This iReport is part of an assignment:
Bitter pill: The cost of health care in the U.S.
Providing Minor Healthcare Services in America: Welcome to the O.K. Corral of Billing Practices
Early-afternoon on December 23, 2005 in Marina del Rey, California, I couldn’t take another minute of a blinding headache caused by a severe sinus infection. I called several “clinics” in the area, but scheduling an appointment at the last minute proved impossible – especially since I was a cash-paying customer. (My COBRA insurance had expired a month earlier.) Finally broke down and headed to Daniel Freeman Medical Center’s Emergency Room.
With no health insurance to poke holes in, I convinced the lady at the ER window that I, indeed, had the financial resources to cover the bill. (How much could it cost anyway? All I needed was to see a doctor and get a simple prescription for antibiotics.) I took a seat in the waiting area and remained there for three hours. (Granted, a sinus infection isn’t a life-threatening condition.) Fortunately, an aquarium nearby contained many of the same characters as the 2003 film “Finding Nemo,” which provided a pleasant distraction as the minutes slowly ticked away. Catching up on two year’s worth of People Magazine also helped pass the time...
Three-and-a-half hours later, that mysterious door to the back finally opened, and a very gruff, clipboard-toting nurse yelled out my name (she could’ve easily moonlighted as a Roller Derby finalist or a “Raging Bull” contender against De Niro). She led me down a long hallway and into an exam room. “The doctor will be with you shortly,” the nurse barked. She shoved a file folder into a plastic tray on the door and slammed it shut.
Once again hanging in chronological limbo, and being an admitted numbers freak with anything having to do with money, I spent a few minutes trying to figure out just how much all of this was going to cost. $500? $1,000? I couldn’t get an exact handle on a number, but both figures seemed acceptable at the time, particularly considering that my pain tolerance was rapidly nose-diving into the abyss. Money wasn’t really that important at the moment when compared to my sinus throbbing-induced misery.
Then about a half-hour later, I could hear footsteps quickly approaching. I glanced down at my watch; it was exactly 6:00:00 pm. The door suddenly swung open and the doctor bolted in, while scanning my file like it contained classified information.
“Okay, let’s see,” he uttered. “Sinus infection today, huh?”
“Yes, I’ve had them a couple of times before,” I replied. “Unfortunately...”
While scribbling feverishly on a patient form, the doctor asked, “In pain? Want some Vicodin?”
“No, just need some antibiotics to kick the infection, Doc. Gave up the hard stuff a few years ago,” I admitted, “including Heineken and Jack Daniels. Regular Tylenol will work.”
He chuckled slightly, and then pulled a prescription pad out his jacket pocket.
Seconds later, the doctor handed me a script for five days worth of Amoxicillin, and then he exited the exam room and scurried down the hall. I looked back at my watch; it was precisely 6:00:27 pm. Not even a half-minute with him after a four-hour-plus wait. But I was fine with that, now that I had some real medication coming. It was time well spent.
I put on my coat and headed to the business office to square-up the bill. After a few minutes of standing in line, the clerk informed me that Freeman’s billing computer system was down and she couldn’t pull up my charges. “We’ll just mail it to you,” she said.
Cool. I hit the nearest exit. And without delay.
Two weeks went by and, as promised, the bill arrived. Total charges: $2,200. That’s right, over two-grand to spend four hours at Daniel Freeman Medical Center watching fish, thumbing through People Magazines, and spending less than thirty seconds with a doctor. Moreover, the Amoxicillin – without any prescription drug plan coverage – ran me another $115. Fortunately, after several back-and-forth haggling sessions with the hospital’s billing office, Freeman eventually backed down on the $2,200 bill and accepted $500 in cash for the whole thing. (I won, sort of.)
The point of my story here...is easily punctuated by an identical incident that occurred nearly ten months later in early-October 2006: same sinus infection symptoms again, but this time I had major medical health coverage, thanks to a new employer. Consequently, my out-of-pocket cost to see the doctor (for about three whole minutes): only $20. And my co-pay for Amoxicillin at CVS? A mere $4 bucks.
Only the American healthcare-industrial complex can justify such “Wild, Wild West”-like pricing variances...just for a severe case of the sniffles. (The only time $2,315 versus $24 for the same thing ever made sense to me was during my college days...when I was hammered to the gills at some kegger.)
Obviously, Daniel Freeman Medical Center was trying to string me up with charges for a lot of other patients’ unpaid bills -- just like all other major medical centers in the U.S. do. (Right, M.D. Anderson?) And I know this is true: I’m a licensed insurance agent and health plan underwriter. Having reviewed thousands of medical bills, from Pennsylvania and Florida to Texas and California, one thing is abundantly clear: America’s healthcare providers are the O.K. Corral of Billing Practices. “Just bill ‘em first, Festus, and avoid questions later...”
With no health insurance to poke holes in, I convinced the lady at the ER window that I, indeed, had the financial resources to cover the bill. (How much could it cost anyway? All I needed was to see a doctor and get a simple prescription for antibiotics.) I took a seat in the waiting area and remained there for three hours. (Granted, a sinus infection isn’t a life-threatening condition.) Fortunately, an aquarium nearby contained many of the same characters as the 2003 film “Finding Nemo,” which provided a pleasant distraction as the minutes slowly ticked away. Catching up on two year’s worth of People Magazine also helped pass the time...
Three-and-a-half hours later, that mysterious door to the back finally opened, and a very gruff, clipboard-toting nurse yelled out my name (she could’ve easily moonlighted as a Roller Derby finalist or a “Raging Bull” contender against De Niro). She led me down a long hallway and into an exam room. “The doctor will be with you shortly,” the nurse barked. She shoved a file folder into a plastic tray on the door and slammed it shut.
Once again hanging in chronological limbo, and being an admitted numbers freak with anything having to do with money, I spent a few minutes trying to figure out just how much all of this was going to cost. $500? $1,000? I couldn’t get an exact handle on a number, but both figures seemed acceptable at the time, particularly considering that my pain tolerance was rapidly nose-diving into the abyss. Money wasn’t really that important at the moment when compared to my sinus throbbing-induced misery.
Then about a half-hour later, I could hear footsteps quickly approaching. I glanced down at my watch; it was exactly 6:00:00 pm. The door suddenly swung open and the doctor bolted in, while scanning my file like it contained classified information.
“Okay, let’s see,” he uttered. “Sinus infection today, huh?”
“Yes, I’ve had them a couple of times before,” I replied. “Unfortunately...”
While scribbling feverishly on a patient form, the doctor asked, “In pain? Want some Vicodin?”
“No, just need some antibiotics to kick the infection, Doc. Gave up the hard stuff a few years ago,” I admitted, “including Heineken and Jack Daniels. Regular Tylenol will work.”
He chuckled slightly, and then pulled a prescription pad out his jacket pocket.
Seconds later, the doctor handed me a script for five days worth of Amoxicillin, and then he exited the exam room and scurried down the hall. I looked back at my watch; it was precisely 6:00:27 pm. Not even a half-minute with him after a four-hour-plus wait. But I was fine with that, now that I had some real medication coming. It was time well spent.
I put on my coat and headed to the business office to square-up the bill. After a few minutes of standing in line, the clerk informed me that Freeman’s billing computer system was down and she couldn’t pull up my charges. “We’ll just mail it to you,” she said.
Cool. I hit the nearest exit. And without delay.
Two weeks went by and, as promised, the bill arrived. Total charges: $2,200. That’s right, over two-grand to spend four hours at Daniel Freeman Medical Center watching fish, thumbing through People Magazines, and spending less than thirty seconds with a doctor. Moreover, the Amoxicillin – without any prescription drug plan coverage – ran me another $115. Fortunately, after several back-and-forth haggling sessions with the hospital’s billing office, Freeman eventually backed down on the $2,200 bill and accepted $500 in cash for the whole thing. (I won, sort of.)
The point of my story here...is easily punctuated by an identical incident that occurred nearly ten months later in early-October 2006: same sinus infection symptoms again, but this time I had major medical health coverage, thanks to a new employer. Consequently, my out-of-pocket cost to see the doctor (for about three whole minutes): only $20. And my co-pay for Amoxicillin at CVS? A mere $4 bucks.
Only the American healthcare-industrial complex can justify such “Wild, Wild West”-like pricing variances...just for a severe case of the sniffles. (The only time $2,315 versus $24 for the same thing ever made sense to me was during my college days...when I was hammered to the gills at some kegger.)
Obviously, Daniel Freeman Medical Center was trying to string me up with charges for a lot of other patients’ unpaid bills -- just like all other major medical centers in the U.S. do. (Right, M.D. Anderson?) And I know this is true: I’m a licensed insurance agent and health plan underwriter. Having reviewed thousands of medical bills, from Pennsylvania and Florida to Texas and California, one thing is abundantly clear: America’s healthcare providers are the O.K. Corral of Billing Practices. “Just bill ‘em first, Festus, and avoid questions later...”
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