From the Editor’s Perch

The High Cost of Medical Care


The High Cost of Medicine

To increase the availability of medical care, we must drive down costs.   And I can’t see costs going down until medical consumers begin to shop.  Let me illustrate this with two recent examples.

Recently I had a long standing sebaceous cyst on my lower back removed.  It had slowly enlarged and gotten infected.  The surgeon said it was right on the line between doing it in the office and doing it in a surgical suite.  He would feel more comfortable doing it in the surgical suite, he said.  I have insurance, so it didn’t occur to me to inquire about the cost.

The procedure took 45 minutes of surgical time.  Billing for the hospital surgical suite use was around $8,000.  A bill for $2,000 from the surgeon arrived sometime later.  Sometime later a bill for $1,000 arrived from the anesthesiologist.  This is $11,000.  I had no idea!  After the insurance negotiated and paid their portion, I was still left with around $1600.  out of pocket expense.  This is still quite a bit to have a bump on my lower back removed.

I told my neighbor who said he was in his doctor’s office and showed him a like bump.  The doctor asked him if he’d like it removed?  My neighbor said, “Yes.”  My neighbor said the doctor recruited two nurses and they removed it right there in the office.  He paid $100.  (Whether or not this was the ‘after insurance’ payment or not, I didn’t think to ask.)

In retrospect, if I had stopped to consider the expense of the procedure, I might have done three things.  First, I might have had it removed earlier, prior to its growth and prior to its infection.  Second, I might have opted to have it removed in the surgeon’s clinic offices.  And third, I might have shopped around for a better price.  I told my son, for $11,000 we might both have flown back to Thailand for a week’s vacation, had the lump removed and returned, none the worse.  He’s currently watching me closely for another ‘bump’ to manifest.

My other example is my friend’s experience which I will give you in his own words:

I’ve had a blockage in my left ear since Feb. It was just normal wax
buildup; I tried hydrogen peroxide and carbamide peroxide drops for weeks,
but that only softened it.

I made an appointment for the ear blockage at the clinic where my primary
physician works. They told me they’d clear out the ear canal with an
elephant wash. I asked the nurse how much that would cost, because I’m
uninsured. She said she had no idea and she would check. A day later I
searched for “elephant ear wash” on the web and found the Elephant Ear
Washer Bottle System by Doctor Easy
<http://www.amazon.com/gp/product/B005M2B5P0/ref=oh_details_o00_s00_i01?ie=U
TF8&psc=1
> . I ordered one with two-day shipping and canceled my
appointment.

The appointment would have cost $300 for the office visit + treatment.

The Elephant Ear Wash kit cost $30.

It’s nothing more than a spray bottle connected to a very narrow nozzle. I
cleared the blockage in 5 minutes.

The fact that the nurse had no idea that their treatment cost 10 times as
much as a perfectly safe home treatment–and the fact that I never asked or
had to ask about the actual cost before–says a lot about the health care
system.”

And folks, there you have it.

Photo by Carl Nelson of a scene from the play, Dark Farce, by Freddie Brinster

Update: 8.22.13  –  This article in the Wall Street Journal provides more focus and information:  http://online.wsj.com/article/SB10001424127887324139404579017113415486176.html

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2 Responses to “From the Editor’s Perch”

  1. dangblog Says:

    I would go to Elephant Car Wash in downtown Seattle and leave the driver’s window open. You’d get your ear and car washed for a reasonable price. Don’t take a car with a nice interior.

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