Congressional and Senatorial leaders are supposedly trying to bring down out-of-control costs of health care. It is strange to me that I haven’t heard more about the actual, every-day costs for services being charged by providers, all of whom are contributing to the soaring increases in health care costs we are dealing with today. Has anyone ever considered commissioning a team of professionals from the best business management companies in the nation to study the health care industry, and make recommendations to Congress on what they might realistically do to improve things? For instance, recommend realistic and reasonable charges for services?

Since providers of health services are ‘private sector’ entrepreneurs, I’m not sure what control Government has over them, in terms of what they can charge, but certainly the Congress can control what Medicare and Medicaid will pay for services to patients they are responsible for. In my opinion, these agencies have been much too liberal, and probably are partly responsible for increasing the standard for fees and charges of many medical services over the years. If this were not so, bills would not have risen to the point of absolute absurdity that we find them today.

Can anyone truly legitimize a cost of almost $6000 for five hours in an emergency room, most of which was waiting for results of four tests?   Patient went to emergency room on advice of her physician for a simple Electrocardiogram, because she had a ‘strange’ sensation in her chest. She needed to know if she was having a heart attack, or if the EKG indicated any legitimate need for additional testing. The administering technician informed her that the EKG ‘looked’ normal. (EKG 5minutes $482) The ER physician then claimed to see a ‘minor’ anomaly that warranted additional testing: Chest X-Ray 10minutes $241, three or four vials of blood drawn for lab analysis $1311, CT Scan 20minutes $2185, Emergency Room Fee $1307, Drugs Administered in Emergency Room $258, ER Physician Fee $987-Total Charges $6,771!

The example above was real, recent, and it was a Medicare/Advantra patient. Had the hospital involved not expected payment from Medicare somewhere close to the amount billed, or even 60% of the amount, I’m sure they would not have billed it. Two points: First, the charges were over the top excessive, and second, once the EKG indicated no heart attack, the tests, according to a highly regarded cardiologist, were inappropriate. In today’s medicine, and given the age and condition of the patient, a heart catheterization was the surest way to diagnose and determine care for her. Eventually, this procedure was used, revealing a blockage that was corrected by installation of a stint. Had the patient started with this Cardiologist to begin with, Medicare would have been spared the first $5700 for tests that were questionable at best and probably unnecessary.

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