Billing - Hospital Style

Yesterday morning I was reading in the Boston Globe that local hospitals are padding their bills with charges as high as $500 called “faculty fees” and/or “facility fees.” (It must be for all that enjoyment that we all feel sitting in the waiting room for the doctor while our parking fees rise.) To, personalize it, later the same day I received bills (there was more than one.) from the Lahey Clinic totaling close to $1,000 for what my coverage did not pay for a recent surgery. I’m part of the 47% for which that is not a trivial amount. The surgeon and staff were very good, no complaints. What irks that hell out of me is that the surgery is routinely performed at the hospital. So the hospital billing department must know within a reasonable amount what the cost was to be. There were no complications. The hospital billing department also deals with my coverage daily. They must know what the difference would be before the surgery. It was not an emergency. So why could they not inform me? Would it possibly have been because I might have shopped around to minimize my out-of-pocket expenses? In addition to the bills, I received a begging letter. Gee, guess how much I am inclined to give? Why is there not some legislation that requires that informed consent also involve information about the costs to the patient? It is time to bug our legislators to create some useful legislation around this.

Sequestration

Sequestration has several different definitions in the dictionary. The first of these is banishment or exile. What exactly is being banished here? It would seem to be common sense and common sense of purpose. In particular it seems to be the Republican Party which has banned any common sense whatsoever. They seem not to have thought about the recent national election or to listen to their own leaders, such as Karl Rove who talks about making the party more inclusive. Instead Republican congressional leaders seem to be focusing on the very few. Of course, those very few provide an awful lot of money. Apparently that short term gain is more important than any long-term survival as a party. However, the Democratic Party has its own problems. They just seem to reflexively oppose everything that the Republicans propose. Some of what they’re asking deserves at least consideration. The second definition of sequestration is retirement. What exactly is being retired? It certainly is not the nation’s debt. The Republicans keep yammering that the cuts are only 2 or 2.3%. And that certainly does not sound like much. Until of course, you think about what 2%. A 2% cut in an earlobe, though painful, wouldn’t be bad. But a 2% cut in brain tissue might have a different effect. Maybe an organ not in evidence is a poor example. A heart/ No there is not much indication of that either, but you get the picture. Certainly 2% of monies to aid the disadvantage is a huge cut. But this 2% will not affect Congress’s retirement pay. Indeed, Congress has excluded itself from having any cuts whatsoever to their pay. So the pain of sequestration certainly does not start at home. The last definition is confiscation. Certainly among those things confiscated is any sense of political dignity. To listen to these people (and I use the word ‘people’ only in a polite sense) is come to believe that any sense of logic has been confiscated. The same people who argued just a short while ago that these dire consequences would certainly force all involved to a compromise. Now these folks seem to think that the sequestration is but a drop in the bucket, a mere irritation, certainly well absorbed by the American economy without any consequences. Perhaps it is time to sequester, retire, this Congress and start again from scratch.