Published March 30, 2000 by 
Peninsula Daily News
Port Angeles, Washington
Copyright 2000 Eric Rush 
www.ericrush.com

Medical bait and switch
 
  I’m beginning to believe that some private enterprises think they’re the government. Their arrogance gives them away.
  If a large medical clinic treats customers as though they were taxpayers in for an audit, I shudder to think of what it might be like if we ever get national health care.
  Airline pilots have to get a thorough medical examination twice a year. Older pilots require an EKG—and electrocardiogram—once a year as part of the exam.
  There are three grades of FAA medicals. Private pilots get a cursory check to see if their hearts beat and their eyes and ears work. I think my first medical 25 years ago cost about $25.
  Commercial pilots are poked and prodded more thoroughly, and the costs are a bit higher.
  Airline pilots, especially old ones, are checked even more closely for signs of defects.
  My semi-annual medical exams cost about $100 these days. Once a year I get an EKG to make sure my heart still works right. That’s an extra $30 or so, but I never paid close attention to which parts of the exam cost what.
  Not his year, though: 

Dear Medical Clinic Billing Department:
  This protest goes back to my bill dated Feb. 12, and the charges of Jan. 21.
  I paid for my FAA First Class Medical by credit card at the time of service as I always do. The amount charged and paid—$128—was the customary charge for that service, including the usual $30 for my annual electrocardiogram.
  You might imagine my shock at the additional $202 tacked on to the $30 EKG charge on my Feb. 12——a 773% increase.
  I didn’t have time to wait through your phone system’s “your call is important to us,” so I called my local clinic’s billing department to point out what I assumed to be an error. The clerk was baffled and said she’d investigate.
  A letter from the local clinic (copy enclosed) advised me that “we have adjusted $142 from this account...as a patient courtesy to reflect a more graduated price increase.” How nice. How courteous——a mere 300% increase, not 773%.
  The problem, according to the letter, is that you suddenly discovered you have been undercharging for EKGs, apparently since the dawn of medical science. It appeared from my bill that you were trying to recoup years of undercharges over the span of a couple of weeks.
  No one I know pays $232 for an EKG. I haven’t yet found anyone who pays even as much as $90.
  My position is this:
  You can charge whatever you want for any service you provide, but anytime you jack up the price of any service by 773%, or even by 300%, you owe it to your clients to warn them ahead of time. What you do not do is go back later demanding more money for a bill already presented and paid.
  If I filled my gas tank, paid the $30 bill, and went home, and then the oil company sent me a bill for an additional $232, or even an additional $90—or even an additional dime—because they’d discovered their gasoline “has been grossly under priced for many years,” (to quote from your letter)...well, I’ll leave it to your imagination as to what I might reply to that oil company in face of such a ludicrous demand.
  Your failure to properly charge for your services “for many years” is your problem, not mine. Take it out of your accountants’ hides, not mine.
  I consider my bill for my FAA medical exam and EKG to be paid in full with the clinic’s acceptance of my payment made at the time of service for the reasonable, usual, and customary amount charged at that time——$128.
  In the future, I’ll ask for an estimate of charges when I make any medical appointment, just as I would if I were taking my car in for a tune-up.
              Most sincerely,
 
 
 


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