An out-of-control health system

Obamacare is not here yet, or is it? In October 2011, my wife visited a doctor in Parkersburg. As she had done many times before, she paid a $20 co-payment with the remainder paid by insurance. There was no “facility fee.” Then the doctor moved to the Belpre complex of Marietta Memorial Hospital.

In April 2012, she paid a $20 co-payment for the doctor visit with the remainder paid by insurance. But wait, there was an additional bill sent to insurance by MMH, for a “Treatment Room Fee” of $300, which, after insurance, cost my wife $41.09.

Fortunately, for these doctor visits she was covered by my workplace Cobra insurance. Between the April 2012 doctor visit and her next appointment in October 2012, the Cobra insurance expired. She was now covered by an independent insurance plan.

In October 2012, my wife visited the doctor at the Belpre facility of MMH. We received a billed dated Jan. 26, 2013, for $300 from MMH for a “General Clinic” charge. The independent insurance coverage reduced the charge to $194.40, which we paid.

Now, it is August 2013, and we just received a bill from MMH for $202 for a physician office visit in October 2012. If my calculations are correct, that amounts to a $502 charge for an office visit of no more than 30 minutes. Also included in this bill from MMH is a charge of $202 for an April 2013 doctor visit (she was seen by a physician’s assistant) reduced to $116.98 after insurance. We have not yet been invoiced for a “facility fee” for the April 2013 visit.

Am I mistaken or is $502 for a routine consultation visit to a doctor a little outrageous? According to syndicated columnist Froma Harrop in a column in The Parkersburg News and Sentinel earlier this year, the Medicare Payment Advisory Commission (Medpac) proposes ending this ridiculously expensive practice: Paying hospitals vastly more for seeing a doctor in real estate owned by the hospital. In fact, Seattle, Wash.-based Group Health Cooperative has told the hospital systems it contracts with it will no longer pay their fees for ordinary visits to the doctor. And it won’t let them saddle patients with them, either.

Is it any wonder our healthcare system is in such a shambles? And Obamacare is still four months away.

W. Edward Hofmann