MEDICINE IS A WONDERFUL INVENTION, IF YOU CAN AFFORD IT

MEDICINE IS A WONDERFUL INVENTION, IF YOU CAN AFFORD IT

(New Choice Health, Pacific Source, Wall Street Journal)

(Angies List, Jackie Norris, New York Times)

(Heartsite.com, Frazer Chronicle)

 

I took a stress test yesterday, and the test really stressed me, I may be kicking the tires on 70 years of age, but gee, come on, I couldn’t even do the treadmill part, they had to shoot me up with some sort of chemical cocktail that mimicked me working out…..to my heart. Let me tell you, if you take a stress test, try your damndest to do the treadmill, that chemical mix gives off feelings like your having a heart attack for about a minute or so…..worst minute or so I’ve experienced in quite some time.

 

You can’t eat after midnight, no coffee…..water only, and I love my morning brew…..coffee is my friend, but not the morning of the stress test, so right away I’m irritable, and a bit gnarly, wanting that coffee. But the no coffee thing was by far the easiest part of my morning.

 

I read all the directions that my doctor had given me, I followed all the do not take these medications because deal, and like I said (I didn’t have my morning brew), but when I get to the hospital, I’m sittin’, and my stomach’s growlin’ and then this guy starts telling me about his triple digit  blood pressure, and how he drinks two pots of coffee a day, and all I want to do is get this day over with…..and it’s only 8:45 A.M.

 

Thankfully this guy comes for me, we go back to this room and he injects me with some kind of nuclear mixer that’ll show up in an x-ray…..and then he sends me back to the waiting room. Luckily the guy with the race-car blood pressure is gone…..and it’s just fifteen or so minutes later and I’m down the hall to this x-ray room and one of the most uncomfortable 20 minutes of my life.

 

This guy slaps my butt onto this rock-hard x-ray table where I must lay completely still, with my arms above my head while this machine takes pictures of my upper torso. It was the longest 20 minutes of my life…..but I made it, even though I had several back spasms.

 

I next was escorted to the treadmill room where who should I see…..Mr. triple digit blood pressure, two pots of coffee in the morning guy. I lucked out because before he could say a word to me, he was taken around the corner and hopefully shot. I shouldn’t say that, cause he really did seem like an okay guy…..kinda!

 

The nurse made me take off my “T” shirt, a Traverse City, Michigan Beach Bum’s baseball shirt, shaved five or six parts of my chest and attached some electrode type holders, sat me in a chair, hooked me up to a machine, took my blood pressure, (124 over 84) injected me with the heart attacking causing chemical mix…..and, as they say…..the rest is history.

 

After another 20 minute round of x-rays on the dreaded table of torture, I was done, and with a reassuring message from the guy, (Gary) “no news is good news.” I peddled around the house waiting for the doctors call that…..never came, does that mean that I’m in the clear…..only time will tell, but I feel good about the no call thing.

 

WHAT DID MY HALF DAY IN THE HOSPITAL COST

That my friends is the $64,000 question, my wife and I have a decent health plan, the prescribed payment schedules are listed in our policy as well as on our health care cards. However for me that really isn’t good enough…..I want an itemized list of what the charges are.

 

My cost for the stress test through my insurance plan…..out of my pocket is $75, I suppose you could call that (my deductable,) seems pretty liberal to me, since the procedure, here in Green Bay costs anywhere from $950 to $2800. I’m sure that my insurance company has a bargaining agreement with the hospital that my doctor chose. How it happens makes no difference to me, as long as the job gets done.

 

However I can attest to this, I spent four hours at getting my procedure done, and it involved maybe one hour of medical staff assistance, the rest of the time I was on some sort of medical machine manufactured by Sieman Technologies, I looked them up, their really big, the preeminent leader in the industry.

 

What my procedure was, was two basic MRI’s, minimal in size, but non-the-less MRI’s, and I can only guess at their cost, since a full-blown MRI can cost, on average $1,200 here in the United States. Of course there were the two injections, getting hooked up to a scanner that measured my pulse and my blood pressure, oh yeah; I did get my chest shaved in several spots.

 

With all the hub-bub going on about Affordable Care, and Obama-Care…..are they the same, and wasn’t there something passed a year or two ago that was supposed to take care of this issue.. I swear I simply can’t keep these issues straight in my head.

 

WHAT’S YOUR FAVORITE MEDICAL PROCEDURE

For me it’s the Colonoscopy, the test itself is an in and out deal, you sleep through the whole thing, and there are some fine looking nurses to look at you after your in the recovery room. Of course the fluid you drink the night before is the pits…..but the actual procedure is smooth.

 

However the cost…..wow, for me, two years ago, $1350 on my wife’s health insurance from the city of Green Bay. My wife used to work for Risk Management for the city, and she figured that there were upwards of 1000 employees and covered beneficiaries that were eligible for the procedure, that would, in effect break the city’s self insured program. That was several years ago, and my wife switched departments, so I never did hear whether Green Bay’s medical program is busted or not.

 

From the little research that I’ve done on this issue, (the costs of medical procedures) the United States seems to be high on their charges, really high…..like REALLY HIGH! An Angiogram, (blood vessel x-ray) in the U.S. $914, in Canada, $35, a Colonoscopy in the U.S. $1185, in Switzerland, $655, a hip replacement, $40,364 here, in Spain, $7731, (kind of like Spain takes the pain) away, Lipitor in the U.S., $124, in New Zealand, $6 bucks and than that old MRI in the United States, $1121, and in the Netherlands, $319.

 

Now somebody out there is gonna talk about “yeah, maybe the prices are cheaper, but how long does it take a person to get the tests” or the really, really big lie, “maybe it’s cheaper, but how competent is the test.” You know what, that would be right, but I’ll tell you this…..for many, many Americans (me included,) we’d like to find out how long the procedures do take, and how competent are the doctors in these foreign countries, and how really good are these medical plans, and how much do they cost…..I’ll bet a band-aid won’t cost $50 or $75 dollars either.

 

HOW MUCH IS THAT DOGGY IN THE WINDOW

People talk about Affordable Care and how it’ll cost billions, trillions, or kazillions, or bazillions, I can’t keep the figures straight in my head. I do know this, for every person out there that is uninsured (medically speaking) it’s a scary situation…..especially if they have kids. I can remember a time in my life when my family was uninsured, and I’d worry about sickness or injury not so much for me, but for my wife and kids.

 

Now I gotta warn you, what’s next is a bit technical, and a bit complicated, however, using my formula of simple, I think you-all will understand the statistics of the facts. This part has to do with medical providers, and how they pile-on as it where, like in football when a runner is hard to bring down. These practices are wide spread, and happen throughout the medical care industry.

 

Upcoding is usually identified with Medicare fraud, where health care providers bill for higher CTP (current procedural terminology). This system was developed by the AMA (American Medical Association) and is used to describe medical services and procedures.

 

Phantom procedures, submitting claims for procedures that were never actually conducted, and is a common method used by physicians to obtain unearned compensation so that they can buy that new SUV or take the wife and kids on that Jamaican holiday or get the girl-friend a new fur coat.

 

Exaggerated claims are used by medical professionals where they exaggerate medical care, or upcoding, just another scam to inflate the bill that is sent to Medicare. Of course there’s the old Unnecessary Services or Unbundling, and a real zinger, Double Billing. What each of these practices do is a way to fool either the Federal Government, or a patient’s insurance company.

 

I’m sure it’s a constant battle out there in the war between health care providers, the Federal Government, and the insurance companies. We seldom hear about it, or miss a story on page five of your local newspaper.

 

There are common practices within the medical provider, and either the fed or the insurance company that experts say is ‘way too complicated’ to explain, however using my formula of simple, I feel confident that you’ll have absolutely no trouble understand my explanation, and grasping and embracing my formula.

 

When you walk into your doctor’s office, and either a cute little blond with some heavy cleavage, or that “all business type” greet you, they don’t see an incoming patient, there’s a “ding, ding, ding” that goes off in their head. The very first thing that they check is your ability to make payment on the upcoming medical event. They are interested in the financial numbers that can be billed to which-ever health care plan that you have, oh yeah, you’ll need to pay that deductable right now.

 

Don’t have a health plan…..no problem, just belly up to the pay window…..cause we except cash in  any denomination, and from several different countries. However writing a check will take several minutes cause we gotta check the balance in your account, “go ahead and have a seat, we’ll call ya when were done.”

 

It’s a brave new world out there in the health care industry, the competition is brutal, and the practices can cut the guts right out of a family in need. I had my stress test, sadly I’m not due for another Colonoscopy for another couple of years…..and by then who knows what it’ll cost?

 

HAVE A NICE DAY!