By HANS DUVEFELT
I have a patient with no health insurance but a brand new Mercedes. He says he can’t afford health insurance. He shies away from the cost of his medication and the fees for our office visits. His car cost a lot of money, and I know authorized Mercedes dealerships charge about $ 140 an hour for their technicians (not just the mechanic) to spend time. Routine service costs hundreds of dollars, which seems to be more than the cost of his own doctor visits.
His new Mercedes has a warranty, but not his body. He risks financial disaster if he becomes seriously ill without insurance.
I have another patient who was on a muscle relaxant for a short period of time. His insurance wouldn’t cover it without prior approval. The cash cost was approximately $ 14. We suggested he pay for the medication and told him that if prior approval had been given, his condition would be resolved. He chose to go without it.
The brutal truth is that a GP’s opportunity cost, how much revenue we can potentially generate from treating patients, is around $ 400 / hour, or $ 7 / minute. There’s no way I could get prior approval in less than two minutes. So it would have been more cost effective to pay for his medication than to do the unreimbursed paperwork (or computer work or phone work) on his behalf. But of course we can’t.
This patient and many others think that health insurance is such a comprehensive package that everything should be covered. They feel moral outrage when they have to pay out of pocket.
Even Sweden’s socialized medical system has co-payments. Why do some Americans shy away from a one-time cash charge of $ 14 for an uncovered drug when the monthly, lifelong co-payments for modern COPD inhalers that many fixed-income seniors rely on can exceed $ 100?
Hans Duvefelt is a Swedish born rural family doctor in Maine. This post originally appeared on his blog, A Country Doctor Writes. here.
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