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Posts published in “Day: November 25, 2019”

How’s your day going?


One of the rare advantages to living with some 90,000 seniors in adjoining communities is the great health care. Family docs and specialists for absolutely everything. On every corner.

Three months ago, we needed the services of one of those specialists for back surgery for Barb. Reamed off the arthritis that had grown on her lower spine, rebuilt the base that had dissolved and inserted eight screws to hold it all together. No followup prescriptions. No pain. Just some rehab in an excellent facility. As I said, “great health care.”

Since we’ve received no bills in these 12 weeks, we got to wondering what total charges were and what Medicare and our secondary insurer paid. So, we got online and checked it out.

Because the charges were many, involving nearly a dozen providers - some we’d never heard of - and a lot of descriptions were puzzling, we had to go piece-by-piece to see who got what.

Ironically, the surgeon was less than $10,000. We’d expected higher. Hospital charges were divided into a couple dozen categories which included other specialists and their attendant equipment. Hard to put a dollar figure on her five-day stay but I’d guess another $20,000.

Then, there was a seven-day stay in a rehabilitation clinic with more docs and therapy sessions twice a day. Great place that produced good results. And she was issued some specialized rehab equipment.

But, here’s the kicker. Medicare is showing a total charge of nearly $240,000! Almost a quarter-million bucks! Unbelievable. But, that’s what it says on the page. How the numbers went from $30-40,000 to $240,000 we can’t figure out. But, that’s what it shows.

In actuality, it appears Medicare paid about 80-percent of something and the “medigap” insurer paid about 20-percent of what we figure was the approximate balance. And, as I said, we’ve received no other billings. Wanna talk to me about “socialized medicine?”

Medicare is under continuous audit, so they’ll get around to our account one of these days. But, it’s kinda like living under a Sword of Damocles. Will we open the mailbox one day and find a six-figure bill? Or, will the hospital and all providers, who also audit accounts on a regular basis, find errors and shower us with surprise charges? Or, do the feds use some curious mathematics known only to them? We’ll let you know how things shake out in a couple of months. So far, not a dime out-of-pocket.

Then, there’s this. A couple of weeks ago, the CEO of Idaho’s St. Luke’s health care empire announced his retirement. On his way out the door, he came up with this bon mot: “The nation has to move away from fee-for-service health care.” Read that again. “The nation has to move away from fee-for-service health care.”

Now, here’s a guy who’s spent the last decade atop Idaho’s largest hospital system making, I’m certain, a healthy six-figure salary. In retirement, I’m equally certain, he’ll probably have a healthy six-figure income. And, as he’s leaving a life’s career in fee-for-service medicine, he now admits it’s all wrong?

He’s right, of course. The U.S. is about the last industrialized nation using fee-for-service. Many countries, with far smaller economies, provide quality care for all with different systems. We should, too.

One of the things about our current cast of Democrat presidential wannabees that irritates me are promises of a “better world” if all we do is pick one of them. Road apples, as Col. Potter often exclaimed!

Stop promising free this-and-that, concentrate on the middle ground and deal with issues of real substance: healing divisions, making government a servant rather than the master its become, school shootings, poverty, universal health care, deal with the national economic imbalance, overhauling defense funding, etc..

Congress holds the nation’s purse strings. Presidents can only propose. Congress, alone, decides how much will be spent and on what. All this candidate chin music amounts to nothing, no matter how worthy the cause, if Congress doesn’t write the check. Period.

And, there’s this. Today’s workers will not have jobs for 30-40 years with the same employer that end in retirement unless they’re in a very large corporation. In fact, we’re told many on the job today will change careers half-a-dozen times or more which means they need retirement and health care plans that move with them. Fee-for-service care and the accompanying health insurance costs will eventually get too high for most people which means more uninsured care. And, that’s damnably expensive!

So, where are we? Well, at our house, we’re anxiously awaiting what could be a six-figure medical bill. Or not. A highly-paid Idaho health care executive says we must change the way we charge - and pay - for health care. Or not. Political campaigners are “promising the moon” on all sorts of things they want you to believe. Or not. And our traditional employer-provided health care days are numbered so we’ve got to change the system. Or not.

Other than that, have a nice day!