California Dreamin’…
May 31, 2007
Email This Post
Print This Post
I read this article from the LA Times…it deals with Minute Clinics, price transparency and consumerism, and comes from California - which if we’re all to believe the rhetoric, is where all trends start. So - that being said, this is kind of interesting. Thoughts/comments welcome.
DOCTOR’S LIST PUTS A PRICE ON CARE
By Lisa Girion, LA Times Staff Writer
May 28, 2007
A decision by a major medical group to post rates could push rivals to do the same, letting Californians shop… Click here to read the full article.
This sort of price transparency seems to have the potential to exert both positive and negative effects on healthcare delivery. On the positive side, it will most likely lead to open competition between providers, which will most likely drive costs down. This cost decrease could ultimately prove temporary, though, as competition has also proven effective at driving smaller organizations out of business. Larger groups, such as HealthCare Partners Medical Group, will be better able to absorb fluctuations in costs and customer base as they enjoy advantages, such as quality of care provided and expanded affiliation, that smaller groups and independent practitioners do not.
As far as factoring in the effect of Minute Clinics and their like, I think their effect will be limited to the routine tests and procedures, as mentioned in the article. However, it is very possible that these retail clinics will be the first facilities in many areas to introduce this sort of pricing, and could serve to force the issue with local providers in other fields.
It seems to me that a natural step in this process would be the direct marketing of medical tests and procedures to the patient, rather than the practitioner. This is something that has been evident with prescription medications for a while now, and we have all seen what effect that sort of branding has had on the costs of medication.
As an uninsured and low income person I am delighted to hear about anything that allows one to “shop before one drops”. Several years ago I took a prescription medication to try to treat Tinnitis. I have been living with it since it suddenly came on in January of 2002. Within a few days of taking a low doseage of Neurontin I developed a very copious nose bleed that I could not stop even with phone calls to a nurse practioner. I tried dealing with it and had a temporary cessation as long as I stayed still. At about 6pm, when I got up to try to feed myself (I live alone in a small rural town) the bleeding began again and I couldn’t stop it and by 11:00 that Saturday night I had to drive myself to the emergency room (covered in a plastic garbage bag with a whole for my head so I wouldn’t be soaked in my own blood. I am over fifty and haven’t had a nose bleed since I was a small child. And those few incidents were always the result of getting smacked in the face while playing. I also do not have high blood pressure.
The bill for what amounted to about three hours of waiting until a Doctor looked in on me and some slap dash stiptic pencil treatment and a poorly inserted sponge - taped across my face and barely inserted in my nose (in all about 15 minutes of actual attention) I was allowed to go home. As soon as I got home the bleeding began again and I went to bed that night with duct tape across my nostril. Since no offices or clinics are open on weekends I had to return to the emergency room where I waited another two or three hours for someone to look in on me and after some heated words from me concerning the reluctance of the second Doctor to even bother to consult what the first Doctor had written the night before I was finally given a proper “plug”. The bill for this cavalier and not at all hurried treatment was $2500.00. While I was there the Doctors simply ignored anything I had to say about what I thought was the cause of the bleeding. The Neurontin was packaged with warnings about the possibility of unusual bleeding. And neither Doctor treated the issue as life threatening. But the itemized bill was padded with high cost for medicine, (cotton swabs, some stiptic type cuetips and a swab of coagulant that both doctors applied but the first let sit so long it had to be reapplied after his gab fest with a doctor at the front desk. The room was swarming with a lot of busy looking people, paper pushers, nurses and nurses aids. One would place the tray in readiness for the Doctor, and just as quickly another would remove it before anything was done so yet another would have to find it again. Very silly and very stupid. But quite the show.
The bill for the two visits listed them as “life threatening”. That was an outright lie. And the billing was official fraud. I was not given a transfusion. Only a pile of towels. Not once was I ever given an idea of how much anything would cost and that has been the story of any visit I have made to that area Hospital in a New England State whenever it has been my misfortune to have to go there.
Do not down play the fact that when patients are in need, that is the perfect opportunity for any system to take advantage of their vulnerabilty. A school nurse could have stopped that bleeding. When I finally found out where the bleeding was occuring - I couldn’t see for myself in a mirror because the bleeding obscurred the source - it was down at the tip of one nostril, I could have stopped it myself with an ice cube - but the nurse I consulted over the phone that Saturday morning advised my to hold an ice pack on the bridge on my nose, not under it.
To close this, the Hospital ultimately wrote the entire visit off. I didn’t pay a cent. But even if I had been insured or had a much higher income, I would have been a fool to have paid more than $50.00 for the miserable and hopelessly inefficient level of care I received. You will have to go a very long way to cleanup your act AMA because it is obvious that Hospitals are something of a boondoggle, fed by decades of fraudulent billing by Doctors and Hospitals (an honest Doctor over thirty years ago told me that) and the ease with which people hand the whole cost issue to the insurance companies. Do not understate the fact that Doctors are protecting their “turf”. That is in the Hippocratic oath I noticed. Evidently Hippocrates wanted Physicians to keep their “arts” secret the way Venetian Glass blowers guarded their trade. But it is still a highly selfish and self serving action on the part of Physicians. What good are the “wonders of modern medicine” if even the simplest of matters cost more than a trip to Europe (much cheaper actually than trying to spend two weeks vacation here) I was able to spend two weeks in Italy on half that cost when I had some spare cash. Italy has a very good and efficient medical system, by the way. But I have yet to hear any American Doctor praise any other country’s system. We do not have the best health care system in the world. only the best “puffed” and most expensive. But then the US isn’t really the best at much of anything anymore, is it?
That Italian vacation was taken in 1998. I haven’t had a trip overseas or even across the country since. I know that as a consumer I face a future crisis that will be very similar to the old Jack Benny joke about the stick-up man demanding “your money or your life” His answer, “I’m thinking about it.” I’m afraid the answer I will have to give is “my life”.
Paul Rosa
The state of America’s medical care is in dire need of overhauling, especially emergency medicine. I have been misdiagnosed in our local ER three times and my daughter has been misdiagnosed several times as well. I had been diagnosed with IBS and several other gastrointestinal problems and after two years of agony ended up not only in the ER, but having an emergency radical hysterectomy! My daughter was diagnosed with a deformed tail bone which was to require surgery that would include breaking her back, only to find she had a pionidal (sp?) cyst two days later. Two days following this she had the cyst lanced following two days of antibiotics, several weeks after that she required having the gland removed. She spent six agonizing weeks with an open incision which required packing with gauze twice a day. I won’t even mention the cost of the original ER visit she had including a series of x-rays. Both she and I have been to the ER for serious conditions and had the ER doctor only talk at us and not even examine us! I do think medical care costs too much in this country, some of it is the doctors. However, it is the greedy insurance companies and idiots HMO’s that drive the cost of medical so high it is almost impossible for the poorer folks to afford. If you’re on any sort of assistance, your doctor is not given the right to practice medicine, rather, the insurance companies decide what procedures are payable and what medications they will cover more often than not based on whether these insurance companies are in bed with each other. It’s a disgrace. Simply a disgrace. It’s also a disgrace for the poor to have to resort going to ER’s where they wont be turned away due to their financial status. Physicians, heal thyselves. Insurance companies, shame on you.
I thought they seemed like a good idea until I read they do not want to meet the requirement to have sinks in their patient care are! No sinks in 2007???? Is this more about health care or profits for CVS?