Flawed Logic

I was going to write about the Garden State Plaza Mall in NJ but instead am ranting about this.So I'm sure we've all been there. You're sitting in the doctor's chair. Most likely somewhat exposed - literally. A boob threatening to peak out under your flimsy hospital gown. Trying to stay warm from the cold examination room. You tell your doctor that something is just not right and they respond with,

"Oh, sure, I'll do a test for that."

"Great," You respond with relief that whatever was ailing you will be discovered and cured.

Days later, you hear nothing from your doctor which means everything was fine. And you feel fine.

But then you get a bill from your insurance. Not covered. $675!!!

WTF ?!%$#@

So you mean if I had just waited TWO days without asking my doctor to perform any tests, I could have saved $675?!?!

You're outraged. In what universe is it okay to give someone a service of some kind only to find out afterwards what you owe? No estimate. No idea that it will even cost you money. Plumbers and contractors guilty of this are kept in check through Yelp reviews. But who keeps medical services in check?

So you call your doctor's office. Five transfers and fifteen minutes later, you get transferred to the billing department of the lab.

You have the bill in your hand that itemizes the procedure costs. Over $3,000. You have no idea what any of this means but are racking your brain trying to figure out how any of this could add up to that.

You bring this up to the billing administrator.

Her response, "It doesn't matter. We charge this to the insurance company and they adjust it. They tell us that it should be $675 because they won't pay that cost."

Your response, "So you charge them as much as you can get away with and then they adjust it to what should make sense?"

Awkward pause. I've caught the billing administrator in trying to explain the flawed logic of hospital and lab costs.

And you continue.. "So without the negotiating power of the insurance company, I'd owe $3,000."

Response, "No - well.. we'd figure something out."

You continue. "If I was getting a haircut and the hairdresser told me that I'd look good in this cut - and I said go ahead. Then his salon charged me an outrageous amount for that - beyond what he knew would happen. They wouldn't be in business anymore. In fact, it would be considered bad business. Except I'm not in a hairdresser's chair and this is my health. Potentially my life, and you're viewing me as a source of profit. How does any of this make sense? How is any of this even moral?"

At which point - you've reached a standstill because the administrator has no response. In fact, they probably even know that you're right and the system is FUBARED. And anything she says will probably incriminate her in some way.

Finally, the administrator responds with "The next time you're at the doctor, call your insurance company first and see what's covered before getting any procedure done."

You think about this. This makes sense. Okay. Then you think about it some more. To which you response, "I'm not a doctor. How would I know which tests to ask about? How would I be able to make the decision over whether or not it's worth it to get a test done or wait? How would I know if I'm making the decision between paying an extra $50 or $500? How does any of this make sense?"

You hang up the phone completely defeated - wondering why in this day in age - where the most detailed information about cost is available through a simple Google search - this still happens. And then you log on to your bank account - visualizing that $675 no longer in your account. Money that could have been used for a vacation. A month's worth of food including eating out. A payment to a school loan. But instead, it's mainly going to cover the costs of our screwed up medical system - money to maintain absurd overhead - equipment instead of doctor's intuition / patient time. High medical malpractice insurance. High administrative costs negotiating with insurance company. You are understandably distraught.

And then you contemplate moving to Canada or Europe and wondering how - with a country that has gotten so much right - they could have gotten something so wrong.