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    My $4.07 check from an insurer: A sign of the times


    A few months later, our office received a check from CICP for my services. My group had billed a total of $1,332.25 for my services (both the consult and the procedure). The check was for $4.07. Total. Sum. Finale.

    When my office manager first showed me the check, my first reaction was that I had made a mistake in my billing. But our billers confirmed I did everything correctly. My second thought was that this was a partial payment; again, we checked with our billers and that wasn’t the case. 

    Also read - Winning at EHRs and meaningful use is 'Mission: Impossible'

    I live about 15 miles from the hospital, so given the drive to and from the hospital, the check probably covered the cost of gas. Probably. Ignoring my commute, I probably spent about 2 hours seeing the patient in the ER, doing the case, and writing notes and such, which means I was paid $2.04/hour—somewhat less than what a McDonald’s worker in Seattle gets nowadays. And while I don’t know what they pay on a yearly basis for malpractice insurance, I’m pretty sure my cost is higher than theirs.

    I asked my lawyer friend if I should go on and suddenly the topic turned to soccer, something that we both enjoy and is less controversial.

    Anyone who reads this blog knows I believe in a health care system where private practice physicians have a strong role. I feel that large state institutions, whether the VA or a state university, can’t hope to compete with the efficiency of a private practice physician. But certainly not everyone agrees.

    Recommended: My six-digit mistake with a new health insurer

    A year ago, with the delivery of my twins, I learned a very valuable lesson on how consumers of health care view the health care delivery system. I gained first-hand experience with how hyper-capitalism run amok can devastate a family, even when that family had desperately tried to play by the rules. But I also understand that there are two sides to any argument and while I am likely preaching to the choir with this blog, an advocate for a single-payer system may just happen to read this and learn how those of us on the other side view such a system.

    A single-payer health care system (such as CICP or, for that matter, any system that requires providers to provide services without the ability to negotiate cost) is nothing more than nationalization of health care providers’ time, effort, and skills. Over the last few years, I have employed multiple professionals for various reasons—accountants for my taxes and lawyers for help with my health care bills, to name a couple. To my knowledge, none of these professionals are required to provide services to whomever walks into their office for $2.04/hour even if that person desperately needs their services.

    Next: Another insight into single-payer systems

    Henry Rosevear, MD
    Dr. Rosevear, a member of the Urology Times Clinical Practice Board, is in private practice at Pikes Peak Urology, Colorado Springs, CO.


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    • Anonymous
      This scenario happens all too frequently. Working on the outskirts of a major metropolitan city, it amazes me how many people bring family members from foreign countries to the US for care. Once they enter the system by arriving in ER's, they can't be refused treatment. It is an opportunity for our Urology residents to learn but concept of entitlement becomes meaningless when this care is free. I don't think people would expect this from their auto mechanics, plumbers, tree service people, etc. In these cases, it is RARE that I ever get a thank you from people with no insurance. I guess they don't realize (or simply don't care) that we provide this care gratis or for minimal reimbursement. Even if they don't have insurance, a simple gesture of gratitude or card of thanks would be nice.
    • [email protected]
      Henry, welcome to ColoradoCare! I live in beautiful Steamboat Springs but now only practice urology in rural Nebraska. I only do cases that I can walk away from. I work two days a week and am paid for my work based on wRVUs. It is a good model so call me if you are interested.