Skip to comments.Patientsí Costs Skyrocket; Specialistsí Incomes Soar (New York Times)
Posted on 01/19/2014 2:11:51 PM PST by lbryce
Kim Little had not thought much about the tiny white spot on the side of her cheek until a physicians assistant at her dermatologists office warned that it might be cancerous. He took a biopsy, returning 15 minutes later to confirm the diagnosis and schedule her for an outpatient procedure at the Arkansas Skin Cancer Center in Little Rock, 30 miles away.
That was the prelude to a daylong medical odyssey several weeks later, through different private offices on the manicured campus at the Baptist Health Medical Center that involved a dermatologist, an anesthesiologist and an ophthalmologist who practices plastic surgery. It generated bills of more than $25,000.
I felt like I was a hostage, said Ms. Little, a professor of history at the University of Central Arkansas, who had been told beforehand that she would need just a couple of stitches. I didnt have any clue how much they were going to bill. I had no idea it would be so much.
(Excerpt) Read more at nytimes.com ...
Patient Given No Choice
A fair-skinned redhead who teaches history at the University of Central Arkansas, Ms. Little had gone to a private dermatology practice in Heber Springs, Ark., to check some moles on her arms when the physicians assistant on duty noticed a whitish bump like a tiny fragment of thread on her face, she said. Her family practitioner had told her it was just a clogged pore.......
I may be behind the times, but I don’t think anyone can take a sample and return fifteen minutes later with full lab values.
Hospitals have pathology departments that routinely do what are called "frozen sections" for surgeons which allow the surgeon to know,while the procedure is underway,what's going on with the patient...that is,if it's cancer that he removed and,if so,what kind? I suppose it's possible for a free standing clinic to have such a capability but it would have to be a really big facility to support such a service.
This is rather interesting in that most Dermatologist offices are not in a medical center. They’d be in an office building, and I’m not convinced even if every office in the building was chemo related, they could support this level of lab work.
Hey, I could be wrong. I appreciate the mention. It was interesting.
I had a very small white bump in the front middle of my neck where my neck connects to my body. We went to a dermatologist for my husband, not for me, but the dermatologist said that little white bump was cancer and I needed to get it off. It’s a low type cancer. No long after, he took off the bump, doing it in his office, not a hospital. The thread he used for the stitches was black.
Picture me - black stitches across the bottom of my neck where my neck attached to my body. I LOOKED LIKE DRACULA’S BRIDE like my head was stitched onto my body. That looked so bad, I did not leave my house until we went back to get the stitches out. That line of stitches could not be seen after a few months - can’t tell where that happened.
The dermatologist said that cancer happened because that spot at the base of the neck isn’t normally covered with cloth - sun hits that spot. If you put on a shirt, the open area of the neck at the top of the shirt is where it was. If you get such a bump, get it taken off.
I think it is “not fair” that surgeons make so much money, they shouldn’t make any more than a high school dropout working at McDonald’s. It’s just not fair! (/sarc!)
It sounds like the procedure was more involved, because they had to get all the cancer, but since it was on her face, they needed to do “micro-surgery” to ensure minimal invasiveness.
“For example, the procedure performed on Ms. Little, called Mohs surgery, involves slicing off a skin cancer in layers under local anesthesia, with microscopic pathology performed between each stage until the growth has been removed. While it offers clear advantages in certain cases, it is more expensive than simply cutting or freezing off a lesion.”
I guess, according to the article’s author, she should have just had the cancer cut out and so what if she ends up being disfigured? Welcome to Obamacare!
And of course the article is also trying to generate class envy — why is a surgeon who is smart, highly skilled should make more money than some random unskilled worker?
Just what we expect from the NYT. Watch for more stories like this.
As Rush has pointed out last week, there aren't any real prices for anything in health care now.
Like those who write for The Washington Post, this writer seems to paid by the word. Who cares what color the woman’s hair is or that she “fair-skinned”? Stupid verbosity.
She works for the State and undoubtedly has insurance. She is probably looking at the face rate of her medical charges rather than the negotiated rates. The question is how much did the insurance company pay. These vary enormously.
More generally the story illustrates the issue of monopoly pricing by virtue of the context within which the service is bought. It does not have to be that way but few of us take the time or even think to ask how much a specialist charges for an office visit and what a typical set of diagnostics is likely to cost. If you do not know the price how can you negotiate or decide you need to look for another specialist.
I think you captured what the NYT was trying to convey, except they were pretty much specific against dermatologists, if I read the article correctly.
I think stories like this in the NYT are a weathervane for shifts in the party line.
Obamacare obviously requires a scapegoat or scapegoats (”wreckers”, to use, appropriately, the Soviet term).
I had thought it would be the insurance companies, but they have clearly bought themselves a seat at the table when the blame gets assigned.
“Specialists” are an obvious target. The government doesn’t want them to deliver the care they alone can give, because people live longer and use more resources. AND, specialists are more likely to gum up the works as Nurse Practitioners and PAs become the predominant caregivers.
So, blame the specialists. And do it by casting them as part of the 1%, Check, and check.
You can learn a lot from reading the New York Times.
The other side of the equation is what if this had not been identified, treated and mitigated. The Legal profession is wringing it’s hands. The hallmark of “Socialized Medicine” is no lawsuits
incos don’t like to tell what they pay because the competition can start to under price them.
“The hallmark of Socialized Medicine is no lawsuits”
A LOT of lib-dem ambulance chaser/slip and fall “lawyers” are PO’d, and it’ll only get worse.
The only part that I’m unsure of is whether we are witnessing the NYT telegraphing to the Communist, um, I mean the Democrat party apparatus and their wholly-owned subsidiary a.k.a. “the media”, what the next scapegoat-du-jour is supposed to be, or whether it’s the other way around, and the Obamunists have just dictated to the NYT which sector of private enterprise to demonize as their next boogeyman.
Reimbursement strategies have become a game. Insurers etc. find reasons to decline payment or coverage. Doctors...and their business managers....who are NOT stupid then find ways to repackage the methodology they use. The insurers catch on and change their reimbursement strategies....and the medical establishment counters. It’s just like an arms race only it involves words, CPT codes, diagnostic procedure codes and most of all MONEY.
The incentive first and foremost is MONEY.....the insurers want to charge as high a premium as possible and pay out as few $$$ as possible in benefits for medical care, the result is PROFIT.
The doctors are also in it for the money. Many MD’s truly
want to make a positive difference for people but virtually ALL of them want that difference to make them more MONEY.
It’s the perfect prescription for price gouging, insurance manipulation and fraud.
Specialists are an obvious target. The government doesnt want them to deliver the care they alone can give, because people live longer and use more resources. AND, specialists are more likely to gum up the works as Nurse Practitioners and PAs become the predominant caregivers. So, blame the specialists. And do it by casting them as part of the 1%, Check, and check.”
Specialists are always going to play a part int he healthcare system; patients are referred to them routinely by mainstream medicine. A friend had an expensive operation for his young daughter, and while he could pay the hospital $20 per month for the rest of his life, the specialists were able to garner his check to get their payments more quickly. He warned all who would listen about this loophole; he’s working 3 jobs to make ends meet, has already had a heart attack since, and is barely 50 years old...