Yoga greed

The yoga studio is stylish: stripped wood floors, exposed brick walls, ambient music playing in the background. Among the comfy sofas in the waiting area, a wide selection of expensive yoga clothing is displayed for sale. Burlington has a lot of yoga studios, but I can’t name this one in case they sue me. I know that wouldn't be very yogic behavior on their behalf, but underneath all the window dressing they’re not a very yogic place. 

The receptionist was sipping something beige and gloopy out of a see-through plastic cup. We’d met before. She wants to be a yoga teacher but hasn’t completed her training yet. If she hadn’t already told me how passionate she is about holistic health and how much she believes in maintaining the purity of the human body, I would have sworn she had a hangover.

Ideally, I wanted to see the finance manager, but the finance manager doesn't have a fixed schedule and hasn't been returning my calls. The studio prides itself on upholding a laid-back approach to the work place which, the receptionist had explained in one of our earlier conversations, counters the relentless, insidious corporate ethos of so many other businesses. It's possible this makes the staff happy, but it doesn't contribute towards excellent customer service. 

I smiled, said good morning, and explained I’d like to talk about the bills I'd been sent; and the receptionist winced slightly - which could have been hangover related, or might have been her reaction to me speaking about nasty materialistic money-type stuff.  

‘What exactly don't you understand?' she asked, flicking back a strand of her unbrushed brown hair and fiddling with the edge of one of her big silver earrings. 

'I don't understand why I owe you several hundred dollars when I paid for all my sessions up-front,'  

'I'm sorry if I gave you the impression that you'd paid,' she said.

'But I did pay,' I interrupted. ‘You swiped my credit card, I signed, and you took money from my account.'

'Actually, that doesn't mean you paid.' She scowled at me. 'We don’t know how much to charge for a session until we've contacted your insurance company.'

Medical insurance in the US is complicated:

1. The majority of people pay into some kind of medical insurance arranged by their employer. 
2. If you can’t pay for medical insurance, you’re screwed. (Iola’s school in Cambridge hosted a fund-raiser last year for a family whose 8-month old baby fell ill and died within 2 months. The family were about to have their home reclaimed and to declare themselves bankrupt because they couldn’t pay their dead child’s medical expenses. When I mention this to American friends, they can all think of similar scenarios with people they know). 
3. Some insurance providers operate 'co-pays', where the individual pays a flat rate up-front for each medical visit; other insurance providers have a 'deductible' which means the medical provider bills the insurance company who then bill the individual. The amount of the 'deductible' varies from insurance provider to insurance provider, from employer to employer, and from individual to individual. 
4. Once the 'deductible' amount has been met, a greater portion of medical costs are then covered by the insurance provider. (It has taken us several years to pay the deductible and other bills related to Maya breaking her leg nearly three years ago; it will likely take us several more years before we have paid all the costs associated with breaking my neck. Illness and injury in the US are comparable to taking on an additional mortgage.)
5. Different medical providers charge different amounts for the same services. So, for example, a mammogram might cost several hundred dollars with one hospital but several thousand dollars with another. 
6. And the same medical provider might charge different amounts for the same service depending upon the client's medical insurance provider. 

It is all very incestuous and almost impossible to untangle, and nobody likes talking about it very much. In the yoga studio in Burlington, the receptionist stared at her computer screen, as though hoping I might go away. 

'If I hadn't shown you my insurance card, would I owe you money? ' I asked. 

‘No,’ she answered. ‘If I hadn’t contacted your insurance company, the amount you'd paid would have covered the service.’

‘So it’s like going to the general store, and buying a gallon of milk.’ I began. ‘I pay $4 for the gallon of milk, but mention that Fred has given me the money to pay for the milk, at which point you decide to charge me $6.’

There is a particular facial expression some people use when they think they're talking to the village idiot; it tends to combine a tight plastic-y smile, clenched teeth and narrowed eyes. The receptionist put on her 'talking to the village idiot' face and spoke very slowly, 'You paid the amount it would have cost if you didn't have medical insurance. But you do have medical insurance. So you now owe this much money,’ she pointed at the bills I had put on her desk.

When I tried to explain I didn't think it was fair, the receptionist lost interest in our conversation. It's possible that, before trying to become a yoga teacher, she aced an assertiveness training course.'I'm not sure what you want right now,' she said. 'Some people like to vent because they feel bad about something, and if that is what you would like to do right now I am willing to listen. Other people want to understand a problem and, if that's what you want, then I have explained it to you and I am willing to repeat my explanation.'

I tried to take a slightly different tack. 'For my first session, I booked a yoga therapy evaluation. I was told it would cost $140. I paid $140. The session took slightly less than the hour I was told it would take. You have now sent me a bill which states I also received 'Therapeutic Exercise' for $110 and 'Neuromuscular Re-education' for $40. I did not ask for those services and, until I received this bill, I did not know I had received them.'

'How would you know?' she asked. 'You are not a medical expert.'

I still like yoga. I used to be able chattarunga with the best for them and my corpse pose is an absolute killer, but most yoga poses are more difficult for me now that I’m metal-necked and nerve-damaged. I'm pleased the receptionist and the finance manager benefit from working in an anti-corporate environment, even if it is funded by their extortion of additional funds from unsuspecting insurance providers. And I hope the finance manager returns my telephone calls one of these days. I haven't paid the bill yet because I still don't understand what I am paying for, so I'm sure she'll soon track me down with a reminder. While I’m waiting, I’m going to download a few yoga lessons from Amazon and set up my yoga mat in the corner of my bedroom. It's not a particularly stylish room, it lacks some of the atmosphere of the studio in Burlington and I'm sure there are ethical issues associated with using a large corporation like Amazon, but at least I'll know exactly what I'm paying for.