Try and get a price quote for a medical procedure before getting it done.
Other than cosmetic as previously stated.
For free market to work, consumers need to have information to make an informed decision on.
I tried to do just that before I okayed Deep Brain Stimulation Therapy surgery to help with my Parkinson's. I let Johns Hopkins know that price was definitely an object, and there was a limit to how much out of pocket cost I could afford, and that limit was right around $1,000. They told me it wasn't their practice to discuss the cost of their services beforehand, and I told them that any expenditure of that size, whether surgery or remodeling your home, required an estimate, in order that the consumer be able to make an informed decision. They repeated, we don't give estimates. So much for the free market in health care. The free market requires that the buyer be made aware of the price of that which he is considering purchase, does it not? The refusal to give a hard estimate, if done in the home remodeling industry is a sure sign of incipient fraud. Fraud is still a crime, at least officially. I told them if they wanted to have the revenue from the procedure, which my online research told me was in the neighborhood of a quarter million USD (nice neighborhood, btw), THEY WERE GOING TO HAVE TO GIVE ME AN ESTIMATE OF THE OUT OF POCKET COSTS I COULD EXPECT, becsause if the cost was significantly higher than my $1,000 limit, I would pass on the surgery. The last young lady I talked to seemed unusually cooperative, given her compatriots' intransigence on the matter, came back immediately with a figure just under a grand. I said do it. When the bills started coming in, the total out of pocket was well over $11,000. I asked them exactly which part of "I can only afford $1,000 out of pocket for the procedure" they didn't understand. They said there were two procedures, that the young lady who had given me the quote weassn't authorized to do so, and what was her name? I lied and told them I didn't write it down (no sense in letting them fire a potential witness). They told me the quote she had given me was for the first procedure. I said WTF? It was sold to me as one procedure with two stages: the first in which the wires were implanted in thr brain (for which I would be awake for the entire operation...a FUCKING NIGHTMARE, but I won't get into that now), and the second in which the pulse generator would be implanted in my chest and the cable run from the generator up my neck and behind my left ear to the wires under my scalp. They tried to claim that was two seperate procedures. I went off.
To make matters worse, the surgeon broke one of the implant wires during the second stage, so the goddamn thing never worked properly even though my neurologist, who sold me on the surgery in the first place AND was the first person the surgeon called after he fucked up, told me it worked fine. I went to Georgetown University Medical Center for a second opinion. They got some odd readings from the system, so they turned the pulse generator off, checked the system again, and got an impedance reading of 4,000 ohms with the system off. For those of you not familiar with electrical circuits, there should be no impedance reading on an open circuit. Impedance or continuity means the circuit is either closed or has a short to ground, andf when the ground is your brain, this is no small concern. The folks at Georgetown told me to leave the system tuned off, and set an appointment for me with one of their neurosurgeons for the next day (a Saturday, no less),and did x-rays and a CAt scan right then and there, so he could see them before we met. Georgetown UMC is a great hospital, btw. It's a magnet nursing school, and therefore a nurse's hospital, and it shows in their attitude toward the patient. When you are in the waiting room, they don't just call your name and have a nurse escort you to an examining room to cool your heels for 23-30 minutes waiting for as doctor to appear. The FREAKING DOCTOR COMES OUT TO GET YOU, and usually within 5 minutes of the appointed time. This is in contrast to Johns Hopkins, which is a fine hospital, but it's a surgeon's hospital, and they tend to be a tad arrogant. Oh, and one more thing: when I met with the neurosurgeon at GUMC, he had none of the arrogance of the asshole at Hopkins who botched the original procedure (and you should have seen that jerk shuck and jive and call me "boss" after he fucked up). The surgeon at GUMC actually had a bedside manner AND a personality. When I asked him how much it would cost to remove the system, he told me to call the hospital Monday afternon, that he would have all the info to them for pricing first thing Monday morning. When I called, I was quoted a total cost of $20,000 to remove the system, which included 23 hour post-op observation, so it was still outpatient surgery (all hospitals do that...it's a sign of the greed built into the system), and my out of pocket cost, since i had already met the Medicare deductible for the year was right at a grand. I said, "No surprises?" She said, "We aren't Hopkins." (Oh, snap!!). After the procedure, the neurosurgeon came to the recovery room, and told me it had been a piece of cake, that there was no n eed for the added cost of 23 hours of observation, "So get the hell out of here. You can still avoid the lunch rush at Filomena Ristorante if you hustle. It's on Wisconsin Ave, a block from M Street toward the riverfront." I said, "COOL!! Thank you! We're outta here." My bill for out of pocket was $400.
Back to the saga of Zoom vs Johns Hopkins: After severl fruitless phone calls to them, I wrote a scathing letter to them, ripping them a new one for their attitude, their near refusal to quote me any kind of price at all, the bogus estimate they gave me when I told them, "No estimate, no surgery," and their absolute intransigence at making things right, especially since they botched the procedure sufficiently that it could have killed me, and talked about taking action on their malpractice. A hospital official told me that I had no chance on the malpractice, SINCE I HADN'T DIED (so much for malpractice being the culprit in the obscene increases in the cost of health care...and don't even try to argue the point with me...I've done my homework on the topic, and I'll embarrass anybody who tries to run their corporater talking points by me with a good, old-fashioned verbal ass-whuppin'. Don't believe it? Try me.). He also said that he was turning my account over to a collections agency if it wasn't paid immediately, and in full. I sent another letter, this time to Johns Hopkins University as well, since JHU was the billing agent for the doctors, in which I mentioned that I had been told by the surgeon that "Medicare pays me plenty for these procedures, so I don't balance bill," and yet right there on the bill was a balance-billed charge for $1,000, so i raised hell about that AND repeated the malpractice angle, but changed it a little, saying, "I may not be able to beat you in a court of law over this outrageous bullshit, but I'm going to bet that I can crush you in the court of public opinion. I'll just contact Paul Berry and see if my case qualifies for one of his "Seven on Your Side" features (Berry is one of the anchors on channel 7, the ABC affiliate in DC). The surgeon took his charge off the bill, but the total was still in excess of $10,000. Then the phone calls from the collections agency started, but I have to admit I actually kind of enjoyed that. After I politely told the lady who first called that I wasn't going to send them anything, that I was still fighting with the hospital over the amount of the bill, she asked if I would hold for her supervisor. I did, and was rewarded with this deep, oleaginous voice from which all trace of an identifiable regional accent had been studiously scrubbed just prior to the addition of the 6 qts of 10W40, telling me that he wanted to work with me on this matter, and if I would give him my bank's routing number and my checking account number, he would make sure my credit rating wasn't damaged because of my late payment (I told him I didn't appreciate his thinly veild threat, to which he replied, "well, then, maybe you should have paid your bill." Now, I'm pissed. I said, "In the first place, this is not bad faith on my part, but a legitimate disagreement over the size of the bill..." He cut me off, saying, "I don't care what your story is. Are you going tp work with me, or do i need to take steps toward lowering your credit rating?" I laughed at him, "go ahead. Do whatever you want, chuckles. You don't scare me, because I'm legally blind and can't drive, so I don't need to buy a car. My cabin is free and clear, I have all the computer and a/v equipment I could ever want, and I'm divorced. If you had checked out my credit before you decided to run the bad-ass act by me, you would know all that, so why don't you just take your empty threats, and call somebody who gives a shit?" Stunned silence. "Man, this just isn't your day, is it? I bet it's not often that somebody tells you to go pound sand. Oh, yeah, and don't call here aqain. Buh-bye." Damn, that felt good.
It felt even better when I got a call from JHU the next day, from the office of a guy who gets the University to write off hospital bills in cases involving indigence or (cough, cough) bad P/R. He noted that i had already paid $400 to the hospital, and said he was going to journal entry that money over to the University to pay the doctors, and if I would send a check made out to JHU to his attention to pay the remainder of the doctors' bills, he would clear off my debt to the hospital. I asked how much he wanted, and he said $575. I said that was great, but I was curious as to why the sudden change of heart? He said, "Your letter was bouncing around, and finally landed on the right desk."
"Yours?"
"No, actually, my contact at the hospital, who knows what to send to me and when, and your letter raised some very serious issues, and caused reactions that were even more serious."
"Such as?"
"Such as your surgeon waiving his fee. It's illegal for him to offer you a discount that he hasn't already offered to Medicare."
"And i noticed there are ads on ABC for a new reality series called "Hopkins" starting in three weeks."
He sighed, "Yeah, that was definitely a consideration. The fact that you went to Georgetown for a second opinion, and they found a potentially fatal flaw in our work and had to remove it, while we were dunning you for payment and turning you over to an agency for collection doesn't make us look good."
"Speaking of which..."
"I'll call them, and if you get any calls from anybody at the hospital about your bill, refer them to me."
The for-profit health care system put me through the wringer, and I have Medicare, who pays legitimate bills without question, but the for-profit system has corrupted even that, by finding loopholes in the Medicare regs, and changing their procedure coding to take advantage of them.
