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Monday, September 27th, 2010



What’s your best anecdote about the real price of health care?

A new nonprofit group called Cost of Care is hosting an essay contest to spread the word that everyday choices multiply to make health care more expensive for all of us.

Cost of Care Executive Director Dr. Neel Shah says technology and better price information can prompt doctors and patients to make different, perhaps more frugal, decisions.

Right now, lots of us barely glance at our medical bills, but not Princeton, N.J., resident John Phelan. Phelan is a health technology expert and says he always checks his paperwork at the doctor’s office. And when he finds a mistake, he asks about it.

Phelan: I said listen this is kind of weird, this is a little awkward, but I happen to have come here for poison ivy and now I’m looking at a charge that’s all about eczema. She blanched a little bit and said: ‘Mr. Phelan, I’m sorry but oftentimes the doctors are not reimbursed to the level that they like to be, so in this case the reimbursement for poison ivy is not as much as for eczema.’

Phelan is not part of the contest group, but says consumers should be more accountable for what’s happening in their health care. He says the contest could get the rest of us asking questions too.

What does it matter – and what does it cost – if you stay an extra day in the hospital? If you insist on an MRI when your doctor says you probably don’t need one?

Phelan: I think, in general, that consumers have been lulled to sleep.

Experts say inexpensive co-payments and and health bills mostly paid by your employer shield people from the true cost of health care until they face a major medical problem.


One Comment

  • a dermatologist says:

    Today you ran a piece about consumers questioning their health care bills to find errors and save money. However the example that you ran was misleading and left and erroneous implication of the doctor’s “manipulating” the bill to receive increased remuneration. In your example the patient questioned the diagnosis of poison ivy that was entered as eczema. As a dermatologist I would like to inform you that although poison ivy most closely fits the diagnosis of “contact dermatitis” (or a rash that occurs from contact with an allergenic substance) technically this category falls under the broader category of “Eczemas” ( A generic term for inflammatory conditions of the skin; particularly with vesiculation in the acute stages- references are multiple to this via a simple web search). Therefore, although not as specific, it is certainly correct.

    Most importantly for your story- Poison Ivy, Contact Dermatitis and Eczema are all diagnoses- THEY DO NOT AFFECT THE LEVEL OF REIMBURSEMENT!
    Only the visit code determines the level, and this is decided on by a multitude of individual factors including the length of the visit, the complexity of the diagnosis, other conditions that are being treated at the same time as well as many other factors.

    Your story falsely suggested that the doctors diagnosis was incorrect and insinuated that the patient had found an error that afforded the doctor higher pay. The facts that you presented simply do not support that. By this kind of reporting you are fanning the fires of patient distrust of physicians, even where none should occur.

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