So….a couple years ago, the VA set me up with a chiropractor to help with some lower back pain. I was skeptical, but it really helped. It turned out to be a hip issue instead of my lower back and with a simple adjustment every other month or so, the pain was eliminated for a while. My average visit usually consisted of five to ten minutes in the waiting room followed by ten to maybe fifteen minutes on the table. Normally I was in and out in less than half hour and I think the most I ever spent in the office was 45 minutes on my initial visit.
For the sake of anonymity, I’ll just refer to the chiropractor as “Doc”. I liked the guy. He was personable, kept his small office clean and tidy and always seemed to be in a great mood.
I can remember marveling at the efficiency of the operation Doc was running. He had one receptionist who took care of the appointments, patient records and incoming calls. The building was small and modest, yet looked and felt professional. There was a small waiting room with maybe ten chairs along with the obligatory array of aged magazines and there were five rooms where he cracked spines and necks. It was almost an assembly line…you’d check in at the front desk, sit down for a couple minutes, the receptionist would take you to a room and set your file on the table, Doc would pop in and look at your file and a few adjustments later you were on your way out the door and Doc was walking into the next room to see the next patient. I’d never been in that office when there wasn’t a full house… there were always people coming in the door and leaving out when they were done.
About a year after I’d been getting my back adjusted there, my wife started having some issues and I suggested she call and see if he could squeeze her into his schedule. He said he could work her in that day and that walk in adjustments were $40 a visit. Forty bucks for a walk in appointment seemed like a pretty good deal so we didn’t bother getting her insurance involved and having to deal with paying on the deductible. When she got home that evening, I asked what all he’d done and it turns out that he’d done exactly the same types of manipulation to her that he always did to me.
Now…my mind runs all the time…there’s always something going on behind that stupid look on my face. So the next time I’m sitting in the waiting room at Doc’s I start to do some math. A quick observation of the clock on the wall, the number of people in the waiting room and the number of people coming out of the treatment rooms, tells me that Doc sees roughly six patients an hour. He’s open from 8:00 in the morning until 6:00 in the evening Monday through Friday. Adding in a lunch break sometime during the average day, rough estimation tells me that he sees between 50 and 60 patients a day. We’ll go with 50 just to stay on the conservative end of the numbers. Fifty patients a day and $40.00 a pop comes out to $2,000 a day. $10,000 a week. $40,000 a month. $520,000 a year. That’s pretty damn good seeing as he has only one other employee, who probably isn’t making much more than minimum wage and what I’ll assume is a low overhead, my assumption being based on the size and age of the building he was working from. I was kinda proud of Doc at that particular moment. He’s about my age and I figure after all the smoke clears at the end of the year he’s taking home somewhere around $400K. Hillbilly Logic, right? Not too shabby.
Then I opened the mail one day and had an envelope in the box from Doc’s office. Turned out it was an invoice…A bill for $398.60. I looked the paperwork over carefully to see how many visits they were billing me for thinking that the VA had kicked back against the last years worth of payments for some odd reason. Nope….it was for one visit! I ended up having to drive to the office and question the receptionist who promptly informed me that she’d mistakenly sent that bill to my address instead of sending it to the VA.
Peeling the onion back with the receptionist I learned that if you come in off the street for treatment they charge a person $40 for an adjustment. BUT, if you’re referred to the office through your medical plan they charge the insurance company at a much different “negotiated rate”. My fifteen minute, $40 adjustment just became a $400 adjustment simply because I had good insurance…damn near $27 per minute that I was actually being treated.
It was then that it dawned on me that I rarely ever saw anyone stop at the receptionists desk on the way out of the office to pay that $40, which meant that nearly every patient coming in and out of that door was covered by insurance and Doc wasn’t making $400K a year….he was making a ton more.
Now…please don’t get me wrong. I have nothing against capitalism. As a matter of fact, I’m a big fan of it. This isn’t a matter of money to me though. This is a matter of morals….and not Doc’s personal morals. This is a matter of morality on a national level.
The Veterans Administration, is taxpayer funded. Medicare and Medicaid are taxpayer funded. So when a medical professional charges ten times their normal rate to those insurance companies they’re not screwing over “the system”…they’re screwing over the tax payer…each and every one of us.
I started doing some research on the legality of this practice and what I found turned my stomach. There were a lot of well written articles on medical billing procedures but this is the one that seemed to break everything down to layman’s terms the best: http://selfpaypatient.com/2014/01/03/insured-patients-can-save-money-by-pretending-to-be-uninsured/. If you go look at that article, be sure to take a minute to read through the comments at the bottom of the page.
I don’t get it. Who the hell is negotiating the “negotiated rates” in these insurance companies? Why would any company which we pay substantial amounts of money every month to look out for our best interest negotiate a rate for a service at five to ten times that of the normal amount? The only answer I can come up with is simply greed. You ever notice that after you’ve been to the doctor, quick care or emergency room your insurance company sends you an itemized listing of the services they paid for your treatment? You know the ones I’m talking about…everything from $25 for an aspirin to $15,000 for a twenty minute life-flight. Those itemized bills are the best advertising that an insurance company has. “See how much money we saved you?” Then when they raise your rates the next year, we don’t even think to question them because as far as we know they saved us a fortune last year when we ran over our big toe with a rototiller.
The more I dig and the more I read the more disheartened I become. I guess I always knew it was a racket, but the depth of the deviousness behind the racket is what becomes overwhelming.
Back to the VA, Medicare and Medicaid…tax payer funded insurance programs. Who the hell is doing the negotiations for the rates here? How could someone sitting in an office somewhere decide that it’s acceptable to pay $400 in tax payer money for a $40 chiropractic appointment? Where the hell is the oversight on this shit?
Ya know, I said earlier that this was about morals…well, this whole rambling mess I’m writing was prompted from listening to the talking heads in the media stump for their associated political parties. Government Health Care seems to be the biggest issue at the podium here lately. FREE Government funded Healthcare for everyone! FREE Healthcare for immigrants! Those are great ideas, but the more I hear people talk about it the more I’m reminded of my revelation at Doc’s office that day and the knowledge I gained as I researched the questions that revelation prompted.
First and foremost, the government in this country doesn’t fund anything…We The People fund everything. Do yourselves a favor and do one simple thing….Every time you hear a politician say the words “FREE” or “Government Funded” replace those words with “Tax Payer Funded”. And while you’re at it, ask yourself this simple question: Would you give a person ten dollars if you knew they were going to spend the whole ten bucks on a $1 candy bar? I would like to think that the people we elect to office sense a moral obligation to those who elected them. But how could anyone with any conscience at all be that reckless with our money?
I do a lot of research before I purchase anything….and I mean ANYTHING. I don’t mind spending money, but I can’t stand to WASTE money. Hillbilly Logic at it’s best. You need a certain amount of nickels to make it through life and every nickel you spend is one more you’ve got to earn to make it to the finish line. In any given year I seem to give more of my nickels to government agencies than I spend in this free market economy we cherish so much. Have y’all ever done the math and looked at exactly what you pay out of your pocket to the local, state and federal government every year? Taxes, Licenses and Fees…Social Security, Medicare and Medicaid….Government regulated insurance, tolls on highways that we already pay taxes to maintain, and permits to add a structure to our own damn property. Taxes on all your purchases, and heavier taxes on alcohol, tobacco and gasoline. Hell, there’s even special government fees and taxes in our cell phone and utility bills. And when I turn around and see the way they waste the nickels I worked so hard for it pisses me off. Sit and do the math one time….it doesn’t have to be exact numbers…just “ball park” how many nickels you pay out to government agencies in a given year…and then realize that a lot of those nickels go to pay $400 for a complete strangers $40 chiropractic appointment.
Keep that number of nickels in your head. Emblazon it on your brain. Remember that number when you’re vetting your candidates and heading to the polls. I don’t care if it’s a Democrat, Republican or an Independent…..if you’re voting for someone who doesn’t respect the blood, sweat and tears….the time you spend away from your family….the physical and mental stress….all the things that you surrender to earn enough nickels to make it through your life….if they don’t respect those things, they don’t deserve the job they’re trying to get. Mind your nickels, friends. Each and every one of them.