Miscellaneous Mishmash

Ran into a guy today who had had a kidney stone recently. We swapped stories of going to the E.R. and getting treatment. He had insurance when he went to the E.R.; I didn’t. Our stories varied significantly. 

With me, they took an x-ray, which identified the size and location of the kidney stone. With him, they did a CAT scan (at a cost of $3,500).

We both got sent home with a prescription for pain meds. But he was told to come back in a month for a dye injection “just to make sure it’s all gone.”

Not to second-guess his doctors; but would they really have done all those expensive procedures if he didn’t have insurance? Was the fact that he had insurance a factor in the types of treatment they did? I believe so.

My total bill ended up being about $1,000. His ended up being about $6,000.

There are reports of doctors saying they are pressured by hospital administrators to do expensive procedures when a less expensive one will do, or procedures that might not be completely necessary, if insurance is paying for it. That seems to be the case here.

And here’s the problem with healthcare in America. We have a system where hospitals charge exorbitant amounts of money for procedures, and oftentimes perform procedures that might not be necessary, as long as insurance is covering it.

And then insurance premiums become prohibitively expensive, to the point where the average person can’t afford to buy insurance for themselves.

So I think, if the system is going to be fixed, it has to start at the source.

Another person I knew told me a story where he brought his son to the E.R. with a broken arm. The doctor ordered an x-ray to be taken. But when the x-ray came back, the doctor said the x-ray tech didn’t do a good job, and it would have to be redone. So it was redone. The second time it still wasn’t good, so they did it a third time.

When my friend got the bill, he was charged for three x-rays. Even though it was the hospital’s fault that the first two weren’t done right! 

Where else could you be charged for a service three times because the provider of the service didn’t do it right the first two times??

I read about a study where it compared tests ordered by doctors who owned their own lab equipment versus those ordered by doctors who sent their patients to an outside lab. The study showed that doctors who owned their own lab equipment ordered three times as many tests on average than those who didn’t.

Clearly, the amount they would profit from the tests was a motivating factor in ordering the tests, compared to those doctors who didn’t profit from the tests, and who ordered 1/3 as many tests.

Health care expenses are out of control in this country. Providing insurance for those who don’t have it is a great first step. But unless some controls are put on doctor and hospital overbilling, it’s only half the battle.