Updated with another fun example (January 2015) Below…
Last October, somehow, I injured my elbow resulting in a great deal of pain and a visit to the doctor. Turns out I had Tennis Elbow. And my doctor, at the time, prescribed some physical therapy, stuck a needle in my arm (steroids) and sent me on my way.
Fast forward 5 months to just the other day. The first doctor referred me to a specialist. The arm still hurts, though it is improved and the continued physical therapy (daily and hourly) exercises and monthly visits to a Physical Therapist is now making limited progress. So I schedule a return visit to the specialist that the first doctor referred me to.
My current job offers a pretty good health plan, covers just about everything you could want. With one gotcha. It’s a high deductible plan. In other words I pay for everything until I meed my deductible. That’s 35-hundred bucks. If I count my wife’s deductible that’s seven grand. Needless to say that makes most medical care, for both of us, a very expensive proposition.
So I see the specialist (after paying $100.00 for the visit) and they suggest continued PT (sigh…) and an MRI or maybe another injection.
I put the kibosh on the MRI as I don’t have $1,500.00 to spare and suggest we try the injection. They run off for a while and come back and tell me that the injection (the same thing that my previous doctor gave me) will cost me $255.73.
I flat out tell them I can’t afford it (I can’t) and that it is absurd that 20cc of a common injection should cost so much. And no, offering to put it on a payment plan doesn’t help. It’s still the same amount of money. They wander off saying they’ll ask their Operations Manager and I get ready to leave without the shot.
they come back and say they can give me the shot for $66.23.
Fortunately they don’t notice my jaw dropping onto the floor as I readily agree and they proceed with the shot.
I think that, right there, is an excellent description of the symptoms (sorry) of the problem with healthcare in the US. They were ready and willing to charge someone almost $200.00 over their cost profit, just because most people would pay it because they need the medicine.
Fucking shameful.
And just today I got this in email:
We received confirmation back from your insurance company regarding the claim filed by [redacted] lab. The insurance company applied $1,355.61 to your Out of Network Deductible leaving you with a total patient responsibility of $2,259.36. However, because you are protected under the [redacted] lab Sure Pay program, [redacted] lab has discounted you $2,159.36, leaving you with a reduced charge of $100.00.
So I am supposed to believe that out of a lab bill of over 36-hundred dollars they are willing, out of the goodness of their heart, to just forgive almost 22-hundred dollars of my bill for a token payment of $100?
I call bullshit. The whole health care industry has turned into a massive racket designed to get as much money as possible from the insurance companies. Who then, in turn, keep raising their rates for shittier and shittier coverage for you and me.
I’d bet anything that their whole pricing structure is a complete fabrication designed to extract massive profits with no bearing on actual costs.
Fifteen months later, still fucking shameful.