Medical care: Free market or fee racket?

Today I found some links to stories about those who have no insurance pay for medical care many times what Medicare would pay.  A trite example is charging more for a single over-the-counter pill than the hospital's own pharmacy would charge for a whole bottle.

If you have a few hours to gnash your teeth, read

"Bitter Pill: Why Medical Bills Are Killing Us", Steven Brill, Time, 2013-02-20

"Healthcare Isn't a Free Market, It's a Giant Economic Scam", Mike Masnick, tech dirt, 2013-02-22

Please pay your bill on receipt

Or if you prefer, you can pay for this column as soon as you read it and receive a five-percent discount.

This little entry was triggered by a wonderful spoof of the health care system by Nicholas Kristof, "I Cost More, but I'm a Specialist", New York Times, 2010-02-20. He writes that "We Americans have the greatest news care system in the world…" His bill for our reading his column is $1,681.63.

He also has a link to another spoof, "If Air Travel Worked Like Health Care", Jonathan Rauch, National Journal, 2009-09-26.

Since I'm only 1/100th as good as Nicholas Kristof, my bill for your reading this column is $16.82. I'm sorry but we do not accept credit cards nor do we bill your news insurance provider.

One of the many hidden costs of healthcare

Every month I receive a statement from the medical center we use. Part of me says to ignore it unless it says "Pay this amount". After all, why should I? The agent that sold us the Medicare supplement said, "You will never see another medical bill."

He exaggerated a bit because there are certain optional services that are not covered by Medicare, supplemental insurance, or other insurance programs. Like contact lenses. Insurance will cover glasses, but not contact lenses. At least for us who use them by choice.

In fact, optometrists offices will not turn over contact lenses until the patient has paid for them. I was surprised one year to see that the cost of contact lenses was passed on to Medicare even though I had paid for them. When I called the medical center office about this, I was told that they sent it on for deniability. I gave up trying to argue with a non-profit bureaucrat. Fortunately, this pass on has not occurred again.

However, the cost of the "contact lens evalution" is both not covered and not immediately passed on to the patient. It has run from $32 to $36 over the last few years. One year the medical center wrote it off before even charging me, one year I paid it after a few months without even being billed for it, and other years I wait until I'm billed for it.

On my July statement I was finally billed for the May 2008 contact lens evaluation. I paid the $35 without question. The cost for my May 2009 contact lens evaluation was carried forward on the June and July statements. The August statement is due in a few days. I bet the $36 for this year's evaluation will still be carried forward.

One of the marks of a successful organization is good cash flow. That is get payments due as soon as possible; then you have cash to pay your own bills and invest in new equipment, and so forth. $30-something may not be much in the big scheme of things, but how many of these little charges are floating around without being billed? How many larger charges are waiting on various non-profit, corporate, and government bureaucracies waiting for a judgement?

Here is the first place to "wring efficiencies" out of the system.