WE GET WHAT WE PAY FOR,
MORE OR LESS
Journal of Healing – March 19, 2003
By Mary Koch
Medical doctors are beginning to lift a page from the lawyers' billing manual.
The Associated Press recently reported on a growing trend among the nation's doctors,
who are charging for phone calls, prescription renewals, e-mails, photocopies and filling
out forms – the myriad, time-consuming activities that are embedded in the practice
of medicine today.
What took the doctors so long? Gas stations and lawyers have been doing this for years.
You pay extra for "full-service" at the gas pump. Hire a lawyer and your bill
will include itemized charges for photo copies, phone calls, Faxes, etc. Staples and paper
clips are, I believe, still thrown in as part of the service.
Call a lawyer after hours when someone near and dear is picked up for DUI, and you'll
get a bill. Rightfully so.
Yet the most critical medical advice my husband's doctor ever provided came with a
middle-of-the-night phone call. I woke the doctor out of a sound sleep, but neither we nor
the insurance company ever saw a bill. Perhaps life-and-death medical advice is beyond
price. More likely, the doctor knew insurance wouldn't pay for a phone consultation when
he wasn't even on call.
* * *
INSURANCE AND Medicare have also saved a bundle in hospital costs because the
doctor was willing to stay in close contact by phone when we've insisted my husband could
be safely treated at home during bouts of pneumonia. The doctor doesn't see a dime for his
services. Insurance doesn't know what it's missing in hospital bills.
I'm all for doctors charging for the hours they, their nurses and staff spend on
paperwork and phone calls that are demanded but not necessarily paid for by insurance.
A critic of the extra charges on medical bills, quoted in the AP story, complained that
doctors are nickel-and-diming their patients. It isn't nickels and dimes; it's billions of
dollars. Most health care economists agree that an estimated 20 to 30 percent of our
national health care dollar goes for administration. Wouldn't it be interesting to know
just what portion of your doctor's bill is for medical services and what portion is for
the financial paper chase?
* * *
THERE ARE always drawbacks to every sensible solution. If it works for lawyers,
gas stations and doctors, we could be on our way to a fully itemized society. Marketing
opportunities abound.
At the grocery store check-out, your bill will include a rental fee for the cart –
and a coupon for a low-cost, long-term shopping cart lease. You'll also pay a
"feel" fee for picking through the fresh produce, a surcharge for spending extra
time in front of the freezer section on hot days, and a browsing fee for magazines leafed
through but not purchased.
Shoe stores will charge for lacing up every pair tried and rejected and for the little
"footies" provided to customers who neglect to wear socks.
Churches will pass the offering basket several times during a worship service: donate
if you want music, give again if you want a sermon, give some more if you want prayers. In
some cases, they could pass additional baskets for those willing to donate for shorter
sermons or no music.
And yes, dear readers, we in the newspaper business are also feeling the pinch. Your
subscription pays only for the headline and first three paragraphs. Since you have chosen
to read to the end, you are expected to pay our full readership surcharge. Just send your
check, cash or credit card number to the unsecured address below.
(Mary Koch writes about health care issues and her experiences as a
family caregiver. Her husband, retired newspaper publisher John E. Andrist, was severely
disabled by a stroke in 1993. They welcome your letters at P.O. Box 3346, Omak WA 98841 or
visit them on the Internet at www.marykoch.com) |