A youngster visits his Otolaryngologist (hearing doctor) for a routine examination and is billed $175 for the consultation, of which his insurance company pays $145. He came from the barber shop and he mentions that he has an itch in his ear. The doctor takes a look, removes a hair with tweezers, and adds a charge of $215 for “Foreign body removal external ear canal” of which the insurance company is charged the full amount.
The second procedure cost the patient nothing, so why even take note, let alone be concerned? Why chance alienating a physician and possibly someone with whom you may encounter socially some day?
Here’s why. The year earlier that cost of his father’s company insurance plan went up 44%. In order to reduce the cost to a less 11% increase, the protection was diminished by requiring a $2000 deductible for hospital treatment. Two-thousand dollars is a huge figure – perhaps unattainable – for the desk clerks, the room attendants, the grounds keepers, the cooks and servers covered by the policy. Because of excessive health care costs, in part as exemplified above, they have been deprived of the peace of mind and essential health coverage that they had in the past. For many, $2000 deductible is equivalent to no coverage whatsoever!
An isolated example? In the same family the father considered a tooth implant. He was told by his long time dentist that the cost would be $1900 up front just for the surgery. When asked how long the procedure would take, he was advised two hours. Assuming that the dentist was not caring for any other patient during over the course of the time, the almost a thousand dollars an hour rate comes to revenue of around $40,000 a week or $2 million a year. Charge $500,000 for overhead, that still come to a $1.5 million net. Even assuming lesser earnings per hour for other procedures, it still implies that the dentist is netting a huge amount of money each year.
(Ironically, doctors working in fields such as public health and infective diseases may be underpaid in comparison with non-health care professionals.)
A cleaning lady who works in different homes over the course of the week comes up with an immunity condition. She is suffering terribly from sores and fatigue. She has no insurance. She cannot afford ongoing care. She will only be eligible for hospital treatment when her condition has become so advanced that it is life threatening. At that point the direct health care costs plus the social safety net costs will exceed by many multiples what proper care for her condition would have cost. And she may die!
Are these exceptional circumstances? All three have occurred in the Watchdog’s household over the course of a few months.
While other advanced nations provide superior health care for as high as 12% of Gross National Product and the USA is spending 17% and still climbing, there simply is not enough surplus in the economy for investment, modernization and social services.
So long as patients don’t care what they are charged because they are insured, and insurance companies don’t really care because they can up their rates, and doctors and hospital must spend a huge share of their revenues on unnecessary paper work and liability insurance, and there exists no incentive for the practice of preventive medicine and some are being over-compensated for their work, our nation will be bled dry and continue down the road to second class status.
