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Online Community Lesson
Putting Together the American Time Capsule
I remember a photograph of a time capsule buried on the city-hall lawn by high-school teacher Robert Henke and his students some time in the early Seventies. If we were to put together a time capsule of America in the new millennium, what would we include?
I would include a Medicare statement, something which my parents receive periodically. Why?
A Medicare statement epitomizes the growing disconnect between the public and its doting bureaucracy. Who, other than employees of a medical-billing service, understand what is being said in a statement?
My father received a statement which reported a one-night stay at Good Samaritan Hospital, at which time he received an angiograph, at over $11,000, with his co-pay at over $900 of that amount. When we made inquiry with the Medicare division of Omaha Mutual, we were told that Good Samaritan had billed over $50,000.
What was happening here? Apparently, Good Samaritan billed as it pleased and Medicare chopped away at the bill until the bill came down to $11,000. But, still, $11,000 for a one-night stay and angiogram?
How can a patient know whether he or she has been billed correctly? He cannot. Medicare statements are in code; a layperson could not understand the billing even if he or she knew English well. (What is the point of sending a statement to a patient if he or she is unable to understand the statement?)
And there is a bigger problem. How does Medicare or the patient know that the listed services on a statement did in fact take place? The statement might come months after the hospital stay, which means that the patient is unlikely to remember the details of his or her stay. Is this why Good Samaritan’s bill for a one-night stay and angiogram was for over $50,000? In other words, did Good Samaritan think that it could fabricate a bill with impunity?
If you answer the multiple-choice questions below and e-mail to firstname.lastname@example.org with “Lesson answers” in the subject field, you will be credited toward a “certificate of recognition in community affairs” to be awarded in 2007 by a local nonprofit organization.
1. A Medicare statement
(a) is an example of how health care is provided in America.
(b) is troubling.
2. What would be a sustainable solution?.
(a) Have a large committee of seniors say how documents should be written.
(b) Require a paper trail, that is, a list of services performed with which a patient leaves the hospital.
(c) Universal health care, which significantly reduces the rather large American health-care bureaucracy.
May 17, 2007