Healthcare Run Amok

A lot of people have been spending a lot of time lately discussing the issue of what's wrong with our healthcare system in this country. Everything ranging from how much it costs to who gets to decide to whether allowing the government to run it is such a good idea. It's such a huge issue Congress and "Obama" have been trying to ramrod it through before the people have the chance to really go over it. And as usual, the messiah hasn't read the bill.

Well, my own little slice of what's wrong with the system hit home in July. Right around the 4th, everyone in the house picked up a nasty sinus infection that came out of nowhere. We tried the usual - vitamin C, hot chicken soup, lots of water, copious amounts of sleep. Nothing helped, it was getting worse by the day. Finally after getting up one morning and ending up seriously lightheaded after showering and being unable to cool down, I headed for the doctor. Keep in mind, I usually fight off crap like this in a couple of days, with nothing more than C and sleep. So to seek medical help was a drastic thing for me. Even more so with no insurance.

So I get to the urgent care facility. Sign in. First thing out of their mouths: "Do you have insurance?". Not something logical like "So how can we help you". The receptionists eyes glazed over when I told her I didn't have any - and promptly drew an immediate demand for $102. Cash or credit. I was basically standing there going WTF. Especially considering the room was full of obviously uninsured illegals and their anchor babies. Yeah, whatever, I handed her the card cause I felt like shit.

So I go sit on the exam table after waiting the customary TWO FUCKING HOURS for the doctor to be "not busy" anymore. The nurse comes in, does a blood pressure check ( all normal ) pulse rate check ( normal, for being sick anyway ), and a respiration check ( again, normal considering ) then she leaves. Doc shows up 15 minutes later and asks what color the mucus is. "That disgusting yellow color you never see", I say. He walks away. Comes back 5 more minutes later and hands me a prescription for Biaxin 500mg antibiotics and Prednisone 10mg. That's it, time for me to vacate. This is what I paid $102 for? Like, duh, I already knew I needed antibiotics.

Anyway, head for the pharmacy to get my pills. At least Wallgreen's is a decent enough place. The pharmacists were even all hotties, so it was a nice bonus. Handed her the script, waited another 15 minutes, then go to pay for my stuff. Jesus Christ people. $90 for the GENERIC version of Biaxin? What the fucking hell? The other shit was only $9 but I mean come on. No wonder nobody can afford this stuff.

So I get home. Out well over $200 but with my happy pills in hand. Bit of a strange side note, apparently Prednisone has a nice warning in its instruction packet saying it has immune suppressive side affects. Ok. Wait. I'm sick as a dog and the guy gives me something that's going to suppress the only natural weapon I have against it? And I paid $102 for that advice? Figuring maybe, just maybe, he knew what he was doing I took that and my first generic Biaxin pills. It took nearly a week to drop the sinus infection and all the ugly gross things you could possibly imagine going along with that. I can't help but think the two drugs were working against each other, yet both had big fat warning labels saying "take until gone". Mr. Gut by this time is telling me to ignore the label on the Prednisone because my general over all feeling of being "well" isn't coming back. So the 5 remaining pills met their fate in the toilet. Sorry doc, you've been overruled. I did however keep and completely finish the Biaxin. Turned out to be the right call, cause 2 days later I was entirely over and done with it all. Next time I won't bother filling the immunosuppressive drug prescription. That's just plain daft.

Anyway, one might think this is actually a wild success for the system despite the questionable drug selections. It doesn't end here. As I'm sitting here regretting once more having consumed a pastrami sandwich two days ago (story for another time) the mail comes. The medical facility sent me something. Opened it. Nearly put my fist through the LCD after I saw what it was. The bastards are billing me for $184 more for an "Office/Outpatient Visit, EST". The other stuff they actually did - the original $102 - is also listed under "Measure blood oxygen level" and "Unapplied credit". OK, so wait. WAIT. What the hell? Are you people seriously attempting to bill me a second time for the visit or what? I'm sorry but that's simply not going to happen. You already got paid for your illegible handwriting on a small 3x5 piece of non-recycled paper. Your drug partners already got their payment for their overpriced generic Biaxin. You're not getting another $184 out of me for something that quite frankly never happened. You can take THAT to the bank.
Chino Medical Group, Inc. "The services you need, the care you deserve."
Otta be changed to "The services we can get away with billing you for, whether you deserve the care or not."

I have no illusions that I am alone in this either. This kind of thing is clearly systemic. Apparently they get away with it because they've computer automated the entire process of ripping people off for doing nothing at all to pay for their flow of illegals. This right here is a prime example of what's wrong with the system in our country. Medical centers grossly overinflating their costs and drug companies happily joining in. If you want real reform in the system, don't push for government run. Push Congress and the "president" to put an end to this kind of fraud, waste, and abuse in the existing system we already have. Even with all it's imperfections, pitfalls, and outright strongarming, it's still better than Canada, England, and Cuba by a long shot.
"It is pointless to resist, my son." -- Darth Vader
"Resistance is futile." -- The Borg
"Mother's coming for me in the dragon ships. I don't like these itchy clothes, but I have to wear them or it frightens the fish." -- Thurindil

Well. I guess that's that then.

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Posted on Aug 1, 2009 5:11 pm by Samson in: | 18 comment(s) [Closed]
Sounds like you had the pleasant version of the story.. you should try it as a medicare patient (due to disability) sometime.. not that I'd want you to become disabled, just saying...

You've hit the real problem on the head this time, Samson. It's not that our health care system needs to be nationalized or even reformed, just properly regulated -but- only to the extent that it eliminates the fraud and quackery that are present in most medical facilities today.

It may well be the pleasant version. And I probably would never have commented on the experience had the bastards not sent me this bogus bill for bogus services that never happened. The response they get is going to consist of nothing more than this entry's address on the statement stub. I doubt they'll go look, but I'll have made my point just the same.

Yes, the system needs at least some level of reform. Even if all that means is new regs put in place to stop the madness. Quackery and fraud is about what this amounts to. I doubt the doc even knew WTF he was doing. I bet all he did was go to some computer and ask a database. I already knew what I needed, I didn't need him to tell me this. I just needed him to be able to go buy the pills. I'm seriously considering just using the internet the next time I need some antibiotics. It'd cut out about 90% of this hassle.

I would deal with all medical issues via the internet myself except that the doctors are supposed to be the important step to verify that we haven't misdiagnosed ourselves because we don't have access to nifty things like x-ray machines and blood labs and such, but that also assumes that you've got a decent doctor who cares at least enough to make the effort to actually do their job and they're getting harder to find these days.

If Obama really wants to help the health care system he shouldn't be trying to turn it into a nationalized disaster but instead he should be campaigning to do something about the insurance doctors have to pay for against malpractice and something about the prices of the medications and what prices medical facilities can charge patients. You can't make doctors care about their patients, but you can eliminate the desirability of being a doctor just because it's a get rich quick scheme so that the folks who want to become one will be the ones who really want to help people.

Ouch. By the way, you should ask my friend sometime about going to university urgent care with a stomach bug. I think they asked her four times whether she could be pregnant.

A couple of notes:

--My guess is yes, they DID charge you twice, and it wasn't an oversight - that's an extra charge precisely BECAUSE you're uninsured. They aren't getting anything from the insurance company to help cover their costs, so they have to take it straight out of you.
--Prednisone is a hardcore anti-swelling steroid. Doc probably prescribed it to bring your sinus inflammation down. I have tremendous respect for it because it's done things like save my dad's hearing, but I can also see how it would be overkill if taken for something too light or too long.

Also, @Conner:
You can't make doctors care about their patients, but you can eliminate the desirability of being a doctor just because it's a get rich quick scheme so that the folks who want to become one will be the ones who really want to help people.

Four years of grueling undergraduate plus seven years of even more grueling graduate work? That's hardly a get-rich-quick scheme, in terms of both time and money.

And finally - the words "pastrami" and "regret" in the same sentence do not compute. ;)

Eleven years of education is hardly a blink of an eye to some people, just ask those professional students for life that you find in many post-graduate schools. And double billing because the person is uninsured is still double billing (fraud). As for theleven years being tough financially, isn't it the loans (mortgages primarily, but loans in general) what our politicians are telling is brought the economy down? It's not like most of the newer doctors these days are even out of pocket for their "education".

Oh, and pastrami computes just fine with me in the same sentence as regret if the pastrami's a bit past it's final "sell by"... ;)

Well clearly the whole issue is systemic for sure if the same kind of quackery exists over such a wide area. Isn't the AMA supposed to be keeping an eye on these hosers?

No, sorry, the logic that they're stiffing me because they can't stiff the insurance carrier is no justification. Let them eat it the same way they'll eat it for all those illegals that were in the room. I'm not paying for their quackery and fraud.

I wouldn't call medical school a get rich plan either. Hundreds of thousands of dollars in debt is a poor path to fabulous wealth. Not to mention 8 long years.

Yeah, the pastrami thing, it'll get a post of its own, don't worry. :)

I don't know about you, Samson, but when I was growing up everyone's mother wanted their son to become a doctor or a lawyer because those were the professions that were assumed to assure financial success, 8-11 years of medical school and the associated costs (all of which are paid by loans/grants) are a fairly small price to pay for thereafter being able to freely bilk everyone you meet and fully expect them to literally owe you their lives for having done so. It may not be such a quick path, but it's still a get rich scheme. It wasn't always thought of that way though, once upon a time doctors charged for their services and medicines what was considered a reasonable fee and were often repaid in services or goods rather than via insurance companies...

No, sorry, the logic that they're stiffing me because they can't stiff the insurance carrier is no justification.

Wait, what? Look, call this devil's advocate if you like, but why is that bad logic? The way insurance companies work is that the number of people they have buying their plan allow them to contract over a wider network of medical people and negotiate prices down with the hospital - because the money hospitals can get from insurance may be lower than what the hospital would like to charge, but it's guaranteed. When you come in without insurance, they've got no guarantee they'll get paid -- oh, they can check that you can cover part of the visit, but they checked that you had money to pay for that initial charge, not for whatever else it might have cost them to run tests and whatever on you had you had something more complicated. So you're higher risk for them to treat. Higher risk, higher premium. I'd call that entirely logical capitalism. Are you subsidizing the people who can't afford their care, period? Sure, but so is everybody with insurance. And even with insurance, something serious and long-term can bankrupt you.

Also, I believe I was unclear above - when I said "charge you twice," I didn't mean "double billing," I meant like "an extra charge for something incurred during the visit which has its own fee." In your case, that's uninsurance.

Um, Regina, being charged for not being insured certainly sounds like double billing to me. How do you justify that it's not billing for nothing?

For my own part:

- Put me down in the "going to med school is not a get rich quick scheme" column. 8-11 years, epic loans, etc, etc, and plus I've seen the stuff pre-meds get to study, and it's pretty non-trivial. Not much of a complaint out of me with regards to doctor pay, although perhaps some issues with regards to a couple of individual doctors I've seen.

- Evidence the drug companies will fuck you story: Had an eye exam a couple years back, doc thought I had somethingoratother, wrote me up for some ointment. $99 uninsured, as it turns out. So they got the generic for $9. I'd still like to know what's with the extra $90.

- In another memorable fiasco, not only did I get misdiagnosed, it turns out that Valtrex is expensive and tests your insurance randomly won't pay for (generic blood draw, I think) are likewise. These things have not favorably impressed me with the insurance folks, either.

Those things (among others), considered, it's hard for me not to figure that we need either a national healthcare system or some enormous level of oversight and regulation, since leaving the companies to their own devices seems to not work at all.

Regina said:

By the way, you should ask my friend sometime about going to university urgent care with a stomach bug. I think they asked her four times whether she could be pregnant.

At least your SHS seems reasonably competent at what they do based on the one time we were both there. In my case, two events:

- SCSU's student health folks won't cover graduate students AT ALL, despite mandating that you purchase some sort of health insurance. I'm not sure whose fault that is, but WTF people.

- Back at OSU, I once had the unfortunately memorable experience of being grilled for a couple of hours on the possibility of my being anorexic, despite my questions about being really hungry and could they feed me, and despite having just fainted, which among other things slammed my head into a desk and concrete floor, leaving it ringing and with a very nice scalp wound. Which I guess I might have wanted them to look at, only they didn't bother to do any such thing.

Which I guess is more of a "student health sucks" thing and less of a "the system is broken" thing. But.

Regina said:

When you come in without insurance, they've got no guarantee they'll get paid -- oh, they can check that you can cover part of the visit, but they checked that you had money to pay for that initial charge, not for whatever else it might have cost them to run tests and whatever on you had you had something more complicated. So you're higher risk for them to treat.

Ok. Let me remind you. They got paid. $102 out of pocket to have my BP, pulse, and respiration taken. There were no further tests done. There was one question from the doctor about what color my snot was. He didn't even bother to shove a stick in my throat to see how things looked back there. Even incompetent school nurses do that much. And let me make it perfectly clear. Nobody at the facility treated me for anything. I walked out with a piece of paper that had doctor scribble on it.

So are you seriously trying to tell me they're trying to charge me $184 because of the risk that I might not otherwise pay? Or that they're trying to charge me for tests they MIGHT have run had I come in puking all over the floor and wanted to know if I had Ebola? Where I come from attempting to charge me for either the high risk of non-payment or for tests they DID NOT RUN is fraud. No other way about it. If I tried that with my bank I'd be arrested. Maybe I should call the cops and have the doctor arrested. Sounds like it might be fun.

BTW, as you might have guessed, that high risk I might not pay? Yeah, it's a sure thing now cause they got paid. Not getting paid twice. Or rather almost 3 times.

You should see the charges they come up with to try to bill you for if you endure an actual hospital stay, particularly for more than a few days.. things show up on the bill like a charge for special examination by some doctor you can't recall having ever met that, upon researching further, turns out to have been some random doctor who passed by your room one day and poked his head into the doorway to see if the room was still occupied, just one of many examples I've seen routinely.

Score one for the little guy (that's me)! Apparently the Chino Medical Group has now seen the error of their ways, thanks to receiving a copy of this blog post in their last "bill" and has seen fit to "correct" it and now say I owe then $5.79. Why, who knows, but that I'll pay if only to keep their computer off my back now. Let this be a lesson to all - if they think you're out there spreading the word to all who will listen, they'll do what they have to to keep it quiet. The publicity doesn't help them.

Gratz! And it only took them two months to capitulate on the matter too. Though I'd be curious as to how they are justifying the extra $5.79, I can see where it's a small enough fee, certainly in comparison to the original $184, that it might not be worth continuing the fight over.

Certainly not worth the attached threat to turn the $5.79 over to collections and thus ruin my credit rating. :)

I can't really imagine any creditor going completely nuts over an indication that you defaulted on a $5.79 medical debt once... especially if you were actively fighting the issue (either in small claims court or via written letters to the three credit bureaus (so the fact that the debt was in dispute would appear on your credit report with the debt itself) along with other media contact). But, I do agree that for $6 it's hard to feel compelled to take a stand. On the other hand, if you really wanted to fight it, it might be possible to demonstrate to a small claims court that this was a standard practice of this facility that was effectively cheating hundreds, if not thousands, of people (and their respective insurance agencies) routinely thus opening the door to a class action suit and/or punitive damages. Also, if you actually won, you'd be entitled to awards of reasonable legal expenses and interest and, in today's court system, an award for the mental anguish that this caused you. *rolling his eyes* ..remember, it's those same liberal judges that you usually get riled up about for doing just that sort of thing that get to decide these things after all. ;)

No, I can't imagine anyone would seriously hand a $6 bill over to collections either. I think it was just an automated computer warning. And no, it certainly isn't worth fighting them over it at this point. I imagine they were hoping I'd feel the same about the original amount, but obviously they found out otherwise. :)

As far as dragging them into court, that's half the problem with the system we have right now. Were I to have done so, the cost to them would have been well into the thousands, and assuming I won, someone somewhere has to pay for that. Guess who gets the bill?

Sadly enough, you have a very real point there. In the long run it'd be their patients who'd get screwed in the end. Frankly, that's the biggest factor in why medical everything costs as much as it does already.

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