Monday, November 19, 2012

My Blood Ran Cold

     Yesterday I received a bill from my medical group. I picked it out of the pile of mail with great trepidation. My insurance is supposed to take care of this, I thought to myself in a panic, that's what I pay them for, over $600 a month! So what could be wrong? Am I going to get socked with some outrageous bill? Did something fall between the cracks?

     I swear, if you don't have high blood pressure and stress-related anxiety problems before you get a medical bill, you sure will afterwards.

     I threw the envelope on my desk; I couldn't deal with this right away; I'd look at it in the morning. So this morning, with shaky hand, I reached over and picked up my letter opener, slit the envelope, took out the bill, and unfolded the sheet of paper. My eyes quickly darted down a short list of items and found the bottom line. I owed $50.

     Whew, $50, no problem. But wait a second, that's my co-pay. And I paid the copay at the medical group when I saw the doctor (good luck getting into see the doctor if you don't pony up your copay).

     So I Xeroxed my credit card slip, plus the receipt I got at the doctor's, and sent it in to the billing address of the medical group. Hopefully, it's just a mistake on their part, and that'll  be the end of it. Although I know my daughter went into an urgent care center when she was here over Christmas 2010. She called her insurance company in advance to make sure her visit was covered. She gave them her numbers, filled out the papers. Long story short, she's still getting bills for that visit, almost two years later.

     Anyway, after mailing my response, I went to slip the bill into my filing cabinet -- and noticed the rest of the itemization. I'd had a problem with my finger, and in point of fact, I actually hadn't seen a doctor. I saw a Physician's Assistant. The PA was actually a nice guy, and seemed perfectly fine, and also seemed to know what he was doing. But he's not a doctor. Yet I had to pay the same $50 copay. Then the group billed my insurance company an additional $125 -- which, I hate to say it, actually doesn't seem that excessive as far as medical bills go.

     The PA gave me a Cordisone injection into my finger. A little vial of fluid. Took him about 30 seconds to administer the dose. And the cost?  $525.

     Doesn't that seem a bit excessive?

     I read in the New York Times today that there is a shortage of some medicines -- not Cordisone, but some others. I'd think that, at $525 a pop, there'd be enough profit it in so that plenty of companies would be making plenty of medicines.

     I don't know what the solution to the health care crisis is. Maybe having me see a Physician's Assistant instead of a doctor, for my non-emergency problem, is part of the solution. But still, the bill for my 15 minute visit was $713. Clearly, something has to be done about the costs of health care.

     I agree with the president and others who think it's important that all American have access to medical care -- at least some medical care, if not the very top-of-the-line care. You know, preventative care, basic care, etc. But at the rate we're going, it seems we'll soon be spending our entire gross national product on health care, with nothing left over for houses and cars and restaurants and vacations. We'll just spend all our time taking care of one another and never get anything else done.Surely, that's not the solution.


Bob Lowry said...

Hospitals charge $5 for a box of Kleenex or $45 for a hydration kit (small plastic water pitcher and glass). One aspirin can easily show up as a $10 charge.

There is absolutely no connection between pricing and reality. For those with insurance the $6,000 charge for a night at the hospital costs the insurance company $650. Which cost is closer to the real cost of providing a service?

Who knows?

Lee said...

Good luck with that. Every time there's a discussion about cutting health care costs, the AMA gears up to fight any reduction of reimbursements for doctors. They are immensely powerful.

We owned family-run pharmacies for 30 years and only WISHED we had the clout of the AMA. Pharmacy reimbursement has been whittled away over the years, which is one of the things that made the small independent pharmacy a thing of the past. They are few and far-between.

schmidleysscribblins, said...

Something is rotton in Denmark for sure.

1. Thousand of workers are being shifted from full to part time because employers must pay for health insurance for all full time employess as of Jan 1. This really makes life difficult if you are barely able to pay your bills with full time pay. Expect 1 or more kids to move back home soon.

2. Our state is wrestling with whether or not to set up its own "mandated" insurance program or let the Feds do it. I see the states of WI and LA have opted out and will let the Feds do it. What does this mean to the national debt in a few years?

3. I have a government health insurance so we are in the front line of "experimentation" when it comes to picking up the tab.

4, David's insurance is from a French company (used to be Bell Labs before the Feds busted up the American owned company). He had a Medicare Advantage plan which covered his eyes and teeth. Now he must buy extra insurance for those items. He also pays more for the SAME prescription drugs.

5. My SIL is probably going to dissolve his business owing to the the new health care law and the expiration of the Bush tax cuts on operations as well as high income earners. Bill's business is a small roofing concern, and family owned since 1870 when it "recovered" from the Civil War. He will be forced to lay off many workers in their 50s who will NOT find new employment.

Conclusion, I can't win and you probably can't either.

Linda Myers said...

We've been retired for two years. The only budget surprise is the cost of medical care - Medicare isn't as good as our employer-paid programs were.

So we watch what we eat and get our exercise. We do have control over that, and hopefully it will help.

The dentist, though - that's another issue entirely.

Stephen Hayes said...

That does sound excessive. Like you, I don't know what the solution is, perhaps adding a bit of the socialism that seems to keep costs down in Europe and elsewhere.

Dick Klade said...

We've been billed so frequently over the years by hospitals and clinics that were already paid by our insurance that we conclude it is deliberate. Probably some folks don't understand or want to take the time to resist the bogus charges and the health providers reap double profits. We really need true universal health care to stop this kind of crap from happening.

#1Nana said...

You are preaching to the choir. My doctor just started me on a new medication. The pharmacist said "It's sort of spendy, are you sure you want it?" I told her I didn't have a choice...sorta spendy was a $200.00 copay. My insurance company paid over $200. also. At my current dosage, I'll have to refill in three weeks. That's a good vacation that I won't be taking!

joared said...

As a service provider, I can tell you we don't receive what Medicare and some insurers pay -- most cases, maybe one-third. All the middle people get the bulk, some situations harvest a double mark-up. Meanwhile, the actual coverage and service the patient receives keeps getting cut back.

Galen Pearl said...

I hear you. When my daughter got very sick on a trip to Paris, a doctor came to the hotel, spent about 45 minutes with her and charged me about $60. Then I went to the pharmacy to fill prescriptions for five different medications. Cost? $35. So go figure.

Friko said...

Sorry, Tom, that sounds excessive. Surely something’s not right somewhere and somebody is being ripped off.

I’d be terrified if I had t rely on your system. You can’t imagine how grateful I am to the NHS. My husband just got his first hearing aid. Total cost: £0.00 for examinations, fittings and delivery of appliance.

He can hear me again. Not so good.

Anonymous said...

Sorry to come in late on this, but I follow sporadically.
My question is:
Where can you get health insurance for $600 a month?
I would retire now if health insurance was affordable.
My wife is 61 and type one diabetic
so not having insurance is not an option.