chicago at 773-296-6700 or see a Patient Services team member to sign up.
Read More>>

Recent Health Tips

  • Trump’s New American: Sick, Dirty, Dumb, and Homeless

    Trump’s New American: Sick, Dirty, Dumb, and Homeless

    You’ve got to admit the past few days have been Washington nail biters. There was Obamacare (also called the Affordable Care Act, or ACA), slowly mounting the stairs to the guillotine. Up on the platform, blade-release rope in hand, was Donald Trump, quite GQ in …Read More »
  • A Medical Flip Flop for Chronic Fatigue Syndrome

    A Medical Flip Flop for Chronic Fatigue Syndrome

    Initially I thought I’d misread the conclusion of the re-analysis of the standard treatment for chronic fatigue syndrome (CFS). “The claim that patients can recover as a result of (cognitive behavior therapy) and (graded exercise therapy) is not justified by the data, and is highly …Read More »

March Sale: 20% Off SophytoPRO Skin Care Products

Topical Functional Skincare For Total Skin Transformation
SophytoPRO products are topical supplements that support good microbiome and healthy skin function.  More>>