The implications of spiraling medical fees

I’m getting old. My hearing is deteriorating. The hearing-aid vendor sent me to an ear doctor to take a quick look at my eardrums before selling the aids—a five-minute visit. No problem. Medicare covered about half of the $370 bill.

Medical care in the United States is suspiciously expensive. Insurance premiums and co-pays continue to rise. Patients expect to be charged for office staff, exams, tests and procedures. I didn’t realize that using the Enloe Ear, Nose & Throat clinic—one of about 20 outpatient offices owned by the nonprofit hospital—would generate a separate “facility fee” of $188. The second bill arrived weeks after the doctor bill. Only clinics owned by a hospital are allowed to charge this fee. Medicare paid about half of the facility fee bill, too.

Independent physician practices don’t charge the fee until they are bought out by large hospital administrations. Patients at hospital-owned clinics are being double billed without improving quality or patient outcomes. Organizations like the Association of Independent Doctors have emphasized facility fees add “zero value” for the additional cost. Hospital executives explain that the fee payments allow them to provide charitable treatment to uninsured patients. But consumers should not be burdened with extra costs when no additional benefits are delivered.

These spiraling fees deter us from getting the preventative care we need and result in escalating insurance premiums, swollen co-payments and raised taxes. Excessive fees endanger the viability of Medicare.

When doctors surrender their independence to become employees of hospital conglomerates, charges go up and service is diluted. Patients have to pay both the doctor and the corporation she works for. The powerful hospital lobby has swayed legislators to go along with the facility fee scam for now. Choosing autonomous North State doctors and clinics that are not employed or owned by the Enloe monopoly will save money, make medical insurance payments more efficient, and encourage physicians and medical providers to remain independent.