Doctors, Hospitals and Insurace Companies: Are They Conspiring Against Us?

This past July, I went to the emergency room here in Austin, Texas, with a pretty nice cut to my thumb. I never was admitted to a room. I just sat out in the hall on a gurney while the good doctor anesthetized and then stitched up my thumb. There were seven stitches to be exact. I then was told I needed a tetanus shot and I consented. A few weeks later I started to learn that the bills were totaling $2925.25. Am I crazy to think this is scandalous? I didn't spend the night. I didn't get general anesthesia. I didn't even get a room. I got seven stitches.

Honestly, I thought the total might be close to $500, and I would have been willing to pay that, but man was I off. I'm one of the many Americans who doesn't have full coverage health insurance and I don't want it. I think it's a scam too. I can actually afford to go to the doctor (or the chiropractor or the acupuncturist or the midwife etc.) expressly because I don't buy full coverage health insurance. However, since I do live in a society where we have made it impossible to pay for anything major as far as health care is concerned, I feel it imperative to have catastrophic coverage. I pay about $90 per month, and I have a $7000 deductible. So, if I lose a limb I come up with $7000, which I could do. Then I'm covered up into the millions somewhere. Great. Like there should be any health care that costs a million dollars... Otherwise, I just pay for my health care and try to take really good care of myself.

So the story gets weirder. I gave the hospital my insurance card because that way the insurance company has proof of me paying down part of my deductible for the year. The hospital submits the $2925.25 to the insurance company and due to an agreement they have together, they reduce the bill to a total of $2020.28. This gesture doesn't make me happy, it just makes no sense. $2020.28 is still an outrageous amount for me to be expected to pay for the procedure I had. If I had gone to the local doc-in-the-box, the entire thing wouldn't have even cost me $800. I did not know this at the time.

So what's up with my Insurance Company having the ability to reduce the bill? Shouldn't a bill be a bill? Period? Should I pay less than my insurance company would pay on my behalf? If insurance companies pay a premium to doctors and hospitals, that would explain why health insurance is so dang expensive. There once was a time when the local doctor could take chickens and eggs as payment. What happened to that type of compassion? I used to think that the doctors were victims too - that if they didn't have to pay exorbitant amounts in malpractice lawsuit insurance, they wouldn't have to charge so much. Now, maybe that's true, but if you've seen the invoices of cancer doctors lately, you know that the numbers are so staggering that even malpractice insurance can't justify the amounts. We recently saw one of my mother-in-law's cancer doctor bills. The oncologist saw her for a total of 5 minutes, told her she was doing great, and the office visit alone was $900. It's a good thing she's covered, and a really good thing she's re-covered.

There are still doctors out there who are in medicine for the right reasons, whose prices are still totally reasonable, and who haven't let the system get them down. And do you know what? We shouldn't sue them if they make a mistake. We're free to choose any doctor we want. They've all taken the Hippocratic Oath. Can we pass a bill that makes malpractice lawsuits illegal, but still have systems in place to weed out any dangerous doctors? Like perhaps we could have a complaint system. At a certain point, you lose your license to practice medicine. We could take insurance out of the picture entirely. Doctors don't pay for insurance and neither do we. We just pay the doctors directly. How about that? And we don't sue them either.

Oh, but wait. I must be dreaming. That's right. I don't have billions of dollars with which to lobby congress like the Insurance Industry. I guess my son's college fund for this year can cover the seven stitches in my thumb.

I could give up there. That was a great ending to the article, to the thought. But, that's right - I don't give up.

If there's anyone else out there who thinks I'm on to something, let's get our minds together. When the ideas are in line, the money will follow. Let's change the system. No more health insurance at all, just good ol' affordable health care.

But seriously, as of now, I do have to come up with $2000 to cover the stitches. And it's the college fund I'll have to forgo. Hmmm.