Surprise Medical Costs Shock Even Doctors: A Healthcare Dilemma



The author, a retired physician, recounts his experience of getting a small scalp growth removed, and expresses concern over the excessive cost of the procedure. He notes that the procedure, which was relatively minor, was charged at $10,440, significantly higher than his estimation of $440. He criticizes both the health care providers and the insurance companies, suggesting that the overinflation of charges is a result of insurance companies minimizing payments to physicians, clinics, and hospitals, and also due to the fact that surgical procedures are paid more than cognitive encounters like disease management and preventive medicine.

Patient Insights on Exorbitant Healthcare Costs

Note: This article expresses personal experiences and thoughts on high healthcare costs. Learn more about editorial commentaries or contribute your own experiences here.

After a year, I opted for removal of a small persistent growth on my scalp, fearing it could be cancerous. It was tiny, less than half an inch.

I made an appointment with a surgeon at my local healthcare organization. I envisioned a simple clinic removal, but the surgeon suggested an ambulatory surgery center due to potential scalp bleeding. I agreed, despite fearing an unnecessary fuss.

The procedure was identical to a major outpatient surgery. I was prepped by a nurse on a gurney, had surgery in a fully-equipped room, and was tended to by three nurses. No sedation, just local anesthetic.

I was impressed with the care and compassion received from the medical team.

The procedure lasted 20 minutes without complications. I was observed for 30 minutes post-surgery and then drove home.

The insurance benefits statement revealed a shocking $400 charge for the 10-minute surgical consultation. Even more startling was the surgical procedure cost: $10,440. Insurance covered $10,000, leaving me with a $400 bill.

The total charge of $10,840 for a small skin excision far exceeded my most skeptical estimates.

As a physician myself, I was appalled at the high cost despite knowing the intricate workings of healthcare corporations. In these huge entities, physicians often have no idea of the cost implications tied to their decisions.

This exorbitant charge for a relatively simple procedure is outrageous.

Realistically, this procedure should have cost $440, not $10,840. This inflated price is a result of the current healthcare system, where physicians, hospitals, and clinics increase charges to offset insurance underpayments.

Insurance often pays more for surgical procedures while underpaying for disease management and preventive medicine. This results in clinics and hospitals overcharging for surgical procedures to compensate for scanty payments on medical visits.

Healthcare organizations should provide intermediate outpatient surgical care for procedures that don’t require a high-level surgical suite, reducing costs.

Insurance companies should pay fair amounts for services without bureaucracy, discouraging overprovision and overcharging.

This is a glimpse into the games between healthcare providers and insurance companies. If all stakeholders don’t contribute to a viable remedy, healthcare costs will continue to balloon.

By Wayne Kaniewski, a retired physician and small-business owner from Minneapolis.

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