To bill or not to bill; that’s been a question

There is no question that the costs to our healthcare system is growing to a level that is already beyond affordable. Cuts are upon us left, right and centre. The factors contributing to the rising expenses are plentiful, involving the culture of physician over-ordering investigations (part of it to ensure quicker, more accurate diagnoses, and part of it to avoid litigation out of fear of errors or delays, but we’ll save that for another posting), hospital administrative costs (which I’m sure they have their own excuses and reasoning), as well as costs attributed to patient factors. This is where we’ll focus on this posting.

One of my biggest pet peeves are impatient patients that unknowingly run up costs. If your child developed pain to their ear 20 minutes ago, it does not mean you need to be seen in the Emergency Department this instant; treating symptoms or waiting to see your family doctor would be a more reasonable option. Or, if you truly felt that you had to go to the ER, and registered and are waiting, but cannot wait any longer, leaving and driving to another hospital hoping to be seen faster is definitely not okay – this actually puts a double cost onto the system. Each time someone registers into an Emergency Department, there is an automatic cost to the provincial health fund.

A suggestion that has floated around as a means to help educate the public was to send faux bills to each person after a visit to a hospital, clinic or doctor’s office. Nothing would change in how healthcare is delivered, and no money would be sought from these faux bills. The idea is to inform each person how much their visit cost.

Hospitals in the USA send people real bills, that itemize each expense that their visit cost. If Canadian hospitals were to do the same, the theory is that the public would have an idea of the real expense that their healthcare is costing the public system. Too many people just assume that “healthcare is free”, that they (some) pay their taxes, and they’re entitled to any and every test they think is necessary.

Of course, the detractors believe that this idea would have a negative impact on overall health; that once people feel that they’re burdening the system, they’ll shy away from seeking medical attention, which may result in an adverse outcome that could have been averted had they come in.

The best case solution would be the happy median between the two. If this idea were to work out perfectly, people would think twice before coming in, and hopefully would hold off going to the Emergency Department for non-emergencies, realizing that they could get the same level of care at a cheaper cost to the healthcare budget.

Implementation of this project is nowhere near being rolled out, due to the debates and controversies. The idea does have some merit though, and could bring a new level of transparency and understanding to a public that is eager to have doctor’s billings published and available for all to see. Instead of lynching the physicians for how much they bill, perhaps it would be enlightening to see why they are billing to much, eh?

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