Angry Patients Stuck With Big Medical Bills After “Bait And Switch”

WBZ-TV ^ | February 14, 2012 | Joe Shortsleeve

[The Antiyuppie]

“Funny how people are so damn willing to have their medical conditions taken care of immediately then piss and moan when they get the bills........”

I take it that you work in the medical industry. I think things are funny, too. I think it’s “funny” how the cost of medical inflation has wildly outstripped inflation. I think it’s “funny” how auto technicians are expected to charge for prices to repair/replace things “while they are in there” at a lower price, while apparently, snipping a tag of skin off while you already have a knocked-out patient on a table with a camera/cutter stuck up their $@#$ is an entirely new event.

What I don’t find funny is that my salary has not increased the same amount as medical inflation has 1990, even including my experience and significant promotions.

Again, assuming that you work in the medical industry, if you don’t get this under control yourselves, either the democratic president in 2012 or the one in 2016 will be glad to help you do so.

[Chode]

it's called liability since part of that extra cost goes for the Extra malpractice insurance that goes along with surgery vs a screening procedure, and they aren't just skin tags, snare one wrong and you have a hole in your colon... then it becomes real surgery to fix it

and if they don't know it was a through hole, you go home with a perforation that leaks feces which can REALLY cause problems... something the mechanic doesn't have to worry about

blame the lawyers for the extra cost of practicing preventative medicine and the high cost of malpractice insurance

[Chode]

make that

blame the lawyers for the extra cost of practicing preventative defensive medicine and the high cost of malpractice insurance

[Kirkwood]

“that’s why i told the doc NO polyp removal during the screening procedure when i had mine done”

Sheesh. Why even bother to get screened if you don’t want any polyps out? You want to go through the process of getting cleaned out all over again for a second procedure? Or you plan to keep the polyps and let them turn into cancer? That makes no sense.

[heartwood]

On the one hand, around $450 for the patient’s share of a colonoscopy with sedation and polyp removal does not seem outrageous.

OTOH the insurance company is making pettifogging distinctions between “preventative” and “diagnostic” and not warning the patient what will happen if polyps are found. It would scarcely be a “preventative” colonoscopy if the polyps were not removed. And the whole point of taking a look at someone’s colon in the first place is to “diagnose” if cancerous or pre-cancerous conditions are present. A colonoscopy in itself has no “preventative” value.

[Chode]

because the screening was free... i couldn't afford anything else at the time

i just thank God there were none to be removed

[Hot Tabasco]

Again, assuming that you work in the medical industry,

Assuming just makes an ass out of U, not me. No, I never worked in the medical industry. However, I was a benefits rep for over 30 years for my corporation and my job was to administer my company's benefits plan as well as our UAW pension plan.........

So I have heard all the complaints and dealt with all the problems our employees had with our insurance carriers. 90% of the problems were caused by the ignorance of the employees of our plan and their expectations compared to the realities of what we covered........

[Hot Tabasco]

if you don’t get this under control yourselves

And by the way, my company was self insured.......do you know what that means?

So don't preach to me about rising healthcare costs, I'm fully aware of them.......

You got a problem with the cost of removing a polyp during your colonoscopy then the next time go see your auto tech.........I'm sure he'll give you a cut rate deal........

[Hot Tabasco]

...and the next time you need a coronary bypass but want a cheap rate, go to Canada where they can provide you with a really qualified general surgeon...you might have to wait about 8 months tho.

[CharlesWayneCT]

That only makes sense if you either are going to keep the polyps, or think you can shop around and find a cheaper removal service. Otherwise, aren’t you just going to go back and do the procedure anyway?

[CharlesWayneCT]

The reason for “free preventative treatment” is that by catching things early, you save money for the system.

If people have to pay for tests, they often won’t take tests, in part because they don’t have the money to fix problems, in part because the tests are annoying, and in part because they are afraid of what they might find out.

But you can’t actually perform all the treatment for free. You need people to have some skin in the game, in order to prevent padding of procedures.

In this case of course, it’s just cross-purposes. No point in not getting the polyps removed, but yet you see some people saying that’s exactly what they did, to separate the free checkup and the payments for treatment.

But by getting the free checkup, they know now they need treatment, and can save up money for it. And they likely will, and will therefore save money in the long run, beause the cost of removing the polyp is much less than treating a cancer.

[therut]

Once people think something is “FREE” they all get mad. A colonoscpy along with the physician cost if no polyps are removed is 2,400 at the hospital I practice. He got a great deal. Quit your b87ch9ng. Good grief. People hate to pay a penny for health care EVEN if it saves their life.

[Chode]

that is what a FREE screening is for, to know if you have them or not and at the time i had zero extra dollars to have a procedure done... money dictates a lot of things at times

i was lucky, i didn't have any

[The Antiyuppie]

” I was a benefits rep for over 30 years for my corporation and my job was to administer my company’s benefits plan as well as our UAW pension plan.........”

This, combined with your other post about your company being self-insured, confirms that you (personally) were effectively “in” the medical industry. If you aren’t part of the solution, you are part of the problem.

[The Antiyuppie]

“The reason for “free preventative treatment” is that by catching things early, you save money for the system.”

Oh, goodie! So, that means that I will get insurance at a lower rate, right? OK, maybe that’s unreasonable. How about keeping it at the rate of inflation?

[The Antiyuppie]

“...and the next time you need a coronary bypass but want a cheap rate, go to Canada where they can provide you with a really qualified general surgeon...you might have to wait about 8 months tho.”

According to Wikipedia, whose source is the CIA World Fact Book:

US Life expectancy ranking:
Canada: 12th
US: 20th

From the Kaiser Foundation:

How much spending per person per year:
US: $7,538/year
CA: $4,079/year

This doesn’t seem like a good value. It appears to me that people in other countries, many of which don’t have people running around in grass skirts and/or dropping dead in the streets, also like to have quality medical care. They seem to be getting a better deal. It isn’t fair to count countries like Japan, with better demographics (in the short term, anyway) and arguably, genes and diet.

The medical-industrial complex is a much bigger threat to the future of the US than the military-industrial complex was even imagined to be.

[Freedom_Isn't_Free]

"No. Doctors do not have any idea which insurance carrier each patient uses, which combination of policy options he has, what is covered and blah,blah, blah",

You have no idea what you are talking about. My wife had this exact procedure done last year. The Doctor's office knew exactly what insurance we had, how much the co-pay was and what the coverage amounts were. And just like with the person in this news story, they decided to remove one tiny polyp (the scope is equipped with a device to do this), transforming this from a preventative procedure to a diagnostic one. The difference in cost out of our pocket was nearly $400. We understand the terms of our policy; we own our business, choose our insurance carrier and pay the full insurance premium for our family and all three of our employees, but there was no mention beforehand of the potential for additional fees for this procedure. Why is it that for healthcare we have to walk in and say "do whatever you want and send me the bill"?

And for the other folks implying that patients are wanting something for free: We pay over $3,000.00 per month to BCBS for health insurance, so we don't get much done "for free".

[CharlesWayneCT]

Why should health insurance go up at the rate of inflation? Inflation is just an average of the change in cost of all goods and services considered to be good for measurement.

Some might go up more, or less. Also, unlike the discussion of “health insurance costs”, inflation is based on similar comparison. I’m pretty sure the health insurance I have today provides access to a much higher value of treatment options than 20 years ago, so of course it should cost a lot more.

Half the problem with medicine is that we have a lot more treatment, and that treatment costs a lot more. I haven’t noticed the price of tylenol getting that much higher, or the price of band-aids. Half the drugs my wife takes are so cheap that insurance is meaningless, because they are old drugs.

But if they put me in a new machine for a test that didn’t exist 10 years ago, and my insurance covers it, of course my insurance is going to be more expensive. That’s not how the inflation rate is set, it is adjusted based on the “similar value” rule.

People want the latest treatment; it would be like complaining because your new car with ABS, traction control, side/rear air bags, GPS/NAV, bluetooth, surround sound CD/XM satellite and Onstar costs more than your 20-year-old car did, even counting inflation.

And Health Insurance isn’t just insurance. It’s part of a complex symbiotic system. At BEST, it is a product that is built not to customer spec, but to government spec, with features forced on customers whether they want them or not. It is not like homeowner’s insurance, paying off damages when you go get them fixed. Instead, Health Insurers are inserted between you and your doctor, trying to dictate the types of service you get, and how you get it, telling the doctor how much they can charge (much less than “retail”) — containing costs by cost controls and rationing.

At worse, your employer is thrown into the mix, so you have an EMPLOYER who wants to minimize the cost of the insurance, YOU who want to maximize the value of the insurance, the doctor who wants to maximize his profit, the insurance company which wants to maximize premiums, minimize costs, to drive a maximum profit. Somewhere in all that somebody is expecting to get quality health care for free.

We’d really be a lot better off with a radical transformation of health care: Remove all incentives for employers to buy health insurance, free insurance companies to set up risk pools instead, throw tax money at the problems of pre-existing conditions and artificially limited access, give the tax credits directly to the people who buy insurance (which is really an “insurance mandate” by other means, so I’m not sure about it), and let people decide what they want their insurance to cover.

Regulate not the items that must be covered, but instead a clear comparative listing of those items and costs to make it easy for consumers to shop around. If it becomes necessary, mandate a set of cafeteria menu items that must be included (costs to be determined by the insurer), and then use government regulation to evaluate the costs if it appears insurers are artificially inflating them to avoid having to offer certain types of coverage. That last part though would only happen if things didn’t work out naturally, which they should because with no regulation and fierce competition for 300 million subscribers, the insurance companies will have a great incentive to tailor policies, much like the car insurance company can tailor your car insurance to your own lifestyle.

So if I’m a single guy, I can pick coverage without obstetric care or birth control. If I’m a married man, I throw those in. If I’m young and don’t likely need it, I can eschew prescription drug coverage, at the risk of getting some lifetime illness that requires special drugs which then will be pre-existing condition. Then I have to beg government to help me out. Oh well....

[Freedom_Isn't_Free]

The cost of the colonoscopy, along with other mandated preventative treatments, is factored into the cost of the insurance. The insurance is not “FREE”, it is paid for (by the patient and/or his employer). So how is the patient expecting something for “FREE”? Good grief ... talk about b87ch9ng!

[ottbmare]

I am not suggesting that you’re asking for services for free. If you have Blue Cross, you’re paying through the nose. My sympathies, and you have every good wish for your wife’s health.

But I do know what I’m talking about here, on a professional basis. This is something I know a lot about. If your doctor knows the details of your particular policy, that’s really remarkable and you’re blessed. Most doctors (and I am talking about the DOCTOR, not her office staff) do not. Most doctors in private practice accept coverage by several different popular insurance carriers, and each of these carriers offers several different types of policies, depending on what arrangement has been negotiated with that particular group. Most doctors leave these details to their staff—the reimbursement specialists, coding and billing people, office manager, (or billing company if they contract the billing and collecting services out). The office staff can punch up your details on the computer instantly. The doctor very often doesn’t even know how to use your procedure codes to tap into his own staff’s software and get dollar amounts for you. If your doctor can, congratulations on having a really well-informed doctor. But usually this is the knowledge area of his or her employees and he or she doesn’t know the details.