A Modest Proposal

To tell the truth, I’m almost to my limit with the health care “debate,” but something stirred my interest the other day: a bill. From the doctor’s office. They said I owed almost $250 more than I already paid for a routine checkup.
So, after calling the office numerous times, we finally got it straightened out: the billing clerk didn’t realize that we are cash customers. Lacking health insurance, like, um, 47 million other Americans, we pay as we go for services rendered. Our status, understood at the main desk where I wrote the check, didn’t get back to the office where bills are processed. I paid $145 for the checkup and some blood work recommended by my OB/GYN, and thought that was that. But according to the bill, I owed an additional $243. Why? Because the billing clerk thought I had insurance. Once she understood that I didn’t, the $243 was struck from the record and I’m no longer a debtor.
But I’m thinking, why should having insurance more than double my bill? Fortunately, I had the answer: “How American Health Care Killed My Father,” an article in The Atlantic by David Goldhill. Below the catchy title is one of the clearest explanations of the current system I’ve ever read.
The essence of Goldhill’s argument is that, in the health care system as it’s evolved, patients are not customers. The insurance company or the US government is the customer, and are billed according to their deep pockets. It’s not that all doctors are rapacious, but simply that it costs money to shuffle papers in offices. That’s what insurance companies and Medicare do, basically: pay people to shuffle papers in offices, and some of that money sifts down to pay the actual bill.
So my modest proposal is this: why don’t those of us with moderate means pay for our own doctor visits and routine tests? That involves making decisions; for instance–in my latest visit, my doctor recommended a biopsy. I did some research and decided not to, and time, I believe, has proved that decision to be wise. The $145 I paid may seem a little steep, but I spend that much on two weeks’ worth of groceries or a month of gasoline. Why don’t we do health insurance like we do auto insurance, where you pay for your own oil changes and new tires, and let the insurance pay for the unexpected disaster?

It’ll never happen, though–it makes too much sense.


One Response to “A Modest Proposal”

  1. Melissa Forte Says:

    I have had has similar situations. One time I needed to get a prescription refilled and the nurse said it was too early, the insurance won’t approve it. I told her I didn’t have insurance, I pay out of my own pocket…so I approve it! She had to call me back in order to talk with the doctor.
    Needless to say I received my prescription.

    I have also found lab work much cheaper than anticipated paying cash.

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