Welcome to the doctor’s. Please remove your wallet.

I’m gradually getting convinced that the entire medical business is a scam. At my last visit to the doctor, at a practice affiliated with St. Joseph Hospital in Nashua, I got a flu shot and a pneumococcus shot, in addition to the normal cursory examination. Since then I’ve received a bill which informed me that those two jabs ran up a cost of $737, of which over $100 isn’t covered by insurance. Normal, honest businesses tell you before you spend sums in that range.

The description was very vague, with amounts for “professional services,” “vaccine,” and “pharmacy.” Nothing said which shot contributed to how much to the costs. I called the doctor’s office, which directed me to the central billing office, which directed me to the St. Joseph Hospital office. I called and had to leave my number because “all our agents are currently unavailable.” They didn’t call me back. I called an hour later and reached someone.

I found out that most of that amount was for the pneumococcus bill, but the flu shot was a significant chunk. What was really outrageous was that the $175 charge for “professional services” was for the same doctor visit that I supposedly just needed to pay a $15 copay for. Of course, it wasn’t even the doctor who gave me the shot. If it took five minutes to prepare and administer the two shots, they billed it at $2100 per hour.

After telling me about this outrage, the woman who answered asked if I wanted to pay immediately by credit card. When I said “No,” she said I’d get a call about the bill next week, even though I just received it a couple of days ago.

If you want to take a doctor to small claims court in New Hampshire, you need an expert witness. That insulates them from most claims. To dispute my bill, I’d have to spend more than I’d win.

Get your shots at the drugstore, not at the doctor’s office — and ask in advance what it will cost. At least you might get out with your skin, minus one tiny hole in it.

I used to donate to St. Joseph Hospital, thinking I was helping people who couldn’t afford treatment. No more.

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2 Responses to “Welcome to the doctor’s. Please remove your wallet.”

  1. Eyal Mozes Says:

    These practices in our health-care system have caused a lot of harm and human suffering; but probably their worst effect has been to get Trump elected president. People’s frustration with the health-care system, and their (totally unwarranted) hope that Trump will do something to fix it, has been one of the factors that made people vote for him. Not the biggest issue, certainly not the most publicized one, and it was the deciding issue for only a small number of voters; but given how close the election was, it seems likely that that small number was still enough to change the outcome. If Obama had done anything to help alleviate such problems, instead of making them worse through Obamacare, very likely Trump wouldn’t be president-elect today.

    The good news, such as it is, is that Tom Price, Trump’s nominee for HHS Secretary, seems well aware of these problems, and sincerely committed to working to solve them. He has on several occasions referred to his frustrating experiences dealing with health insurance, and his desire to work towards improving this system, as a major motivation for his decision to quit his medical practice and enter politics. He has repeatedly introduced legislation to expand Health Savings Accounts, which would make it much more common for doctors and hospitals to receive payment directly from patients; this is the main step that is needed to empower patients in their dealings with doctors, and get doctors and hospital administrators to deal with patients as business to client, including informing them in advance of the costs. Under a different president, Price’s appointment would be a cause for optimism.

    The bad news, of course, is that Price would have to work under Trump. It’s very unlikely that Trump would be willing to cooperate in reforms of the health-care system that give more choices to individuals and reduce his power over all of our lives. From what I’ve seen of Price’s record, my impression is that he is sincere in his commitment, and that he will insist on fulfilling the promises Trump has made regarding health-care reform and that Trump clearly has no intention of keeping; which probably means Price will last for a few weeks, or months at most, before Trump fires him or forces him to resign, and that the practices you’ve described here will continue unchanged.

    • Gary McGath Says:

      People’s frustration also led to Obamacare, in the hope that any change would be for the better. Many people would call what I experienced the “free market.” Of course, it’s actually the result of legal pressures which make the insurance company, rather than the patient, the doctor’s customer. The ACA’s “tax” on the uninsured just ratcheted that relationship up another step.

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