Monday, March 1, 2010

Bloody Hell


Carol recently had a routine blood test – a lipid panel. After checking to see which clinic or hospital in the area was covered by her health insurance, the test was performed at the McAllen Medical Center.

Upon our return from Ecuador we found a copy of the bill in our stack of mail. It covered everything except a $10 co-pay, which Carol had paid at the time of her visit.

The total bill? Are you sitting down? $753.00. The so-called “detailed” breakdown is as follows:

Laboratory $30.00
Laboratory $423.00
Laboratory $147.00
Laboratory $153.00
Total: $753.00

That seemed a tad high for a lipid panel. So Carol phoned the Urgent Care For You Clinic, also in McAllen. Their quoted price for a lipid panel? $55.00. Hmmmm.

Some reasonable follow-up questions might be: Why is there such a glaring difference in cost? Did UnitedHealthCare bother to question what seems like an exorbitant amount of laboratory cost? When Carol asked a representative at UnitedHealthCare via a phone call about possible fraud, their response was “They have seen similar costs for a lipid panel and have paid them.” End of story. There was no interest on the part of UnitedHealthCare to pursue the matter any further.

It isn’t the first time McAllen’s health costs have been called into question:

Flashback to a birding trip we took to the Pacific coast of Mexico. While in a mountainous area one of our group slipped and fell. She sustained a cut on her knee, which required stitches and a trip to a clinic in Tepic, Mexico. While she was being stitched up, the rest of the group was trying to figure out how to pay. Imagine our surprise when the total cost came to $8 and change. Yes, that’s right less than $9 for a visit to an emergency room where we received immediate attention. No forms to fill out. No questions about how we were going to pay for the visit. Never any question as to our nationality. A related trip to a local pharmacy for pain medication and bandages totaled another $15. Lunch later that day cost more.

Some further perspective: About four years ago I walked into an Appleton emergency room for treatment of a scalp wound which required stitches. The cost was in excess of $800. So excuse me for being more that a little upset at a $753.00 charge for a $#$$@!! blood test!

This simply goes to the heart of the matter about why our health care system is so out of whack. The hospital was comfortable charging hundred of dollars for a blood test. The insurance company didn’t question it. Doesn't it make you wonder why insurance companies are fighting back so hard against health care reform? Companies like Anthem.

We’re fortunate in that we have adequate health coverage. Maybe we should just ignore this and look the other way. After all, isn’t it someone else’s problem? We have ours – you go get yours.

We might do just that - look the other way. Except that we have a social conscious. This was not right. It needs to be changed. The spotlight has to be shown front and center on what to us amounts to be complacency and at the worst, fraud. And if it isn’t fraud then explain precisely why.

So what are YOU willing to put up with? Happy with the status quo? Believe we need change? Then get involved. Ultimately it’s your pocket book that’s being picked. Even if it’s as far away as Texas.

2 comments:

  1. Our pocket books are being picked and it is a shame that in one of the richest countries in the world that not everyone has access to basic health care. Insurance companies cut deals for reduced rates, people who are denied insurance coverage but have money are charged outrageous rates and those with nothing just die. Here's my story on surgery in India :
    http://tinyurl.com/yd3dcsn

    ReplyDelete