I have a close friend who is a veterinarian. His clinic is across the street from my place of work. When I am procrastinating I like to walk across the street and visit my friend. Doc lets me watch him do surgeries and lab work. He is skilled at every surgery from orthopedics to hysterectomies and castrations to bowel resections and tumorectomies and ophthalmology and oral surgeries. He does the bulk of his own lab work. He does radiology and diagnostics and regular check ups and trauma care and dermatology and infectious disease care and on and on and on. He has one skilled helper who monitors the general anaesthesia and gives injections. He has one other helper who answers phones and does the prescription filling and clean up of the O.R.
Doc had four years of under grad science and four years of vet school. And he did an internship for a year. He is required by law to get many hours of continuing education every year.
He is a highly trained professional in a profession that has a more competitive schooling than human medical schools. With only one veterinary school in the entire state it takes a lot more oomph to get accepted than it does to get accepted to medical school.
Pooties and woozles and bunnies and horsies are near perfectly analogous to humans. And yet they each have unique characteristics which affect diagnosis and treatment.
So, if Doc's DVM education is on par with an MD, and Doc's patients are anatomically on par with an MD's patients, why the hell does the price difference in one of Doc's bills vs an MD's bill approach 100 fold?
I have seen Doc, in the course of less than an hour, perform an hysterectomy on a dog (a major operation requiring general anaesthesia), set the patient in a recovery room for a couple of hours and then hand her over to her person with a bill for services rendered of around $240.
Then I get a cough. It takes 3 hours, two separate locations and about $210 (mostly paid by insurance) to get a little bottle of cough syrup from the people clinic and the pharmacy down the road.
No wonder insurance companies are tight with the purse strings. The medical establishment are practicing highway robbery.
I call Doc's office because my woozle has a bloody sore on her shoulder. In 30 minutes my dog is on the exam table and Doc and his helper are doing wound care. 15 minutes later doggie is happily off the table and snuffing around and I am being handed a bottle of prescription antibiotic pills and prescription antibiotic spray. I go to settle up at the front desk, see the bill for $30, prepare to pay and Doc says it's on the house.
I get an infected bug bite on my leg. Deciding to tough it out I get a high fever and red lines running all along my leg emanating from the bite. So I call the clinic and they direct me to the ER. I sit there for about an hour after being interviewed by two different people regarding my ability to pay. Then I am directed to a room where I sit for another hour. Finally a physician's assistant comes in, takes a look, tells me I have cellulitis and I need a prescription for antibiotics. She tells me to wait there while she gets me the paper work. So I sit for another 40 minutes waiting for my paper work. Then I go to the pharmacy, pay the co-pay, and finally get the pills. A month later I get the insurance statement detailing the costs and what is covered and what I owe. I have great insurance coverage so I owe very little. But the insurance company paid out several hundreds of dollars. Plus it took about 4 hours and I had to go through about 6 different people (none of them MDs).
I am certain plenty of people out there have similar stories. I am blessed to have health insurance. And it is a good thing too. Because if I was paying cash I'd have been taking huge hits for a bottle of cough syrup and a bottle of pills.
I have lots of family who are MDs and RNs and nurse practitioners. They are deserving of the healthy pay they get. But holy fucking shit if the medical industry does not gouge people who are at their mercy. The medical industry...Charges. Too. Much.
All the hullabaloo around healthcare coverage these past years and I never hear it talked about. Time magazine finally broke the silence a couple months back by asking the question (remember the PayMaster story?). But there has been nothing ever since.
The medical industry is important but they are too self-important. They, like the insurers have lobbied congress to get sweet deal laws on the books at the public's expense too. Requiring a prescription for cough syrup that has as much chance of being addictive as that useless over the counter stuff? I should have gotten the stuff in 10 minutes for about 6 bucks. Instead it took 3 hours and my insurance company paid them $210.
I recognize it will cost more to treat a human than an animal because we put the animal in a cage after surgery rather than a recovery room and because Doc blasts the blues on his stereo but the hospital and clinic pipes in nice elevator music. Could that account for a cost difference of triple or quadruple? Maybe. But why would it be 100 times as much? A hysterectomy for $240 anyone? $2,400? It'll run a human patient $24,000 easily after all is said and done.
I visit all the hospitals in the area as part of my work. It is rare that a hospital is not undergoing some major renovation and expansion. It is near constant. I like a nice clean and pretty hospital too. But do they really need a major renovation annually?
In the affordable healthcare debate, the insurance companies have done a lot to deserve criticism. But the medical industry owns a huge amount of blame for millions of people not getting the healthcare they need too.