“No, I am not doing an electrical physical, I’m here for a cold and I don’t need that test!” ……“But sir, your Blue Cross will cover it” came her soothing reply.
This post appeared on this blog June 14, 2012. It is a true account of a medical encounter at the Valley Day & Night Clinic in Brownsville and illustrates what’s wrong with our current system of fee-for-service health care.
By Bill Rusteberg
I have a cold. Sore throat, dry cough. Have had it for about three days now. Ive had colds before, they are not deadly and go away with time. But, having a cold is miserable and misery in and of itself is contagious to those who have to put up with your whinning. So I went down to the clinic this afternoon to have it treated.
Ok, what the heck is this visit going to cost? I thought. I have a high deductible health insurance plan and of course I am sensitive to costs since this visit, I knew, would be all on me, and not on the insurance company.
After checking in, sitting in the waiting room, and then led to an examining room, the cash register began to work overtime. I had asked the girl at the front desk to check to see what BCBS would allow for the office visit alone, and was told $62. Not a bad deal, below Medicare and above Medicaid, not too bad. “But sir, we may need to run some tests and those are extra”, said the nice admissions girl.
So I’m sitting in this isolated room, door closed, wondering what was going to come next. In comes a nurse asking a whole lot of questions about my general health. Ok, that’s fine. Then another nurse comes in later to swab my mouth and nose for testing – makes sense I thought because, after all, I was in for a cold. Then 3rd nurse comes in and says “Sir, we need to take an xray of your sinus’s please come with me!”. Ok, that makes sense I guessed since sinus may have something to do with my throbbing head and general congestion. But as I walked down the hall to the xray room, I starting to add up the costs, or at least wondering what they were escalating to.
Back to the isolation room, in comes yet another nurse (Nurse #4), clip board in hand, and she says “Sir, I’m here to take you for an electrical physical, please come with me!” “Wait, what is an electrical physical!” I asked. “It’s a physical of your entire body, and only takes about ten minutes.”
“No, I am not doing an electrical physical, I’m here for a cold and I don’t need that test!”
“But sir, your Blue Cross will cover it” came her soothing reply.
“No, you dont understand, I have a $10,000 deductible and this test is going to cost ME money. I don’t want to walk out of here owing you $1000 today when all I have is a damn cold!”
“Sir, I do understand. This test costs about $300. So we won’t do it”.
I left the clinic paying $128.43. This included the office visit charge, xray and sinus and mouth swab test. So these procedures doubled the cost of the visit from about $62 to $128. With the electrical physical my bill would have been almost $500 for my visit to treat a common cold. I have not been to the pharmacy to pick up my antibiotic and cough syrup, so I am not too sure what my total expense will be for the day.
The point of this is to illustrate consumer behavior when one has skin in the game. The other point is, and which I am not certain of, is at what point does the consumer know when to say “No” to additional testing.
Next time I get a cold, I’m going to Matamoros, have a shot of tequila while waiting for the pharmacist to fill my $3 bottle of antibiotic or a $9 Z-Pak.
From a Physician:
Damn, I wish you had the electrical physical so you could tell me what the hell it is and what they can tell from it. I personally prefer the two hat method to cure the common cold. Put a hat on your bedpost. Drink tequila and orange juice until you can see two hats. Go to sleep. If it still is there when you wake up, do it again