A Quote on Health Care Please

The mean and vicious dialogue from those with insurance coverage is so intense that you have to question the compassion of their religious convictions, if there is any. Their perceived selfishness in promoting health care benefits for the uninsured lead me to also question if those with defined benefits have a concern even for friends and relatives without coverage.

What of a parent not yet eligible for Medicare or a grandchild, an adult son or daughter faced with insurmountable expenses? Do those with coverage have the disposition, “Good luck, but you’re on your own.”? Seeking ER care as a last resort may be a final, fatal course of action. Seeking medical attention from a general practitioner requires ‘Full Payment Due At Time of Service”.

Not everyone is fortunate to work for, or retire from, a large corporation that provides company-subsidized health benefits. Unions have successfully fought long and hard for such coverage but people working for small businesses don’t qualify for group rate ‘discounts’.

Although having taken early retirement from the Bell System with a pension that puts me near poverty level, the most important benefit is medical coverage. With modest deductibles and payment of 90% toward doctor and hospital visits, there are still recommended treatments that are ignored because of unknown expenses. I feel fine. Still, I see a family physician occasionally to keep cholesterol and blood pressure levels in check. (When medications brought the levels within normal range, I suggested the medications might not be needed any longer. My ignorance was kindly acknowledged.)

Before a mechanic performs work on a car, the customer is given an estimate and any additional expenses must be authorized by the owner. When dental work needs to be done the costs are reviewed with the patient and provided with a printed predetermination of patient responsibility. A consultation may result in alternative options such as having a tooth removed because the root canal is cost prohibitive.

Generally, quotes on medical procedures aren’t provided unless requested, especially in an emergency room.

A friend was recently involved in an automobile accident. Although not seriously hurt, after four days when neck and back pains developed the family physician sent him to the Brooksville Regional Hospital ER. The charges incurred were in excess of $15K. The automobile medical coverage was $10K. The Coordination of Benefits form submitted to Medicare may pick up the remainder.

It would have been unwise to ignore symptoms that could have proven to be a lifetime problem, but all of the x-rays and scans proved negative. Had the full charges been disclosed he may have opted out of scans of the pelvis and abdomen or declined the Comprehensive Metabolic Panel because he experienced no discomfort whatsoever in these areas.

Those tests alone accounted for over $5,000 in charges. Two x-ray views of the hip came at an additional cost of over $500. The $353.87 fee for the cervical collar is questionable – it was only used momentarily because it caused extreme pain. Perhaps another patient will be charged the same fee for the use of the very same device? I stayed with my friend through the whole ordeal and listened to vague explanations of what tests were being administered but no mention of the whys. It cost $862 just to enter the ER Department.

You have to question if having insurance determines the extent and number of tests that are performed, not for the benefit of the patient but for the monetary gains of the facility.
Of course, the patient is supposed to have faith that a healthcare facility and its doctors and technicians will perform the tests necessary to treat the indicated ailments. In this case, some of the tests were definitely frivolous.

My friend’s experience has greatly affected my view toward seeking emergency room services. Unless totally incapacitated, they won’t like me very much with my mindful concern of both body and pocketbook. The medical profession has the responsibility to promote procedures for the betterment of the patient’s health but it’s also the patient’s right of self-determination to weigh the benefits of any treatment. Without symptoms, what’s the point?

I seldom question the capabilities of doctors and other trained professionals in the medical field, but in the future they may have a hard sell to peddle procedural wherewithal. I doubt a Tony Robbins motivational seminar will help their cause.

Cost containment for the patient’s pocketbook is another important consideration in the healthcare debate. Or is this something else to get nasty about? Oh, yeah, it’s the sharing of healthcare benefits with the uninsured that makes the headlines. That attitude is enough to make some people angry.