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What’s wrong with healthcare

Last updated on February 14, 2023

A few weeks ago, I had an infected finger. I went to the doctor (one who I adore at a practice that I respect) and spent a grand total of five minutes with her. She gave me my options: high-powered oral antibiotics or a quick slice to drain the finger. Being allergic to the two low-grade antibiotics and not wanting to swat a mosquito with a nuclear warhead, I opted for the scalpel. Two minutes from setup to gauze-wrapped finger, no anesthetic. Done.

And then I got the bill. In addition to the $173 for the privilege of the visit, which I had known going in, they had charged me $1,250 for “in-office surgery.” 


For several minutes, all rational thought left my brain. Once I recovered from the shock, I got angry. I’ve had moles removed and sent out for biopsy as part of an office visit, and that process — including the anesthetic and pathology — cost far less than this procedure.

It was after hours, but I fired off an email to the practice. This wasn’t a billing issue. This was a policy and transparency issue. If you’re going to charge more than one thousand dollars for an in-office procedure, you absolutely have to notify the patient upfront. Deciding between a $55 antibiotic and a $1,250 procedure would have been a no-brainer. 

The worst part, to me, is that a couple of years ago, when we had our “good” insurance (low co-pays and no deductibles), I wouldn’t have even received the bill. The insurance company would have paid and that would have been the end of it. But with our new high-deductible health plan, I’m much more aware of the line item costs for everything from visits to immunizations to in-office surgery. I wouldn’t have been completely indignant, and I wouldn’t have known to complain.

Fortunately, my complaint was heard by the practice. I got a call a couple of days later to tell me that several people had met to discuss my email and review the file, and decided that this particular procedure was inappropriately coded, and in fact should have “only” cost $300. (Let’s not even get into the fact that a quick swipe with a scalpel shouldn’t even cost that much; I was grateful that they listened at all.) They also agreed that any procedure that would cost as much or more than the base cost of the visit itself should be disclosed to the patient at the time of the visit. I hope that they quickly implement this policy of disclosure.

But I wonder: how many insurance claims have been filed and paid for grossly overpriced procedures? There simply has to be a better, more transparent and more logical way of doing business in healthcare.

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