I just got my tonsils out two days ago and will be graduating dental school in a couple weeks, so I've been thinking a bit about healthcare lately. I just got a bill today from an ENT. I had gone to the ENT to have her look at my tonsils. In the process of the exam, she checked my ears (not my chief complaint). She said something along the lines of "Hold on, I'm going to just get a bit of earwax out," swung some sort of scope over, and within a minute (I literally think that this was <60 and="" done="" it="" my="" nbsp="" on="" p="" seconds="" to="" tonsils.="" was="" we="" went="">
At the time I thought to myself, "That's a nice gesture. She saw something that needed taken care of that I wasn't really aware of, and she did it." Then the skeptic in me thought, "I wonder if I am going to be billed for that." Sure enough today I got a bill showing that $179 was billed to the insurance, while only $55.03 was allowed. Since I hadn't met my deductible, my portion was $55.03.
Alexia and I were just talking the other day about how odd it is that providers bill a large amount and then it always seems to be adjusted to a "contractual discount." So is the insurance shortchanging the provider by reimbursing less or only allowing a lower amount to be billed? Or is there fee inflation going on causing uninsured people to subsidize the contractual "discounts" insurance companies have?
Furthermore, should you as a provider inform patients of every fee they are going to get charged with? I struggle with this as a dental student. Do you inform the patient about the cost for radiographs and give them an option as to whether they want to get them or hold off for another six months, or do you make your opinion and perform the procedure? Will you be stuck with indecisive patients, who may be unable to understand and weigh the cost/benefit of a preventative radiograph vs. a possible cavity? Should a patient be financially counseled before all billable procedures? And what about billing not for service, but for complexity/time spent plus materials like a mechanic? My procedure to me did not seem like a $55 ear wax removal, certainly not a $179, but then again, I can't judge ENTs, the cost of equipment, cost of schooling, and complexity of procedures.
I guess overall the question is, what level of autonomy and trust should patients be given in their health care? As a patient, I feel capable with my medical knowledge, and the resources available to me, to be fairly autonomous in my cost/benefit analyses and to largely decide what I should and shouldn't have done if given the appropriate diagnoses and professional opinion. Many others may feel differently and may prefer to have the provider take the wheel. However, overall I am in favor of more transparency on pricing, procedures to be performed, potential risks, and especially complications that happened during the procedure, so that the power is in the patient's hands. If the patient decides that they would like to be less involved in the process, at least they were informed.
The difficulty with this is the implementation. I've heard of providers posting prices online, which sounds like a good idea. I feel like there needs to be some informed consent from a financial aspect where the patient either agrees that he or she will either not be aware of every billable procedure before it is performed, or where they are provided with prices and indicate that they would like to be informed of what procedures will be happening and that the onus is on them to get involved if they have a concern. Ultimately, providers shouldn't be expected to unreasonably compromise care because a patient wants to apply their Slickdeals mindset to their healthcare, but I think patients are currently losing a battle against autonomy, confusing medical codes, and convoluted insurance practices. What do you think?
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Friday, May 3, 2013
Healthcare and Billing Practices
Sunday, January 8, 2012
Free Insulated Chicken Coop Plans
My big project of the year, actually of my lifetime (at least in the building category so far), was to build a chicken coop. Alexia talked about wanting chickens last year; I wasn't as thrilled. But, eventually I realized she really wanted them, and so I got on board. She called our borough, and they said we could have 5 animals. So, now we have one dog and four chickens.



Wednesday, November 23, 2011
Eliminate Fast User Switching by Using an Applescript to Toggle Preferences

-- List of properties for hot corners. Just set your hot corners and it will toggle back and forth between those settings and being disabled
property tl : 1
property tr : 1
property br : 1
property bl : 1
property runs : 0
if appIsRunning("GrowlHelperApp") then
tell application id "com.Growl.GrowlHelperApp"
-- Make a list of all the notification types
-- that this script will ever send:
set the allNotificationsList to ¬
{"Switch Notification"}
-- Make a list of the notifications
-- that will be enabled by default.
-- Those not enabled by default can be enabled later
-- in the 'Applications' tab of the Growl preferences.
set the enabledNotificationsList to ¬
{"Switch Notification"}
-- Register our script with growl.
-- You can optionally (as here) set a default icon
-- for this script's notifications.
register as application ¬
"Switch" all notifications allNotificationsList ¬
default notifications enabledNotificationsList ¬
icon of application "Switch.app"
-- Indicate which user or profile is now running
if runs = 1 then
notify with name ¬
"Switch Notification" title ¬
"Profile Activated:" description ¬
"User 1" application name "Switch"
else
notify with name ¬
"Switch Notification" title ¬
"Profile Activated:" description ¬
"User 2" application name "Switch"
end if
end tell
end if
-- Stores existing hot corners as properties for next toggle
if runs is 0 then
set tl to do shell script "defaults read com.apple.dock wvous-tl-corner"
set tr to do shell script "defaults read com.apple.dock wvous-tr-corner"
set bl to do shell script "defaults read com.apple.dock wvous-bl-corner"
set br to do shell script "defaults read com.apple.dock wvous-br-corner"
-- Disables hot corners
do shell script "defaults write com.apple.dock wvous-tl-corner -int 1; defaults write com.apple.dock wvous-br-corner -int 1; defaults write com.apple.dock wvous-bl-corner -int 1; defaults write com.apple.dock wvous-tr-corner -int 1; killall Dock"
set runs_A to 1
end if
-- Sets hot corners back to existing values
if runs is 1 then
do shell script ("defaults write com.apple.dock wvous-tl-corner -int " & tl & "; defaults write com.apple.dock wvous-br-corner -int " & br & "; defaults write com.apple.dock wvous-bl-corner -int " & bl & "; defaults write com.apple.dock wvous-tr-corner -int " & tr & "; killall Dock")
set runs_A to 0
end if
-- Initializes the trackpad preference pane
tell application "System Preferences"
set current pane to pane "com.apple.preference.trackpad"
end tell
tell application "System Events"
tell process "System Preferences"
-- Toggles between natural scrolling and unnatural(?) scrolling
click radio button "Scroll & Zoom" of tab group 1 of window "Trackpad"
click checkbox 1 of tab group 1 of window "Trackpad"
-- Toggles tap to click on
click radio button "Point & Click" of tab group 1 of window "Trackpad"
click checkbox 1 of tab group 1 of window "Trackpad"
end tell
end tell
quit application "System Preferences"
-- Keeps track of where you are at in the toggle
set runs to runs_A
-- Call to make sure growl is running
on appIsRunning(appName)
tell application "System Events" to (name of processes) contains appName
end appIsRunning
Thursday, October 6, 2011
Steve Jobs
I was really surprised when I realized how much Steve's passing affected me last night and today. Today seemed a little gloomy. I knew I loved my iPhone, iPad, and laptop, but I didn't realize that I had grown to look up to Apple's iconic CEO. Thanks Steve.
Tuesday, September 27, 2011
Henny
When I lived in downtown Marietta, I'd often walk to the corner store for snacks. Halfway there, sat an old, shirtless, plump man on his porch. His name was Henny.
Henny would say some of the oddest things to my brothers and me as we passed. Whether he was merely enjoying the lack of accountability that often is afforded the aging, or was conducting his own social experiment, I never knew. Often I would be hailed as the "candyman" as I walked by.
Once while passing, he called out "Your mom's in the hospital!" By this time I had caught on to Henny, may have given him a nod or a half hearted "Oh," but just kept walking, quite confident that my mom was not, in fact, in the hospital. My confidence may have been bolstered by having just been at home minutes prior, and having seen my mom, unhospitalized. Regardless, he didn't fool me.
And then one day, he passed away.
Wednesday, September 7, 2011
Beach with my best friend
Thursday, September 1, 2011
How to re-web your own Chacos
My 5 year old Chacos which I purchased for 40 bucks had seen better days. The soles were peeling off. So I sent them in and got them resoled under the warranty for free. Yipee! It was then that I realized that the webbing was fraying through. I called to see if this was covered under the warranty, but they said it most likely wasn't. They needed to see them first.
- A torch, or matches, or some heat source to melt the ends of your webbing
- About 10' 3/4" wide tubular webbing (costed me a little over a quarter a foot)
- A medium sized needle
- Strong thread (I had to go to Jo-Ann Fabric and Craft for upholstery thread)
- A knife
- Scissors
- A few hours

Tuesday, July 19, 2011
2 Seconds
-- The amount of time it took me to pause at the trashcan and decide that feeding the chickens my leftover chicken was not right. I threw it away.
Monday, July 11, 2011
Drone
....and I got a Parrot AR Drone for our anniversary. It is pretty much awesome. Except for the fact that it is a little out of commission while I wait for repair parts:-).
Chickens
I'd say two posts in one day, but technically my last post was started yesterday. Alexia and I currently have 17 chicks living in our basement bathroom. There are 5 Cuckoo Maran pullets that lay a dark brown egg, 4 Ameraucana pullets that lay blue/green eggs, and 8 Rhode Island Red (we think) roosters that were included in the box to keep the girls warm during the shipping process.
Not sure what to title this
As the title says, I'm not really sure what a good title would be, or what this post is really about. It is just late on a Monday night, and I am procrastinating going to bed. I logged on to Facebook (seems weird to capitalize the F when it seems to usually be lowercase in their logos), and it was weird.
Monday, May 23, 2011
What's that smell?
I just walked past someone on their smoke break (in front of the med school, but that is an irony I have gotten over by now) watching a gas leak unfolding in the street about 25 meters away.
Tuesday, November 23, 2010
Sig Figs
Saturday, July 17, 2010
Google Public DNS and Hulu
Usually my computer literacy helps. This time it hurt. I have spent the last couple hours trying to diagnose why Hulu hasn't been able to load videos lately. It has been spotty here and there. Oddly enough it loads the ads just fine, but today it just failed when loading the show, every single time. So, after I dismissed my conspiracy theories about Hulu trying to boost their ad views, I... I don't know what I did. I guess I called Comcast, complained, had them reset my connection twice, bypassed the router, realized it would work bypassing the router, and then somehow ended up two hours later realizing that using Google's Public DNS was the problem.
Thursday, June 17, 2010
My new de-stressor
SpongeBob. I've been watching an episode or two every day. I think everyone's got 11 mins for a little sponge in their day.









