Having Insurance Shouldn’t Blind Us to Medical Costs
How much attention do you really pay when President Clinton talks about the health care crisis?
If you have no health insurance, like an estimated 300,000 people in Orange County, you probably pay a lot of attention. Being one illness away from potential financial disaster tends to focus people’s attention.
My guess, though, is that if you have a good health plan, all the talk about the so-called national health crisis may sound like one more complicated problem you don’t have time to sort out.
A confession: That’s the way I am about it. I’m sure health care is a big problem; I just don’t think about it that much.
But after a conversation Thursday with a ticked-off Iris Kelleher, a Mission Viejo wife and mother of a 2-year-old, my head may be clearing just a little.
Kelleher first telephoned several months ago, just after returning from a routine doctor’s office checkup for her only child, then 18 months old. She had what sounded like a legitimate gripe and I sympathized, but I didn’t pursue it and pretty much forgot about it--until listening again last night to Clinton’s lament about health care.
Iris Kelleher’s story popped back to mind, so I phoned and had her recite her story again. This time around, I paid more attention.
Last August, she had taken her son Michael in for his routine “well baby” check at a local clinic, the same place she had taken him for previous checkups and immunizations. All parents of infants are familiar with the tests: after a nurse administers the required shots, the doctor tests such things as the baby’s heartbeat and muscular development and conducts an ear, nose and throat examination.
On her son’s previous visits, Kelleher said, the charge for the office visits had always been $70. The cost for the immunizations varied, depending on what shots were required. For example, the total bill for her son’s 15-month checkup had been $130 for the office visit and shots. After her son’s checkup in August, however, Kelleher was given a bill for $177. The cost of the immunizations was only $7 more than the previous visit but when she examined the bill, she noticed that she had been charged $40 for “counseling.”
It was the first time that had ever appeared on a bill.
Kelleher, 39, who had worked for a pharmaceutical company before having her baby, showed me a copy of the bill, which lists the $40 charge under a “Counseling” category and separate from the $70 charged for the regular office visit.
Bottom line: The price of the office visit portion of her bill jumped from $70 to $110.
What upsets Kelleher is that she hadn’t been told there was a counseling fee, nor had she sought counseling. Nor, she contends, did she need counseling. Her son had been an easy baby and she wasn’t having any problems with him. She estimated that the doctor spent a total of five minutes with her, the same as in previous visits. She remembers nothing he said that differed from normal doctor-new mother conversation. Even more to the point, she said, this was one of the few visits, if not first, when she didn’t have any specific questions for the doctor.
“While he sat there and checked the baby and talked to me, I got charged,” Kelleher said. “I raised a lot of Cain because I was really upset. (A woman in billing) said, ‘Didn’t the doctor talk to you?’ I said, you mean if he opens his mouth while checking the baby, I get charged?”
The Kellehers have good health insurance. In some ways, that has only made Iris Kelleher angrier about her experience. She’s upset because she thinks most people with good coverage wouldn’t complain about the $40 charge.
“The people who do have insurance aren’t paying attention to what they’re being charged,” she said. They don’t care if they’re getting gouged as long as they’re getting coverage.”
For the Kellehers, there was a happy ending. Although her statement listed the counseling fee, the bill sent to the insurance company didn’t include it. Iris Kelleher doesn’t know if that’s because she complained.
What concerns her are the people who wouldn’t have complained and what that does to the price structure of the country’s health-care system.
“Probably 90% of the people would let (a counseling fee) go. What people need to do is look at what they’re getting charged, look at the service they’re getting. Care enough. Just because you happen to have great insurance, you shouldn’t take it for granted because there might be a day when you don’t have insurance, you’re going to realize what you’ve done to yourself.”
Obviously, the country isn’t in crisis because of $40. I then tried to reassure myself by thinking that Iris Kelleher is the only person in the country who has experienced such a situation.
I was very comforted by that thought.
I was unable to reach Kelleher’s doctor. I should say, former doctor. She now goes to another clinic where office visits are $45 instead of $70.
I forgot to ask her if they throw in counseling for another $40.
Dana Parsons’ column appears Wednesday, Friday and Sunday. Readers may reach Parsons by writing to him at The Times Orange County Edition, 1375 Sunflower Ave., Costa Mesa, Calif. 92626, or calling (714) 966-7821.
