To: "v.oliver@islandhospital.org"
Sent: Friday, February 22, 2013 12:24 PM
Subject: From Denise Hoverson (Tibbles)
To: Vince Oliver, CEO, Island Hospital, Anacortes
From: Denise Hoverson
Hello, Vince.
Thank you for listening to my worries over my mother's care (Willene
Hoverson) last Fall. I've been thinking about healthcare quite alot lately, and
I'm forwarding a copy of the below letter to a friend of mine in discussion.
Maybe you are interested in what people discuss and can benefit.
I
do think Island Hospital is above the average, and I did not see there what I
saw at Virginia Mason.
Roger
Harris owns a business consulting firm in Seattle.
Always my best wishes,
Denise Hoverson
----- Forwarded Message -----
From: Denise Hoverson
To: Roger Harris <rogerlharris@tabicpro.com>
Sent: Friday, February 22, 2013 11:55 AM
Subject: Medicine
From: Denise Hoverson
To: Roger Harris <rogerlharris@tabicpro.com>
Sent: Friday, February 22, 2013 11:55 AM
Subject: Medicine
Hello, Roger.
It was good to see you. You get my brain
off high-center, you know. Feels good.
I just read this article. I'm thinking
you've seen it:
Time Magazine's article on why health
care costs so much. There are villians, of course, and that ominous
"chargemaster" treated like a Bible. The chargemaster is a book of codes and "suggested retail prices" for the uninsured or cash customer. These rates are way, way higher than any contracting insurance company would be willing to pay. I can see what Obamacare is about, and the
good it is trying to do to tame the corporate tiger. Greedy bastards without a
doubt. But government tames one
creature, and a bigger creature takes it's place.
Went through this mill at Virginia Mason
with my mother, and after reading this article, I better understand what happened. It was a
tour of unending tests, scans and stalling that really went nowhere as it was
obvious that none of the medical players had read her chart in much detail, nor
were they sharing information at rounds. It was hellish. They will never drag my body into that
particular building. I will die first, with a calmer mind and closer to
home.
Although Medicare pays a tiny portion of each test, interpretation, visit, etc., a facility can keep them going so there is a pile of the billings. So the Medicare patient can generate revenue by submitting over and over. It doesn't look to me like Medicare monitors this very closely, so there are alot of unnecessary procedures.
If she did not have Medicare to bill, and tests were at a minimum, she would be charged full fare, and would not be able to see the meter of charges running. These bills can run into tens of thousands or hundreds of thousands of dollars very easily. Maybe if a person knew how high the bill could be projected, she could choose not to take the treatments, look for alternatives, or simply let nature take it's course (in the case of terminal illnesses).
Although Medicare pays a tiny portion of each test, interpretation, visit, etc., a facility can keep them going so there is a pile of the billings. So the Medicare patient can generate revenue by submitting over and over. It doesn't look to me like Medicare monitors this very closely, so there are alot of unnecessary procedures.
If she did not have Medicare to bill, and tests were at a minimum, she would be charged full fare, and would not be able to see the meter of charges running. These bills can run into tens of thousands or hundreds of thousands of dollars very easily. Maybe if a person knew how high the bill could be projected, she could choose not to take the treatments, look for alternatives, or simply let nature take it's course (in the case of terminal illnesses).
Here's what my veterinarian does: I
present my dog Tassie with a sorry expression on her face because she's not
eating, puking yellow bile, won't get out of bed and I'm worried. The vet says
that looks like pancreatitis (oddly enough the same diagnosis my mother had),
and she'd need a hospital stay. While I'm being informed, an assistant brings me
a sheet of estimated charges. So much for scans, so much for medicine, so much
per day for hospital. I have to sign this before they'll begin scans and firm
diagnosis. "It will probably be a little less money than this, but could be more
if the initial treatment does not work, in which case we will draw you a new
estimate." And they were correct. And my dog recovered. And my finances are not
shocked. And the vet and I still have a good relationship.
If I didn't like the estimate, I could consult another vet. If I balked at
payment and he took me to collections court, it would be easy for any judge to
dispose. More savings.
The problem is, the hospital can charge
any damn thing they want. So there is no competition. No competition that you
can see, anyway. I would bet $100 that the small community hospital that
referred Mom to Virginia Mason gets plenty of wooing from the big city hospitals
on a regular basis. I bet they offer big prizes and cash rewards to the small
hospitals that send them business.
We were told that nobody else could
perform the procedure Mom needed except Virginia Mason. The surgeon there wrote
the proceedure and he's been published in all the medical periodicals, lauded as
quite the superman. So of course we went there. Only to hear from a surgeon in
another specialty at Providence
Hospital in Everett that she could have had that work done at St Joseph's
in Bellingham or Providence in Everett. Simple enough surgery, commonly
done.
I may have told you how INCONVENIENT it
was to fight traffic into Seattle every day of the three-week stay, how
confusing (and confused) the staff was there, how expensive it was for Dad to
stay in hotel... If we knew we could go to Providence, it would have been a much
easier trip, and my brother lives in Everett so hotel would not have been
necessary.
I'm going to start interviewing hospitals
NOW before I need one for anything. And I think a groundswell movement of this
type could help change the system. If people knew a hospital could estimate
costs ahead of admittance, they might be inclined to choose THAT hospital over
one that would not.
And maybe rather than remove limit caps
from insurance policies and try to force equal negotiations with payers like
insurance companies and medicare, the goverment could insist on transparency in
billing practices, so that TRUE COMPETITION can bring costs to realistic
proportions.
That "chargemaster" that hospitals
purportedly keep is not unitform, but whim. Each has its own, and as the article
reveals, no one even knows what the formula is. It can be tossed out.
"Overcompensation" to corporate officers
and other employees will cure itself.
What do you think?
Denise
