Andrews Rants

THE MEDICAL INDUSTRY SCAM

Now as many of you know my very own mother is a doctor so this little rant is not some uninformed tirade about the medical industry by someone who is completely ignorant of how it works. I recently received a bill from an ophthalmologist for a procedure performed in his office. The bill was for $775.00 of which my insurance paid $281.10 and I paid my deductible of $70.27 the remaining balance of $423.63 was written off by the doctor’s office. Now here is the problem. I had a skin tag on my eyelid it was a small flap of skin about the size of a pencil lead and about 1/16 of an inch long about the size of a small wart. I would have removed it myself but I thought it might cause scar tissue and cause my eyelid to funk up so I went to a doctor. He came into the room I explained that I wanted it removed he took a pair of small scissors and clipped it off. Pressed a cotton swab to it and then used a little soldering iron to lightly touch it and cauterize the spot. Total time from when he walked into the room 6½ minutes. Yes, I timed it. Then I was back out the door and signing paperwork. If I had known that was all it was going to be I would have done it myself. No pain shot or bandages or fancy freezing solutions just snip dab and there you go. Their expense was the cotton swab and an autoclave round for the scissors. When I saw the bill I freaked out and called their billing department to argue the charges. They told me in no uncertain terms that this was a fair and usual charge. At nearly 100 dollars a minute I find this hard to believe. I was not able to get them to modify the bill and my insurance company upon hearing my story didn’t seem too concerned either. This unconcern and lack of business acumen is why my insurance premiums are so damn high. I personally would not go back to the Johnson City Eye Clinic ever again just because of their business practices. A redeeming quality of the entire thing was that the doctor was nice. Even though he practices there he has no control over the billing on every item that goes through the place. They were willing to bite the write off of $423.63 just to get what they did get. It just goes to show you that the bill was overly inflated with padded prices so they could sucker as much as they could from the insurance and the patient.

Another incident happened at Sycamore Shoals Medical Center last New Year’s Eve. I woke up with a horrible pain in my mid section. I honestly thought I was dying it was so severe. Upon reaching the hospital, they drew blood and x- rayed me and came back with the conclusion that I was passing kidney stones. The whole ordeal was soon over and I hope I never have to go through it again. When I got my bill several weeks later I was concerned about the cost. I requested a detailed billing and when it arrived I received quite a shock. There were two pregnancy tests on the bill in addition to everything else. I called the billing office and was informed that this was standard procedure before an x- ray. Now, for a female, I can understand. You don’t want to zap a growing fetus in the womb without a really good reason. But as most of you are aware, I am a man, one hundred percent ugly, hairy, deep-voiced, mustached, and sometimes bearded man. Sure, I’m fat and got a big belly but I hope that most people can tell that I’m not a lady. The billing department would not budge and I refused to pay the portion of the bill equal to the two pregnancy tests. Weeks later I received a statement from my insurance where they had paid their part of the bill. I was outraged! I called and argued with them and was met with the most nonplussed, I-don’t-give-a-damn attitude that could ever be imagined. I went to the hospitals’ billing department in person and argued my case with the man- hating lesbian in charge and she refused to remove the two tests from my account. I offered to prove to her in a pique of rage that I was a man by showing her I had the right plumbing but she threatened to have me thrown out. I went to the hospital administrator’s office and spoke to a secretary there who assured me that my concerns would be passed on the administrator. That was 3 weeks ago and I have not heard a word but I have received a late notice from the billing department of the Sycamore Shoals Hospital threatening collections action if the bill is not paid in full. Monday, I am going to the Court House and filing a small claims case against them. I will ask that the bill be dismissed and depending on how hard it is for me to find a parking place at the Court House, I might ask for compensation for missed hours of work in trying to resolve this as well as compensation for damage to my credit history if they have reported it. If I get much grief, I might ask for about a bazillion dollars in mental anguish for causing me to doubt my gender and giving me an identity crisis!

On the flip side, I have to look at it from the hospitals’ point of view. The hospitals are out to make a buck just like any other business but unlike other businesses they have to serve everyone regardless of their ability to pay for services rendered. In other words, if John Doe deadbeat goes to Wendy’s and wants a burger he doesn’t get one unless he can pay. This also goes the same at the local Ford dealership or any other business. But he can get a cold, go to the emergency room and they cannot legally turn him away. The result is he gets seen for ‘free’. Sure, they will bill him but he won’t pay and quite frankly there is nothing they can do about it. So their solution is to really stick it to the paying customers to make up the loss. As a result the insurance rates go up, up, up and the cost of medical care escalates beyond control. I don’t think government regulation is the answer though. Sure Canada is supposed to be a prime example of government-managed health care that’s why all the flop headed Canucks come here and pay cash to have their important time sensitive procedures done. They can’t wait 5 years on a list to have a gall bladder taken out or a heart transplant. No the government screws up any sort of business it touches. I don’t know what the answer is but from now on I will refuse to pay any bill that is too high or wrong and before anyone in my family has a non emergency procedure performed it will be agreed upon before what the price is after I have researched the cost and accounted for a reasonable profit margin. For example in Brookes (My Wife) last surgery on her ears where they restored her hearing they charged us 750 on the detailed billing for a disposable set of surgical gloves that the doctor wore during the operation. Using their own stock invoice number I matched it up to the same item in Baxter pharmaceuticals supply catalog from my mom’s office. A case of 100 of these gowns is 22.00 dollars. They are a plastic backed paper gown meant to be used once and then thrown away. Let’s be generous and include another 20 dollars for shipping and ignore the fact that the hospital most likely gets a bulk price which is much less than what a small private practice like my mother has to pay for the same item. That places the cost of each gown at 2.38 if we add in an unreasonably high profit margin say 1000 percent it brings the cost of one gown to 23.80 which covers the cost of the entire order of gowns. How on earth then could they justify 750.00 for this item? I went through the itemized bill spending most of my Christmas vacation cross-referencing prices from various manufacturers. And came up with a revised bill that allowed for a 300 percent profit margin. Their original bill of 47,000 dollars for an afternoon outpatient surgery was adjusted by me down to 11,600 which I thought was still extravagant. I refused to submit the bill to my insurance because those idiots would pay the thing and then raise my rates. After 3 weeks of arguing in which I refused to budge a single cent they capitulated and agreed upon the new billing. Mind you this was not for the physician’s bill it was for the hospital only. The physician charged 975.00 for the entire surgery which I found to be quite acceptable and paid without a complaint. I think the fact that I had their suppliers cost and was allowing for a 300% profit margin and it was still 80% less than what they were charging me made them feel like the thieves they were in trying to slide that bill across. What I wonder is how many people actually question these non summarized bills and just bite the bullet and pay what is asked? I mean who in their right mind pays 12 dollars for an aspirin. You wouldn’t go to the pharmacy and pay 1200 dollars for a 100-count bottle of aspirin why then should you let the hospital charge you that price. Remember my saying “YOU ARE THE CONSUMER NOT A VICTOM” Question the prices and practices of those bills and get them to agree upon beforehand the price for certain procedures if possible. Do not give them your insurance info until after the price is settled upon. Otherwise they will just bill the living hell out of those fools and they will gladly pay it. You can show them you have proof of insurance but that you are not paying until some things are agreed upon first. I mean you don’t go grocery shopping and guess what the price of a can of beans is or go to buy a car and have to wait until after you drive off before you are hit with the bill. Demand satisfaction. If more people will fight back then perhaps the medical industry will do something to correct itself.