The Health Care Industry is ripping off my family.
Over the last ten years, we have been misled, misinformed, and overcharged by doctors, hospitals, medical offices and insurance companies. All have been guilty, and it’s been going on long before the Affordable Care Act was passed.
Like many American families with chronic health challenges, one quarter of my family’s time and money go to health care and health insurance. But after we pay good money for top-notch care, we spend time battling the rip-offs. They dodge our questions, and don’t return our calls.
What pisses me off the most? The FAX MACHINE.
You’ll have to fax that.
We didn’t get the fax.
Can I get your fax number? I’ll try to fax that to you later today.
Are you near a fax machine?
Our copier is down, so I can’t make a copy to send you that fax.
Fax machines are 20th Century Technology. I have a cell phone, and I can take a high quality photo of any document and send it to you while waiting for coffee. I can keep my entire medical history, organized, in my pocket, and it’s backed up on my hard drive at home, on my computer, and in “the Cloud.” It’s even encrypted.
For business, I am now expected to be digitally organized. I haven’t used a fax for business in ten years. If I told my boss or a client that he has to wait because I’m not near a fax machine, I wouldn’t keep my job for long.
However, when I walk into a doctor’s office and see four rows of open horizontal filing cabinets jammed with thousands of manila folders, I feel like I just entered 1988 -- but they’re charging me like it’s 2018.
Since the economic downturn of 2008, any business that has survived has been asked to do more work for less money. When I create a budget for a potential client, that client will always ask for a better deal, because someone wants a better deal from him. There has been a relentless drive for efficiency.
I believe, however, that our health care system has been able to dodge that squeeze for six years now. As the Affordable Care Act kicks in, only now is the pinch beginning to happen in a major way. Doctors, hospitals and health care providers are all worried that they can’t deliver the same quality care for the same price, and still break even, much less make a profit.
But when someone in a hospital, a billing center, or a doctor’s office asks me if I’m near a fax machine, I lose all sympathy. I’m happy to pay more in 2016, but I don’t think I should pay to help someone catch up to the second decade of the 21st Century. I feel like I’m paying for their tuition.
Everyone in the American Health Care System should get used to a question we’ve all been hearing and asking for six years:
What am I paying for? I want a better deal. Actually -- I would settle for a fair deal.
Here’s an example, in which all facts are true. Someone in my family needs an MRI once a year, to track whether a chronic condition is stable, improving, or worsening. Getting the MRI is preventative and therefore cost-effective. If he waits and his condition worsens without him knowing, it can lead to an expensive emergency.
His insurance pays for an MRI prescribed by a doctor.
He called the Mark Taper Imaging Center, which is part of Cedars Sinai, to book his prescribed yearly MRI, and they told him there were no openings in the next month, even though it’s the facility his doctor recommended.
They told him, however, that there were openings at another MRI facility associated with Cedars Sinai, the Mark Goodson Imaging Center, where they could take him right away. He asked if it was the same procedure. He was told yes, it’s the same procedure...an MRI scan.
He got the MRI procedure, and his co-pay was $1500, but he already had spent $500 out-of-pocket last year, so he only had to pay $1000, which made him feel like he’d saved money.
Then his doctor told him that he should have waited and gone to the other facility, because that MRI machine has more current technology. The facility he went to had an older MRI machine, and the readings aren’t as thorough, which was not volunteered. It was also the same price.
I don’t know what happened, but I will now speculate: the older MRI machine has been paid for several times over, and it’s now profitable. However, everyone wants the newer machine, so the older machines tend not to get used as much. I speculate that he was encouraged to use the facility with the older machine to maximize its use, get some profit, and reduce crowding at the other facility.
He also has a friend with the same condition who also needs an MRI once a year. He feels nervous about the headaches he’s been getting, and he wants to be pro-active and get a second MRI, just to be sure.
On a whim, his friend called an outside facility -- Tower Imaging, a private facility not associated with a hospital, and he asked how much it would cost if he paid cash. They told him $1000, and they could take him right away. He negotiated them down to $900.
My family member feels misled and ripped off. He spent $1000 for the wrong test, and he’ll have to spend $1500 again to get the right one.
No laws were broken. However, my family member is now a gadfly activist for his own health care, and he costs billing departments and office staff a lot of time and money with all his phone calls, as he checks every prescription, every procedure, and every line on every bill, as he calculates how to get the best deal.
And guess what? He bought a fax machine and got a second phone line, just to deal with antiquated medical offices and billing departments who dodge him.
Here’s his typical telephone banter, while standing up in the kitchen:
So, can I get that price in writing?
Yes, I have a fax machine. I’m standing next to it now.
Can you fax that to me now?
I was on hold for 30 minutes to reach you, do you mind staying on the line until I get the fax? I’m standing next to it, I will see it come through.
I signed the document and sent it back. My fax machine said it went through. I don’t mind waiting, can you go see if you got it? Yes, I’ll hold.
It sounds like he’s talking to the lady who books rooms for the Sochi Olympics, but he’s talking with the best medical service providers in Los Angeles, at Cedars Sinai and UCLA.
Most patients just accept the status quo, however. They are so worried about their health care, they’re afraid to question its speed, price or quality.
But you should ask questions. You’ll get better care, and you will help an industry join the 21st Century.
Over the next few blog posts, I will share more medical stories. Consider them rants, consider them advice, consider them guidance. They may help you.
I am the son of a doctor, the grandson of a doctor, the brother of two doctors, and the nephew of a doctor. Although I am not a doctor, I run a business that provides health care coverage to employees who work for more than six months, and my family has typical chronic health care problems that require me to know insurance policies and the health care system. I have some good stories to share.
Here’s my first piece of advice about ALL health care providers. Embrace this, and it will give you strength as you ask your questions:
Most doctors are merely adequate, and not great.
Remember that, no matter what they charge, or how they treat you.
That is not disrespectful to doctors. The truth is, most people are adequate. Most people fall into the middle of the bell curve on everything in life --which is the definition of average. A few people are exceptional, and a few people are terrible. This same statistical truth applies to doctors of all kinds, even in the top specialties. If there are 2,000 brain surgeons in the country, only 200 can call themselves great. The mere fact that you are a brain surgeon doesn’t mean you’re a great one. The Peter Principle may be in play here, as well; a doctor may have been a terrific general surgeon, in the top 10%. However, by choosing the more challenging speciality, that doctor may actually have ended up being merely an adequate brain surgeon.
This is true of lawyers, architects, teachers, and movie directors. It is a fact of all professions. Most people are average at what they do, and only a few are fantastic.
There is nothing wrong with being adequate. I love paying an average price for adequate service. I also don’t mind paying for an adequate procedure on an older machine, if it does the job I need. I never want to pay top price for the best when adequate will do just fine, thank you.
However, I don’t want to be misled, or overcharged, or to endure disorganization and inefficiency. The same applies for the office staff. A bad office staff can sully the health care experience that a fantastic doctor delivers.
Therefore, be your own advocate. They are people, mostly average, just like you.
Ask questions about your service and your bill. And please...tell them to get rid of the fax machine.
The Cost of Your Medical Records!
The Medical Reference Number!