Over the past few decades, everyone seems to be blaming everyone else for how high medical costs have sky-rocketed. It kind of reminds me of what’s happened in professional sports where owners blame players and player unions for the outrageous contracts being paid to many professional athletes and yet it’s the owners who ultimately agree to pay those outrageous salaries just to outbid each other.
In the medical field, doctors blame hospitals, hospitals blame doctors and medical companies who in turn blame healthcare insurance providers who in turn blame doctors and hospitals. So, who really is to blame for the high costs of healthcare that many Americans can no longer afford?
If you ask me, I would say it’s the doctors, medical groups and hospitals who are the primary culprits.
For the past few years, my wife and I have been without insurance. When we go to the doctor, we go as ‘self-pay patients.’ Consequently, we are charged a lesser amount for the visit than what they doctor would bill an insurance company.
Another example is when someone in my family was receiving treatment for any injury that occurred at work. A doctor was injecting 10cc of cortisone into constantly spasmed muscles. He would insert the needle, inject a small amount, then reposition the needle and inject some more and keep doing that until he had injected all 10cc of cortisone.
Even though the medical treatment was covered under workman’s compensation, my family member inadvertently received a copy of the bill the doctor was sending to Workman’s Comp. We were shocked to see that he was charging $166 for each time he inserted the needle and injected just 1cc of cortisone. The total bill for the cortisone injection was $1,660 for ten injections for a total of the 10cc of cortisone.
The next time you receive a copy of a doctor bill, look at how much the total charge was, then notice how much the insurance paid, how much was written off or discounted and then how much they are billing you. Ever wonder how they can afford to discount or write-off as much as they do on a regular basis? The reason is because they have a higher price they charge the insurance company than what they charge self-pay or non-insured patients. I’ve seen the same thing happen with hospitals.
In response to paying the inflated charges billed to them, insurance companies raise their rates meaning everyone has to pay higher insurance rates because of what doctors and hospitals bill them.
Years ago, a co-worker was telling me that his wife was the head nurse for a leading cardiologist in the area. Since establishing his reputation, he charged an average of $100,000 just to perform the simplest of heart surgeries. In many cases, he charged more. I asked his wife one day what happens if someone needs heart surgery but doesn’t have insurance. She told me that he only charged about 60% of his standard rate. When I asked how he could afford to so that, she said he makes it up with what he charged insurance companies. Incidentally, every year, that cardiologist would close his office and take all of his staff and their spouses on a fully paid 2-week vacation to all kinds of places. One year they all went to Hawaii. Another year, he took them London and Paris.
Over the years, I’ve personally seen and heard of numerous incidents of where doctors and hospitals charge self-pay patients one rate and then charge higher rates for insured patients. As in any business, costs get passed on and in the end, it’s the American insured American people that end up paying the higher premiums which also means that fewer people can afford to pay for healthcare. It’s a vicious cycle and at the heart of it all are the doctors, medical groups and hospitals!