Being the scumbag, ambulance chasing, personal injury attorney that I am, over the last 20 plus years, I've reviewed more medical records and expenses than I care to guess the number of. Is it an understatement to say our system is broke? Been broke.
I also come from a family with a long line of doctors, so Christmas dinners have some interesting discussions. However, it's allowed me to see our system from different perspectives.
A few weeks ago, I was in the ER at one of our local hospitals. As trivial as it sounds, I had been having nose bleeds for about a week. Not small bleeds. More of a why the hell is blood splattering on the floor level, and on this particular day, there was no stopping it, and I was in a bit of a panic. Fast forward to the end, it turns out my incredibly dumb ass thought there was no rush in getting my blood pressure medication refilled. The pharmacy is 90 seconds from my house. I'll drop the bottle off tomorrow, or next week, or maybe some time next May. I won't do that again. But here's my ER visit.
Check in, give them my card to charge me $200.00, and go sit for 1 1/2 hours in the waiting room with bloody gauze the size of a bed sheet hanging out of both nostrils. I'm called back to triage where they take my blood pressure and ask me what seems to be the problem? Well, it seeeeemmms, that all the blood on my inside, wants to be on the outside. But hey, I'm no doctor. $1 to BR. Triage session over. Back to the waiting room for another hour.
Called back to a room, where I wait and wait and wait. Finally, a nurse practitioner comes in and asks a few questions, and takes that little lighted scope thingy and tries to look up my nose. He says he can't see anything through the blood, but this little scope is really to look in ears. He takes my blood pressure again and leaves. I wait some more. And wait. He comes in again and takes my blood pressure one more time. Then, he gives me a bottle of Afrin. Yes, the same Afrin you would pick up in cold and flu section of Publix. Tells me to spray it twice a day. ER visit over.
I left out no details. That was the full extent of triage, exam and treatment. Got the EOB from Blue Cross showing charges totaling $2,570.44. Three BP checks and a bottle of Afrin. The proper acronym would be, AYFKM?
I had a client a few weeks back that was rear-ended. Kinky!!! Went to the ER with the usual complaints of back and neck pain. God bless her. Came out with a bill of over $53,000.00, which included 5 CT scans at $6 grand a pop.
I could go on with nightmare billing scenarios all day. But, what's the other side of that? Have you seen what Blue Cross pays after deductibles and co-pays? Had I been on Medicare or Medicaid, the $200.00 I paid up front would have been more than double what the hospital received. I deal with Medicare/Medicaid/Blue Cross and other health insurance all day long, and I honestly have no idea how doctors and hospitals stay in business if they have to make it on those amounts. And another part of it is that I guarantee 60-70% of the people in that same waiting room had no insurance at all. But they can’t be turned away.
Then, I think about the fact my Blue Cross premium is by far the biggest expense in our household. Far bigger than my mortgage payment. Why, when they’re not paying shit towards the overpriced bill, and I had already paid more than the visit was really worth when I checked in. But, you can’t be without it. Right?
The system is broke.
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