Working in the health care field, I feel allows me to speak with some clarity on this issue. Case in point, the other day a gentleman came in to have some lab work performed. He wanted me to tell him how much the testing would cost. After looking up the cost to perform the tests the doctor had listed, I was able to give him an approximation. The gentleman then wanted me to make a declarative statement of how much the testing would cost, I told him that I was unable to do that. This upset the gentleman and he would not listen when I tried to explain why.

The problem within my field is that although we have set costs for certain tests, these costs do not reflect the cost of additional testing. Why would additional testing might be needed, if the results of the original testing did not confirm the doctor diagnosis, or if they were in some cases elevated or decreased, additional testing would be needed to determine what was causing this condition.

Overall, in the health care field, no hospital, public or private, will turn away a patient needing care. To do so would violate federal law, and result in the hospital losing its credentials to practice.

The major problem in the cost of health care today is the third party pay system. No longer do people pay for health care out of their pockets, they rely upon insurance companies, medicare and medicaid. The problem is that the government fixes rates for certain procedures, meaning that the government insurance - medicare and medicaid - will only pay a certain amount for certain tests and/or procedures.

The problem arises with the misuse of the system. The emergency room cost of medicine is higher than any other cost besides those involving surgery. The emergency room is also highly regulated. If a patient comes in complaining of certain pains or illness, the emergency room must perform certain tests and procedures. For instance if some who has been lifting heavy weights, i.e. like boxes or moving furniture, comes in complaining of chest pain, the muscles in my chest hurt, the emergency room must do a cardiac workup, which includes cardiac enzymes, ekg, and x-ray. Even though the doctor may suspect only a pulled muscle, the doctor must work-up the chest pain as a cardiac patient. Instead of only a simple blood test and x-ray, the patient will get the whole exam.

The other problem is that far too often, people will come to the emergency room in lieu of a doctor visit. A doctor visit may cost $150 to the patient for meidcare and medicaid, but the emergency room visit is billed at $500. Why??? The patient didn't want to wait a day for the appointment or didn't want to wait at the free clinic in town, so instead they came to the emergency room. This is especially true of medicaid and medicare recipients. The misuse alone cause the increase in the billing of government insurances, which in turn drives the cost up.

Perhaps one of the best ways to fix this misuse and lower the cost of health care would be to implement a co-pay system for the medicaid and medicare recipients. If the patient has to face out of cost expenses, this would cut down on the amount of misuse. The savings from this alone would reduce the cost of private insurance making it much more affordable for everyone, and it would also help to reduce the cost of procedures.

dmk