So you think you're in charge of your medical care?

Well, I can't believe the delusion that many Americans have regarding decision-making about their medical care. The reality is that decisions are made by insurance companies and the hospitals/medical centers. Here's a lovely example:

I went for my annual exam with my ob/gyn. (As an aside, I will mention that I didn't go last year because I was too busy taking care of my mother, kids, going to school & working, to take care of myself by going for an annual exam).

Anyway - we had a conversation about my health & concerns that hit on many areas. I found it helpful, blah, blah, blah. I did my copay at the appointment, as I always try to do. I happen to have pretty good insurance, which means that I can afford preventive appointments like this one.

Lo and behold I get a bill/summary of charges & payments a couple weeks later and I was being charged for TWO appointments. So I call the insurance company, who said, no it wasn't us that charged you twice - that would have been a decision by your doctor. Of course at no point did my ob/gyn say that she was charging me for 2 appointments, so I was annoyed, and called the doctor's office all in a huff. Well, her nurse was as confused as I was and said that I should not have been charged for 2 appointments.

What became clear as we talked was that this was a decision made by a coder at the medical facility where the doctor is employed. So, some non-medically trained data person at the Cleveland Clinic reads over the notes about my medical appointment (which I find offensive anyway - how many secretaries, data entry people, billing clerks, etc are privy to the intimate details of my life??) and decides that my ob/gyn actually saw me about 2 separate concerns, so I should be billed for 2 appointments. It's not about time, it's about the number of concerns addressed, whether it takes 5 minutes or 50 minutes. (Although I know that some circumstances, it is about the amount of time your doctor takes with you).

So, don't tell me that you are upset that the government might make decisions about your medical care (which isn't the case anyway) - the reality is that you aren't making the decisions anyway!