This blog is typically used for important things like recommending food, perfume, scenic Wisconsin day trips, and dog treats. But there’s something bothering me of slightly greater importance and I need to complain a little bit. That’s right. Today’s entry is not a Holly Recommends entry at all, it’s a Holly Complains. So here we go:
A couple of months ago I went in for my first-ever physical therapy appointment. Last summer I hurt my back helping my husband move an air hockey table (Seriously – it was the kind of job that required about four bodybuilders and it was just the two of us. Horrible decision), and I’ve never been completely the same since. It’s been the kind of pain you tolerate and hope will go away. A year and a half later, I’ve accepted it’s not going away on its own.
I didn’t know what to expect at the appointment. It turned out to be very brief, really more like a consultation. The physical therapist looked at my back, pressed on it, made me move my arms certain ways, discussed how I had hurt myself. Then he showed me a couple of exercises in a room that looked like a health club. I purchased something that reminds me of a water aerobics noodle, and left with a sheet diagramming exercises I could do at home. I’d had a couple more appointments lined up, but some things about my schedule changed and I canceled them. So far, that’s my one and only trip there.
I have no complaints about the physical therapist. He was friendly, professional, and attentive. I can’t say the appointment improved my back in any way, but part of that is my own fault; I have not been very good about doing my homework.
My shock and disappointment came when we received the bill for this (brief, probably under 45 minutes) appointment. It was over $700. Our insurance covered the majority of the bill, so we paid our remaining balance. Most people feel lucky when they see a huge bill and realize their insurance covered it. I don’t. I feel like we got ripped off. Where is all that money going that our insurance company is paying? I doubt the physical therapist is making $1000 an hour. There was a receptionist I talked to that day. I guess she gets a portion of it. They have rent to pay on their building, and insurance, and the building needs things like heat and light bulbs. Still, I cannot make sense of this.
A couple of years ago we had someone come out to fix our fireplace. He added a little blob of cement to a crack inside and charged us $400. We felt this amount was a little high, considering what he’d done and the time it took, and he agreed, and charged us (still way too high) $300 instead. But the point is, we had the right to complain, to use our brains and evaluate, to speak up and change things. No one gets to do this with medical bills, because there’s a perception that doctors are mysterious miracle workers, and we should just trust them. And the fact that most people have insurance, and the insurance company takes care of things for them, greatly decreases the number of people asking how a bill got so large. We all just go along with it. The result is that insurance costs way too much, people without insurance suffer terribly, and medical professionals are encouraged to provide service based not on what patients actually need, but on what the patients’ insurance company will and will not cover.
An example of how sad and true that is: Several years ago I mentioned to my regular doctor that I felt the appearance of my nose had changed. There seemed to be a little bump on one side of it that hadn’t gone away. She referred me to a dermatologist. I went in for my appointment and explained the situation to the dermatologist’s nurse. She told me to take my clothes off and put on a hospital gown.
“Why? The trouble is my nose,” I said. She insisted I put on the gown, so I did.
In came Dr. Creepy. He gave me a full “cancer screening” (which meant looking me up and down and, I’m not even kidding, taking a peek in my undies) and then told me I should have called an Ear, Nose, and Throat Specialist, not a dermatologist. He told me this after my ridiculous “cancer screening.” Yes, I wrote a long letter of complaint about him.
Did I get charged for an unnecessary cancer screening that my insurance paid for? Of course. Was it hundreds of dollars? Yes (who knows – maybe thousands – I can’t remember the cost and I wouldn’t be surprised at any amount). This is just another example of how broken our system is. He knew I was in the wrong place, yet he provided unnecessary (invasive!! creepy!!) services and made more for doing so than I probably make in week.
Imagine if there was such a thing as car repair insurance. Not car insurance. Car Repair Insurance. Do you think when you went to get your oil changed and the mechanic recommended $2000 worth of other repairs you’d ever say no if you had insurance that would cover these repairs? Of course not. No matter how strange or trivial the repairs were, you’d have little incentive to turn them down. And would the mechanic ever tell you that no repairs were needed? Of course not. Mechanics would quickly become very, very rich. Everyone with car repair insurance would have cars that lasted for decades. Everyone without would be in big trouble, because they wouldn’t be able to afford the repairs they needed, now that mechanics were charging so much more than they used to.
This is, essentially, what is going on with our health care system in the U.S. Not all doctors are crooks, but even the good ones are a part of a faulty, flawed system that encourages over-treating some, under-treating others, and charging everyone too much. People feel jaded and discouraged. Since most people are helpless to change things, many avoid seeking medical help all together, having lost trust in doctors and our system.
I’m not sure what I can personally do about it. I sent President Obama an email about this just now, expressing my concerns. Maybe he’ll listen! I’d love to hear what you think could improve our system.