Tuesday, August 15, 2023

My Valentine's Day “Roto-Rooter” is Finally in My Rear View Mirror! (published 8-15-2023; article #426)

12/25/2016 photo by Nathalia Segato on Unsplash. Free to use under the Unsplash License.


I apologize, dear reader, for the pun in the title! I couldn't resist it! I call a colonoscopy a “roto-rooter,” as a expression of my style of humor.

Colonoscopies, however, are no laughing matter. Colon cancer is a serious disease. A colonoscopy can detect and remove early forms of colon cancer, before the cancer becomes fatal. An annual stool sample can also detect early forms of cancer.

Improper eisegesis should not read into this article what this article does not say. This article is not opposed to colonoscopies, as preventative measures. In fact, it affirms them, in wise and informed consultation with your doctor. The physical torture of the preparation is far worse than the actual procedure. An annual stool sample, sent off for laboratory analysis, is my preferred option.

The purpose of this article -- the 97th under the topic “Life (such as it is)” and the 66th under "Poly-Tics (Greek 'poly,' many, plus 'ticks,' blood suckers) -- is to publish my critique, from experience, on the high cost of the overly bureaucratic and socialistic healthcare system, in this once great nation.

This Article, in Historical Context

First, however, the historical context of this article must be set. On August 14, 1945, Japan surrendered unconditionally, ending World War II. Yesterday marked the 77th anniversary of that surrender.

On August 15, 2021, this once great nation lowered its flag at the Kabul, Afghanistan, embassy, ending the “War on Terror.” The article of 8/16/2021 remains my public statement.

Anesthetist's Bill, for 22 Minutes of Work

Moving to the purpose of this commentary, the article of 2/15/2023 mentioned my Valentine's Day “roto-rooter.” Also, one of the four sidenotes, in the article of 7/5/2023, noted the anesthetist's first bill, sent on 6/27/2023 and received on 7/3/2023, for $1,440.00. The procedure was on 2/14/2023 (Valentine's Day). Why did it take so long for the anesthetist's bills to start arriving? He sent me three additional bills, on 7/4/2023 (Independence Day), 7/21/2023, and 8/7/2023 (received yesterday). Apparently, once his bills start, they just keep coming. Common business practice is to send a bill, with the due date 30 days after the bill is sent. If the bill isn't paid by the due date, then another bill is sent, after the missed due date.

The log that I have been keeping is now ten pages. In it, I've been recording the mind-numbing and overly bureaucratic details, related to my colonoscopy. The log contains records of Explanation of Benefits (EOBs) received, bills received and paid, letters, and phone conversations. I won the appeal, to my insurance provider, in that I verified that one small polyp, discovered on 2/14/2023, could not have been, logically, a pre-existing condition!

Having received the anesthetist's fourth bill (dated 8/7/2023 and received yesterday), I sent my $467.50 payment, to him, by postal mail, today -- with my pithy letter included. (I saw the mailman take it from the mailbox. Yes, he is a man.) An email, which I had received on 8/9/2023, verified that the anesthetist worked 22 minutes, during my colonoscopy. My letter included the following analysis.

By my calculations, the anesthetist's initial charge of $1,440, for 22 minutes of work, is $65.45 per minute, or $3,927.27 per hour. Thankfully, the insurance adjustment decreased his charge by 67.743% (or $975.50). Thus, my $467.50 payment, for 22 minutes of work, calculates to $21.25 per minute, or $1,275 per hour. Even with the adjustment, that's not a bad pay rate! Wouldn't $21.25 per hour, not per minute, be a good pay rate? For 22 minutes of work, the anesthetist would earn $7.79. I'm sure that's not enough. So, let's try $100 per hour! If so, he would earn $36.67, for 22 minutes of work. That's better -- and reasonable!

Dear reader, how would you like to earn $467.50, for 22 minutes of work? Just earn the proper degree and get a job as an anesthetist! Apparently, it's easy money!

Total Costs, for Colonoscopy

Focusing now on the total costs, for my Valentine's Day colonoscopy, my records indicate the following charges, the approved amounts, and what I paid actually. The information is from EOBs, my bill payment records, and my 10-page document record.

Total charges, for the Cologuard kit, all laboratory, and all services, was $6,120.91, which includes the 1/27/2023 consultation. (The total does not include the $50 that I paid for the 24 pills, mentioned in the 2/15/2023 article.) Total insurance adjustments (decreases) were $3,461.47. Subtracting the insurance adjustments from the total charges results in approved total charges of $2,659.44. As of today, I have paid, for all laboratory and services, a total of $2,446.03 (not included the $50 paid for the 24 pills). Subtracting my total payments from the approved total charges leaves $213.41.

So, dear reader, my 2/14/2023, Valentine's Day, “roto-rooter” may not yet be in my rear view mirror completely! Will some provider send me a bill for $213.41? We will see. If I get another bill, I will write about it, and I will reference this article! Well, that is according to the Lord's will, of course.


As to life, “such as it is,” I hope that my Valentine's Day “roto-rooter” is finally in my rear view mirror! I hope that the EOB mailings, which I have been collecting, have stopped. I hope that the bills, which I have collected, challenged, and paid, have stopped. This sad saga has occupied enough of my time, over the last six months!

As to “poly-tics,” my experience is only one sad example of many. I have major medical health insurance coverage, through a well-known and reputable insurance provider. The policy is in place, to cover major medical care expenses, if, God forbid, they were to occur. The monthly premium is fairly reasonable. I chose the policy, since I'm healthy, can pay the deductible and maximum out-of-pocket costs, if needed, and want a lower monthly premium. I did not select a plan, with a much higher monthly premium, with lower out-of-pocket expenses.

The sadness of my example illustrates the high cost of the overly bureaucratic and socialistic healthcare system, in this once great nation. Months ago, I wrote, in the 10-page document, which I've mentioned previously, that the total cost should have been no more than about $500.00 to $750.00 – for the Cologuard kit, laboratory, the 24 pills, and the about 30 minute colonoscopy (including anesthesia). The “consultation,” before the procedure, was not necessary. Instead, total charges, as I've stated earlier, were $6,120.91 not including the $50 for the 24 pills. If one pill costs about $2.08, why should I not have expected the higher costs, for the procedure?

The healthcare industry needs to be like, for example, the automotive repair industry. Any vehicle repair shop will provide, up front, an estimate on the cost of parts, labor, supplies, fees, and taxes. You decide to do business or not. Competitors are out there!

Healthcare providers, in non-emergency situations, should provide up front estimates, on the cost of equipment, laboratories, medications, supplies, labor, and fees. Then, you consult with your health insurance provider. By that means, you determine your out-of-pocket costs, up front.

Lord willing, I plan to require up front estimates, on total costs, before any future non-emergency medical care. I grow tired of being surprised, for example, by an anesthetist's bill, for 22 minutes of work, that charged me $1,440.00. The healthcare industry needs more competition and less socialism.

Also, let's stop the constant barrage of prescription drug commercials, in the media, such as the walking roll of toilet paper commercial! We can do it! On 4/1/1970, President Richard Nixon signed legislation that banned cigarette advertisements on radio and television. In 1997, while my wife and I were doing mission work in Russia, the federal Food and Drug Administration (FDA) allowed pharmaceutical companies to advertise directly to consumers, on radio and television. If cigarette advertisements are banned, then pharmaceutical commercials can be banned!

What say you?

1 comment:

Anonymous said...

This is an excellent exposé on the high cost of healthcare, which has been out of control for decades. I have similar stories. The cat is already out of the bag. There's no way to stop the train wreck.