Healthcare Costs in America

Is it not the patients who ultimately pay for everything through their insurance premiums or taxes?

Courtesy: doctorsolve.com

(EUGENE, OR.) - In the United States, more people are killed each year by doctor mistakes than in auto accidents. In his film, Sicko, Michael Moore tells us that the quality of US healthcare rates 37th among other nations. For this poor quality work, Americans pay significantly more than any other country. In Sicko, Moore questions why healthcare and social services in the US are so different than that of other countries.

After interviewing foreigners and Americans living in foreign countries, Moore explains that in European Union countries, the government fears the people, but in the US the people fear the government. Despite how poorly Americans are treated, they do not rebel and take to the streets as they do in places like France. Based upon my own experience dealing with the US healthcare system, I offer my perspective on how, doctors themselves, with our permission, are responsible for much of our problems.

When we are finished shopping for groceries, the store clerk rings us up and hands us a receipt that lists each item purchased and its price. When we take our car to the shop for maintenance or repairs, when the mechanic is finished, we are handed a work order that itemizes the parts and labor costs and final bill, which we are asked to sign. Our signature implies that we approve of the work performed and the charges.

The same is true when we take our computers or lawnmowers to the shop or even when we have a flat fixed at a tire shop. With such service providers, we are made aware of exactly what we are being billed for and given the opportunity to question the work and the charges. This system plus normal guarantees provides a basis for recourse if customers are unhappy with the service or charges.

How different things are when we seek the services of our healthcare providers. After doctors and their assistants have completed their work, we are not provided a statement which lists their services or charges. Unlike other businesses, we are not provided an opportunity to review or question the charges.

Despite their many mistakes, there work is not guarantee and the patient must pay again for follow-up complaints. Because of our instilled faith in doctors and our inability to comprehend the medical billing codes and jargon, we seldom question the doctor’s competency or service provided. Especially when we know that our insurance company is going to pay for it, we figure we need not be bothered. But wait a minute.

Is it not the patients who ultimately pay for everything through their insurance premiums or taxes? When doctors pad our bills with charges for excessive time or procedures they did not perform, aren’t those charges passed on to us by the insurance companies?

Due to the lack of meaningful government controls or review by their patients, doctors have unlimited opportunities to exaggerate the amount of time spent with patients or to make false claims about procedures or tests they have performed. Knowing that their patients or others are unlikely to ever review their medical records or question their work, doctors are also free to include personal opinions and false statements in their patients’ medical records.

Because of numerous spinal problems caused by a fall from a ladder many years ago, I have sought the help of many doctors. Several times when bothered by a doctor’s behavior or attitude, I have requested copies of my medical records so I could review the doctor’s diagnostic codes, fees charged, and comments. While reviewing my records, I have never failed to be amazed by the errors and falsehoods. My most disturbing experience occurred in 2011 after being referred to a rehabilitation clinic in Eugene.

From the moment the doctor entered the exam room, he seemed preoccupied and disinterested. During the less than ten minutes he was with me, he talked mostly about my past spinal surgeries and MRI’s, which seemed to have his full attention. It was all too much for him to deal with and he was quick to tell me that he had no idea what to do and walked out of the room. Because his behavior was so strange, I returned to the clinic a few days later and requested a copy of my medical records.

I could not believe what I read. Though he had not performed any testing, the doctor stated that all my neurological testing for strength and range of motion was normal. Since 1998, I have had undergone five spinal surgeries, four of these on my cervical spine. Though the doctor did not discuss the purpose for these surgeries or the results, he stated that these surgeries had not resulted in any benefit to me.

Unbelievable, for without the first surgery I would not have been walking for the past twelve years. Because the doctor had not discussed any of my past with me, I had to assume that he was overwhelmed by the complexity of my problems and supported this by claiming that others also could not help me. In order to bill Medicare, he had to claim that he performed some service, so he just made it all up. For his brief time with me, he filed a fraudulent claim with Medicare for over three hundred dollars, which of course gets adjusted.

I addressed my concerns about this doctor with the clinic’s lead doctor and office manager. When they refused to speak with me or refund the Medicare charges, I filed complaints with Medicare’s fraud unit and Oregon State’s Medical Board. Besides pointing out the doctor’s incompetence and fraudulent charges, I discussed the effect such uncontrolled behavior by doctors has on our nation’s healthcare costs. I am certain that it is common practice among doctors to falsify our medical records and pad our bills in the same manner as this doctor. Doctors work behind a wall of protection provided by their attorneys, head doctors and office managers at their clinic, and highly biased state health boards. However, their greatest protection comes from Americans who hold them in high regard and seldom question their work.

I have filed complaints against this doctor and clinic with Oregon State’s Medical Board. I have also filed complaints with the Medicare Fraud unit. Because of past experience with similar cases, I do not expect any action will be taken against the doctor involved. However, I will provide an update after I learn the results.

I highly recommend that all Americans watch Michael Moore’s, “Sicko” to learn the truth about healthcare systems in other countries. I also recommend that patients request copies of their medical records and review their doctor’s comments and the charges being billed to their insurance company or Medicare.

You can write to Wayne Pierce at: breeze@wrenfeather.com