The American health care system’s billing system is so stupid and is genuinely harmful. I went for a general checkup a while back and I just got the bill for it. There was a large unknown charge so I called to check what I was and it turns out they charged me for a “referral”. So what happened was that my GAD-7 score (which you get checked for every general checkup) was extremely high, and so the doctor asked if I wanted to discuss it. I had always been apprehensive about getting help, but lately it had been getting so bad that I decided to say yes. The doctor then proceeded to ask me if I wanted the phone number of a few local therapist that she thought might help and gave me a couple phone numbers. She wrote it down on a piece of paper and she moved onto the rest of the checkup. That’s it. That was the referral. And she never warned me before I said anything that agreeing to talk about it (even for about 30 seconds to a minute) would incur additional costs. But now I get hit with a $111 fee for a “referral”. For a conversation she initiated.
All this has done is make sure that I will never ever ask for help again or open up to the doctor about any problems that I am having. I know now that I literally cannot say anything during future visits because I never know when I will incur an additional fee without warning (and only find out about it a month later when the bill comes).
This way of billing people—only after the fact and without warning people that doing certain things will incur additional costs—creates a culture of fear where people cannot say anything at all for fear of being charged, and thus do not tell their doctor anything and eliminate any chance of preventative care. This is an absolute atrocity and significantly reduces doctors’ ability to help patients by creating tension, eliminating trust, and rendering their offices no longer safe spaces.
To me, it also sends a message that the doctors are not trying to help people, but rather just trying to make a profit from their patients. Now it is always in the back of my mind that anything they say or ask might not be out of genuine professional opinion or from a place of caring for me, their patient, but rather as a way of finding ways to sneakily incur additional charges and make me pay up (and help the hospital earn an extra buck). My trust in any doctor ever is completely gone for the rest of my life. The only way healthcare works is if there is faith in doctors and the hospital and a willingness to cooperate from the patient’s end. How we bill people is obliterating any chance of that trust and cooperation ever existing.
This needs to change.
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