How can you tell the price of a doctor’s visit?
If you’re like most Americans, you have a good idea of the price of a gallon of milk and a gallon of gasoline. The former runs around $3.59, dropping from time to time to $2.50 if the “sell by” dates are creeping up, or the store’s delivery truck is scheduled to arrive with a big shipment. A gallon of gasoline is about $2.59, although unlike a gallon of milk, the price is subject to change from hour to hour because we let the oil companies get away with abrupt adjustments based on “market” conditions.And if you’re like most Americans, you saw a doctor in the past two years. While we’re encouraged to see a doctor annually for a check-up and a dentist every six months, most of us don’t happily, because most of us don’t need to see one. You know if you’re basically healthy, although seeing a doctor annually is to catch the bad stuff early. If you’re basically unhealthy, if you smoke or eat badly and rarely exercise, you know that, too, and seeing a doctor annually isn’t going to change your habits. But healthy or unhealthy, here’s a question: What’s the price of a doctor’s visit?
Until this week, I didn’t know either, even though I’d just been to see my doctor for my biennial check-up. When I got to his office, I gave the receptionist the $20 co-pay required by my health insurance; I presume the doctor got some or all of that. According to the statement I received from my health insurance carrier, the doctor billed them $131, from which my carrier deducted my $20, knocked off $49 as allowed under a provider agreement previously negotiated between my carrier and the doctor’s office, and ultimately sent my doctor $62 for the time he spent examining me. When I went back to the doctor a week later to review the results of the blood work, I again forked over my $20. My doctor billed my insurance carrier $179, with no explanation as to why $131 the first time and $179 the second. After deducting my $20, my carrier deducted only $11.60 this time as a discount, and paid my doctor nothing, noting that $147.40 remaining would be submitted to my MSA/HSA account.Two doctor visits for about $250; I presume my doctor got the $147.40 from my MSH/HSA account, though I didn’t know that I had one, much less what it is or how it operates.
Of course, my doctor didn’t get all $250. There’s the receptionist to pay, and the nurse, a few inexpensive items to be paid for from that money, like the blood vials sent off to the lab, and some portion of the cost of some very expensive equipment which happily I didn’t need, that day at least. Using the national average of 14 percent, $39 was spent negotiating the provider agreement with the insurance carrier, and in the back-and-forth billing between my doctor’s office and the carrier. At the end of it all, I have the nervous feeling that my doctor made less per hour than my mechanic.So what is the price of a doctor’s visit? One answer would be $20, which is what I paid when I went to the doctor’s office. Another answer would be $62, and $147.40 would apparently also be correct. Then, too, $1,074 would be right as well – the amount is half a year’s insurance premiums plus the $20 co-pay for each of two visits. In the last 12 months, I’ve spent $2,148 on insurance premiums and $40 in co-payments for two routine doctor visits; happily, I’m healthy enough not to need all the services that money would get for me.This month, the President began a series of scripted, no-naysayers-allowed town meetings similar to those he used so successfully to sell his Social Security plan, to convince you that the best way to control the cost of health care is through “consumer-directed Health Savings Accounts.” According to the President, health insurance premiums have risen 73 percent since he took office because “Americans consume (health care) as if it were free (and) they often do not even ask for prices.”
In that, he’s correct. If we had any idea what health care cost, we would shop around, and prices would drop. But for that to happen, I need to know the price of a doctor’s visit. Just tell me, without paperwork, without insurance carriers, and for God’s sake, without “consumer-directed Health Savings Accounts.”Marc Carlisle writes a Thursday column. He can be reached at firstname.lastname@example.org.
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