The Last Person That You Want to See

November, 1999

 

Generally speaking, It's the last person you will ever see on this Earth-- (if you're lucky)

     I'm talking about doctors, of course. From Hipocrates to Jack Kevorkian, the medical profession/industry/fraternity is without a doubt the most talked about subject in our society today. Everybody has an opinion about it. And a second opinion. Patients say doctors are paid too much, doctors say they are paid too little, and the government says that we shouldn't pay at all (at least not directly to the doctors.) It's enough to give you a migraine.

      I've got to tell this story. A number of years ago, when I was doing consumer electronic repairs, a doctor complained to me that my prices were too high. He balked at a $20.00 VCR repair. "You worked on my VCR for five minutes," he complained, "and you charged me 20 dollars for it." "Standard price," I explained, "for maintenance, adjustments and cleaning. I charge the same no matter how long it takes." Then the doc proceeds to whine about having to wait ten minutes while I finished working on the VCR for the guy ahead of him. This was too much -- I had to let him have it. "Listen sawbones," I started, "I've lost count of how many times I lost an hour sitting in the exam room wearing a paper napkin, while I waited for one of you guys to finish up on the guy ahead of me. Besides that, every year there are about a hundred new models of TVs and VCRs that I have to know how to work on. You only work on the same two models." I really got going. "Plus, if I screw up a repair, I cover it with a warranty. You guys cover your mistakes with sod." 
     The doc turned beet red, his jaw tightened, and he was unable to speak. He pulled out a $20 bill and put it on the counter. I've got him now, dead to rights. I rang up the sale, but I waited to play the trump. He picked up the machine, and as he turned to go, I called out after him. "Would you like to purchase a service contract? It's our version of Blue Cross." He just walked away, thinking (I hope). 

     There are now more types of doctors in this state than there are crooked legislators. There are: oncologists, urologists, anesthesiologists -- Neurologists, psychologists, gastroenterologists . Family practice, chiropractors, pediatricians, geriatrics,- podiatrists, optometrists, ob/gyn, bacteriologists . Internal doctors, dermal doctors, infernal doctors. and on and on and on... 
     And since the advent of the credit card....all of them are plastic surgeons.
     This in itself is not a bad thing. It is truly good to have doctors trained to specific expertise. My only problem is how they play off of each other--like a bumper bank shot on a pool table. 
     The big thing in medicine these days is "managed care." Managed care is to medicine as the drive-thru is to the food business. It's lightning fast, they usually give you something pretty close to what you asked for, and in my case, they always get the bill screwed up.
      Back in the "old days", it was simple. If you fell off your porch and broke your arm, you went to the hospital. You would have an x-ray, and the doctor would put your arm in a cast -then you would go home. Back in 1960, you would be out about $75.00 (in cash), and you would then fix the porch railing. In 1999, same railing, same arm- You would call the paramedics, they would transport you to the hospital. You would have an I.V., copious x-rays, blood tests, and evaluations. You would then have several internists laminate your arm (hopefully the broken one) while the clerical staff x-rays your insurance coverage. The time you spend sitting in the hallway waiting for the cast to dry costs $75.00, and six months will pass before the HMO and the doctor get their billing straightened out. In the meantime, you take a cab home and sue your builder. This is modern medicine. 
      Along that same vein, there's the new-medical-discovery-a-week slot in the media. Generally once a week, usually on Thursday or Friday, the medical elite issues forth a statement in regard to some exciting new scientific breakthrough that changes the way everybody thinks about medicine. For example, some clinical research group will state, "In most automobile accidents, pavement is involved." After the public goes wild about it over the weekend, these elites will issue a retraction on Monday or Tuesday, saying "It's not THAT big. It's just a theory, it isn't true in all cases.." This wild interest keeps drug and research stocks afloat, so the corporations can concentrate on their main objective: finding a cure for the common middle class.
        During the last few months I have been experiencing "episodes" of pain and discomfort, for which various medics have urged me to have checked out. (I might add that pain and discomfort from the malady are nothing next to the pain and discomfort of the medical tests, and of course the pain and discomfort of the billing process.) An investigation was started, nonetheless. After several invasive and downright rude tests given by a battery of medical personnel, the problem has been identified as "stress". But there are still plenty of insurance dollars left in the till, so more of the medicinal minions are waiting for a shot at me, hoping to find the mother lode. 
     In the mail today I got a "statement of charges" from the hospital. Across the top of this was written the words "THIS IS NOT A BILL", and "DO NOT PAY THIS AMOUNT." It went on to include an itemized list of everything that happened to me since puberty, and the amounts that they were trying to charge the insurance company for it. I calculated it out. After figuring the hourly rate, I decided that had I been hospitalized for a week, Blue Cross would have been billed an amount nearly equivalent to the Lousiana Purchase. (It would be negotiated down to Texas-size, and my portion might be Dallas, Houston and Galveston.) 
       Another example: Last month, during the course of some work at home, a small piece of fiberglass insulation managed to get around my safety goggles and into my left eye. I went to the local eye clinic in a hurry. (by the way-at age 38 I was the youngest patient in the waiting room) The doc calls me in, looks in my eye, and announces, "There is a piece of fiberglass in your left eye." The doc removes the said fiber and then he leaves. Time spent in doctor's care, 90 seconds. (I timed it) The bill -- $45. This works out to fifty cents per second. At the reception area they asked about my co-payment. "Ten dollars", I say. "Fine," they say, as they total up the bill. I give them a sawbuck, and they give me the receipt. The bill states: CHARGES FOR EYE SERVICE, TOTAL--$45.00. PATIENT CO-PAYMENT PAID-$10.00. TOTAL SUBMITTED TO INSURANCE-$45.00. A week later I got a letter from Blue Cross stating "Emerg Accident Care- amount billed $45.00, paid $45.00. At this point, the only question I can think of is, "Whose lunch did I just buy?" It calls to mind the old toast said by many a legislator---"Here's to integrity--- here's to truth------ six parts gin and one vermouth!" 
     The current system can't get much worse, unless of course we let the feds take it over. Then we would have the same foxes that guard the social security "chicken coop" in charge of the nation's health. Then if I fell off the porch I would get a new kidney and have a leg amputated (at "no charge" of course). 
I saw the doctors, but they saw me coming.

Neil