Health Care...Whats Wrong With This Program?

[strick]

Sam- it was on top of my head...and I'm afraid of needles. Send Bettie on over I'll put her to work

strick

[Islandtrader]

.cost about $450 at the urgent care facility.

Strick,

This is what I thought it was going to cost. Matter of fact that is all I am going to pay.

[Fr. Frank]

Okay, somebody pushed one of my "HOT" buttons.

The doctors are NOT making the money they used to make. A lot of the money is going to insurance companies, 3rd party billing offices and to the government in taxes.

I have a friend of mine who is a primary care physician - Internal Medicine. He has one other doctor working for him who recently immigrated from India, (even though he is actually from Turkey.) He also employs 4 registered nurses, 2 LPN's, and three office staff.
He own his clinic here in suburban/rural Florida, and most of his patients are senior citizens, many of whom are on Medicare.

Two years ago, we were playing golf together, and he told me that of the 11 people who worked at his clinic, 3 had higher personal incomes than he did. The clinic grossed slightly more less than 1.4 million dollars in 2006, and his personal income was just under 80,000.
Of the 1.4 million, over 400 grand went into malpractice insurance for himself and the clinic. Another 340K went to the government in taxes. Medical and office supplies and materials were another 100K. He paid the other doctor a salary of 130K (from which he had to pay his own malpractice insurance of $60K), the Nurse Practitioners got about 90K each, and the rest went to the other staff. He was left with just 80K.

On the other hand, My son went to the emergency room from school with a broken finger right after the first of the year. As we had not met our deductible, we were charged for everything directly.

Here are the costs as originally listed:
Emergency room "Fee" = $485
Emergency room physicians fee to see him = $365
Radiology Group's Xray costs = $65
Emergency room physician's fee to look at xray (no radiologist available) = $410
Emergency room physician's Diagnosis Fee = $110
Emergency room physician's fee to splint and tape finger = $325
Hospital's fee for nurse to splint and tape finger = $85
Cost of aluminum and foam finger splint = $115
Cost of tape to secure splint = $18
Cost of elastic bandage to wrap hand and wrist = $31
Cost of chemical "cold pak" = $44
Miscellaneous emergency room "supplies" surcharge = $19

Total Hospital charges = $797
Total Radiology Charges = $65
Total Emergency room physician's fees = $1190

Total time spent at hospital = 55 minutes

Last week, the billing office for the ER physician agreed to eliminate the charge for splinting and wrapping my son's finger, especially as she didn't actually do it, an ER nurse did it. The also agreed to reduce the total of all the rest of the unbundled services to $475, after I had the church attorney inform their 3rd party billing office in Atlanta that "Unbundling" of medical charges is illegal in Florida, and in fact is a felony. (Like they didn't know it already) When went to her office and spoke with the ER physician directly (wearing my black clericals), she said she had no idea that her billing company was unbundling charges for her services, and claimed not to have known that they billed us for services she had not actually provided. She said the billing company gets 30% of all monies collected on her behalf.

I'm still pissed off at paying $115 for the same foam and aluminum splint that costs $18 for a 3-pak at Walgreens.

On the other hand, we have met the deductible for my son this year already, and more than half the family deductible

[Bigshrimpin]

Ditto on that one.

Bigshrimpin how much your kidney stones cost ya?

strick

Two trips to the ER!! Twin 4mm kidney stones. One last Sunday and the second on Tuesday. Friggin most panful thing ever!! I was peeing blood on the second . . . otherwise I wouldn't have gone back (well maybe . . . just for the pain killers). Only $50 co-pay each trip Blue Cross and Blue Shield. Although . . . It did cost me two days of lost wages, b/c I'm a contractor (for an insurance company ). Single guy insurance is much cheaper than the family plans. Well . . . if you tally up the 12 years of monthly insurance premiums ($5000/year my contribution 10% + employers contribution 90%) and figure that I haven't had any health care procedures other than this . . . the insurance company is making out pretty well.

[Hookdude]

Don’t get me started. (Too late, I just did.)

Having various occupations, sporting interests, and hobbies that are considered risky or even dangerous, as well as an adrenaline junkie’s apparent non-concern for self preservation, I’ve had more than my fair share of “run ins” with hospitals, ERs, clinics, doctors, dentists (hockey before face masks put my dentist’s kid through college!) etc. With 7 broken bones, over 200 stitches, too many torn muscles/ ligaments to recall, and a couple concussions (or was it 6? Ha!) to my credit, there are plenty stories of health care ineptitude for me to relay.

Being found unconscious in a pool of my own blood 2 hours after being taken to Balboa Naval Hospital for treatment of a not too serious “knuckle meets grinding wheel” incident was a good one. But since my wallet wasn’t affected and military health care has a completely different set of rules, I’ll tell ya this “beauty”.

One Sunday in August 2003 I tucked the front wheel in turn 1A of Loudon racetrack, bounced on my right shoulder and slid off the track and out of the race (was in the lead too….bitch.). Cornerworkers and EMTs checked me out, determined that I didn’t have a concussion but offered to take me to the hospital anyway, “just in case”. I wasn’t too banged up and politely refused. Packed up my bike and went home.

Shoulder and back were pretty sore and sleeping was interrupted, but that’s to be expected. Wed. AM while driving to work I sneezed and it felt like King Arthur had just stuck Excalibur in my upper back! “OMG! That really hurts!”

Mass General was 3 blocks from the job site so I walked over and at 6:45 AM, checked in to the ER “I think I broke my shoulder blade.” Plunked down the $20 co-pay and took a seat. I was the only one waiting. “This should be quick.”

At 8:25 after watching a dozen or so cases of the “sniffles” admitted before me, I was taken up two flights to a nurses station/ examination wing and was told (not asked) by the humungous woman behind the desk to “Wait over there.”.
8:35 Gave a cigarette to the janitor who asked me for one.
9:10 An orderly brought me in to the exam room. “Remove your shirt and the Nurse Practitioner will be right with you.”
9:30 The NP came in. She asked what happened, etc.
“Are you in pain?”
“Only when I breathe.”
“Hmm…..this bump on your back is probably a broken rib. There isn’t much we can do for it. You’ll have to go easy for a while and let it heal on it’s own. I can give you some painkillers though. Oh, I’m sorry. It hurts when I touch it?”
“Noooo. The tears about to stream down my face are from my recalling a lost love.”
“Ha Ha. You have a pretty good sense of humor for someone with a broken bone. We need X-Rays to confirm. I’ll get back to you as soon as I get the results. ”

9:40 Back to my “not so comfy” seat at the nurses station. No magazines or TV, but there were 3 girls and 1 guy in a small office chatting about their weekends (past and upcoming), significant others, how they could avoid working on Labor Day, blah, blah, blah that I eavesdropped on for entertainment. When they started laughing and saying “I can beat that.” I leaned around the corner to see that they were all playing some sort of game together on their computers! I silently wished that their boss would walk in and catch them all goofing off.
10:30ish Asked the rather large nurse’s aid at her lofty perch where I could get a cup of coffee and a snack.
10:30ish and one half second, “You can’t eat or drink during treatment.” (From her expression, you’d think I’d asked to eat her offspring.)
10:40ish Quietly asked the janitor where I could get a cup of coffee. He rolled his eyes, gave a disdainful glance towards “The Queen” at her overstrained lofty perch and asked, “How you take it?”
“Black is fine.”
10:45ish Janitor returned with a cup of coffee cleverly concealed in a newspaper.

11:10 An orderly brought me to X-Ray where I met two techs who I’d already seen today. Yup, you guessed it. They were two of the “goof offs”. I was tempted to ask who had the highest score on the game they were playing but feared retribution.
The digital machine (nothing but the best for Mass. General!) was a first for me and showed the images nearly instantly and with amazing clarity. They were even color. (Cool technology)
“Oh yeah, that’s certainly a broken rib. But we have to send it to the radiologist to confirm.”
“Radiologist?! I’m just a stupid construction worker but even I can see, let alone FEEL, that I have a broken rib (it was so misaligned that one could NOT miss it.). Can’t you just show it to the NP so I can get out of here?”
“Sorry, Hospital rules.”
11: 20 Back in the “not so comfy” chair (I swear it was still warm!) and watched “The Queen” rule over her domain. Between chomping on Doritos and gulping Pepsi, she called her kids 3 times, gossiped with her “court” nearly constantly, applied nail polish, and even fielded a call from the cable company (she wanted to upgrade her package to include HBO).
12:00 I suddenly realized that during the entire time I spent in this area I call the nurses station/ examination wing (with 6 exam rooms and about 20 personnel) not a single other patient had come or gone. I was the only one! I’d been there over three hours (plus 1 and 1/2 in admissions), had spent a grand total of twenty minutes actually being attended to, was denied the chance to eat, and hadn’t had a smoke. The low blood sugar and lack of nicotine was getting to me (if not for the kind janitor, caffeine depravation would have been the catalyst that put me in jail!). I’d had enough.

12:01 Told “Jabba the Queen” that I was going outside for a cigarette.
“You can’t leave until the NP signs you out. And if you try to I’ll call security.”
“Then please call her to sign me out.”
“She went to lunch and won’t be …”
“I’ll see her when I get back.”
“YOU CAN’T….”
“I can. And I am. Call security, I don’t care.”
12:35 Returned from smoking two butts (needed them both) and eating 3 candy bars from a vending machine in the lobby. “The Queen” wasn’t on her throne (Lunch? The family size bag of Doritos wasn’t enough?) so I asked her substitute (a new face) if the NP had returned.
“She’s at lunch.”
“Please ask her to come get me as soon as she returns, will ya? I’ve been here all day.”
With a doubting look she said, “I’ll try to remember.” Total apathy.
Back to my “not so comfy” chair.

1:20 Was woken up by the janitor (remember him?) with “ You’re STILL HERE?! What you here for anyway?”
I told him.
“Have you been seen yet?”
“Yeah, waiting for the NP to look at my X-Rays and release me.”
“When did you go to X-Ray?”
“ Right about when I finished the coffee you brought me. Thanks again.”
His jawed dropped.
He went over to “The Queen” (now back from lunch) and said, “That guy’s been here since before I started my shift! What the hell’s taking so long?”
“Umm…..I think we’re waiting for his X-Rays.”
“Then call X-Ray and see where they are.”
“That’s not my job.”
Then he called her a “useless *&*^%$ “ came back to me, asked my name, and said he’d be right back.

1:25 He returned in a huff with my X-Rays, asked me to come with him, threw the X-Rays on “The Queen’s “ lap, and said, “Here’s his X-Rays. Call the NP.”
“I don’t know where….”
“THEN GET OFF YOUR FAT ASS AND FIND HER!!!......NOW!”
Wow! Dude was p!$$ed!
If I hadn’t witnessed it, I would never believe that someone who displaced so much atmosphere could actually run! (Well, “waddle really fast” is more accurate.) Watching her jiggle down the hall and feeling the floor vibrate with her every step caused me to laugh, which really made my rib hurt and I was chuckling and “owing” at the same time.
The janitor asked “You okay?” (He wasn’t laughing.)
“Yeah, I’ll be alright. Seeing you make her jump is worth the pain.” Then he chuckled a little too and told me how little he thinks of the help, that “The Queen” had been asking for it for weeks, and he sees this sort of thing far too often. “Been working here 22 years. If I was boss around here, I’d fire 90% of them. Man I can’t wait till retirement.”

1: 30 The NP came down the hall at a trot (“Her Highness”, wheezing heavily, was far behind ) “I’m so sorry. I thought some one else must have signed you out.” (I think she was trying to cover for the Queen somehow.)
“Can I pleeeease leave now?”
“Almost. That’s one nasty break. I’m surprised you didn’t puncture the lung. And you still could, so be careful. If you cough any blood call for help immediately. Also, your body’s going to “short stroke” your breathing to ease the pain and there’s a slight chance of that causing the lung to collapse. So force yourself to inhale deeply for 5 minutes each half hour the next few weeks. It’ll hurt, but you have to do it. Here’s a script for Percocet. Here’s my card, call me if you need anything. I’m really sorry this took so long.” (She meant it too.)
“Thanks Doc. Thanks Buddy” (The janitor.)
And glaring at “The (still breathing heavy) Queen” I said, “I’d ask for a lollipop but I know they’re all gone.”

6 weeks later I get the bill. $1800 of which I had to pay $360 (insurance covered the rest).
“Oh No. No, no, no, no, NO! Six and a half hours of waiting for twenty minutes of diagnosis and no real treatment? Hmmm… lessee now…. 1800 times three is…….. $5400 per hour?!?!
No. HELL No. I ain’t paying.”

I wrote letters telling this tale to my insurance company (said they were crazy to pay what they had) and the hospital (told them that one of the world’s most premier hospitals is a model of inefficiency, ineptitude and fecklessness. “The best treatment I received was from the guy who sweeps the floors!”)
Much to my amazement, I received a handwritten apology! And didn’t have to pay!

It’s not the professionals (MDs, NPs, RNs, etc.) nearly every one I’ve dealt with was great. The guy that closed my face/nose (goalie stick, 30 plus stitches) so finely that the scar barely shows (he even managed to blend it into my “laugh line”) is truly gifted. The guy that spent 22 hours re-attaching my buddy’s severed hand (log splitter, I actually caught the hand….not pretty) so precisely that he has 95% usage of it is, in my eyes, one step down from The Almighty Himself! The problem is with the insurance companies and low level staff who think they’re in a position of authority. It’s sickening. (No pun intended.)

SO, unless I’m bleeding profusely, I’m “going Rambo” and sewing myself up from now on (Brigade Quartermasters sells excellent suture kits). Any thing serious and I’m putting a collar around my neck, getting down on all fours and going to the veterinarian! I might even bark and growl for effect. (Hey Strick, do you make house calls?)

Didn’t mean to be so long winded. Thanks for letting me vent.

[Fr. Frank]

WOW! I like the janitor.

For all you who get stuck in ER's waiting for the staff who are busy playing video games, or watching the latest episode of "House" on reruns, here's a tip from my wife, who is a nurse and works in a hospital. She absolutely HATES working with inefficient jerks who think they are there just for a job, as opposed to those who are there to care for people:

The name of the Hospital CEO, and the Chief Medical Director for every hospital in the US in public information, and 99% of them have listed phone numbers. If they work for a non-profit hospital, they MUST have public contact information listed.

So, after you've watched the intake nurse lose her 32nd game of Minesweeper, call the CEO or the Chief from your cell phone, and show him the photo you just took while you were waiting for someone to help you. My sister-in-law did this when my then 7 yr. old niece had been waiting untreated and unexamined in the ER in Providence R.I. for 3 hours with bilateral pneumonia, and was subsequently found to have a blood oxygen level of 71%. The Chief Medical officer for the hospital really didn't like being awakened at 1:30 a.m. to learn his empty ER couldn't even see one sick little girl because no aide could be found to transport the child to xray, and union rules forbade the triage nurses doing it. Their entire 4 day hospital stay and treatment was FREE, except for the doctor's fee's which were only $80, a $20 copay per day.

The moral of the story: Don't be afraid to make some noise. Call the CEO, call the Medical Chief, call the Chaplain = SHAKE THE BLOODY HIERARCHAL TREE!! It really, really works. On the other hand, if they are really busy, be patient with the triage process. Some hospitals really do work hard to help.

BTW, when they tell you your cell phone call will "interfere" with medical or diagnostic equipment, that's a lie. That was only true for some old analog cell phones, which were finally phased out completely in 2006. No, repeat NO, digital cell phones interfere with any medical equipment if you disable Bluetooth communication temporarily. And Bluetooth has a maximum spherical range of 50' in open air, and about 25' in a steel reinforced building. (Nor do cell phone calls interfere with aircraft navigational equipment anymore, either, as long as Bluetooth is disabled. But the law was passed banning their use in flight in the days of analog devices)

[Briguy]

Hookdude, that was priceless. The story would make for a good short movie. You could be the next Michael Moore.

Kinda cool how you saved your buddies hand.