Doctor Visits

Doctors are outraged by the new health plan. If payments are cut, they will refuse to care for Medicare patients.

I am one of those old people whose Medicare payments are much higher than the taxes I pay. As you know, I am in dialysis three days each week. These treatments are extremely expensive. I’m grateful for Medicare and insurance which pay for all my medical bills. Dialysis keeps me alive.

Many of the other patients I see at the dialysis center are on Medicaid. Your taxes pay for them. But many of them would not be there if they had not been too poor to go to doctors earlier in their lives.

Before each session the nurse listens to my heart and lungs. The technician takes my temperature before and after each treatment. Since I have two bad arms, a blood pressure cuff is strapped to my left leg. During dialysis that cuff tries to amputate my leg every 30 minutes. Once a month I have complete tests of all the components in my blood.

Once a week the doctor comes around, looks at my chart, says, “Do you have any problems?” and goes on to the patient in the next chair. I’ll let you know later how much he gets paid.

You’d think that would be enough doctoring for anyone, but every specialist I’ve ever seen has insisted that I have a “primary” physician. I’m sure the tiny, young Indian woman listed as my primary doctor is capable. She wanted to see me every three months. I said I’d come once a year.

I saw my primary physician on March 15. This week I received my E.O.B. (explanation of benefits) from my insurance company for that visit. All she needed to do was renew prescriptions. These are all “maintenance” medications which I need to keep me going. One is for my thyroid, which I’ve taken for 65 years!

At the Baylor Senior Health Center I waited for over an hour. The doctor came in. I said, “Do you have the blood tests I asked the dialysis center to send you?”

“No,” said the doctor, “I won’t write any prescriptions until I see the results of the tests.”

The nurse wrote down a list of the prescriptions I needed refilled. I saw the doctor for about five minutes and then waited the rest of the afternoon for the dialysis center to fax the blood tests. At five o’clock I went home. A few days later the prescriptions came in the mail.

Now about the E.O.B. The doctor billed $173.82 for her services, and the Baylor Senior Health Center asked for an additional $102.83. How much did Medicare allow? The doctor was allowed $75.52, of which Medicare paid $60.42, the rest by my insurance. In addition, Baylor was allowed $68.56, of which Medicare paid $54.85, the rest by insurance.

Don’t you think $144.08 was enough to pay for this doctor visit? I think it was excessive.