More Dogs on Main Street
Scientists at NASA announced a week or so ago that they had found water on Mars. Within minutes, Summit Water Company had claimed it was theirs, and filed another lawsuit against Mountain Regional, claiming they were wrongfully diverting it. Somehow, I think the solution to our water problems won’t be found in a courtroom. But there isn’t a whole lot of large-scale plumbing going on.
Meanwhile, though there is water on Mars, there has been darn little in Summit County this summer. I had four inches of snow at my house on June 11. Since then, there hasn’t been enough rain to really spot the car. The trails are dustier than the surface of Mars, the fire danger is soaring, and you finally begin to worry a little about what happens next winter if this pattern holds.
The presidential campaign has been focused on energy lately, with both candidates talking down to us. McCain is all over Obama because Obama has suggested that part of the solution to the energy problem is properly inflated tires. That can improve mileage a couple of percent, and save a lot of gas right now, without costing anything. It is, of course, only part of a more comprehensive proposal. But it hints of conservation, which is anathema to the Republicans. They believe that we have a God-given, constitutional right to drive an SUV, and that drilling everywhere will solve today’s problem, even though the newly developed oil sources won’t be on-line for 15 to 20 years.
I’m just a farmer from Kamas, but it seems to me we ought to be doing both that we need to be reducing demand as sharply and quickly as we can, at the same time trying to find additional supply to bridge the gap between oil and whatever comes next. It’s enough to make you sick.
Speaking of sick, the debate has kind of drifted off health care, which is another of those intractable problems. There is very little about how we are financing health care that deserves preservation. The system is failing, and should have a "do not resuscitate" order on its chart. Here’s a real life example of how screwed up it is: I had an annual physical check up a while ago. As part of the drill, my doctor wanted to run some very routine blood tests. My diet of chocolate chip cookies, pizza, and hot fudge sundaes gave him some concern that my blood might be about 50% mozzarella cheese. So he called for the leaches, and sent them all out to the lab to see what the percentage of butterfat was.
The lab, which is an independent business called LabCorp, ran the tests and rendered a bill for $258. I sort of have insurance. that, I mean I have a deductible of a couple of thousand bucks before the blood suckers at Blue Cross pay a dime. If I get hit by a truck on an odd numbered Tuesday, the coverage is pretty good. Otherwise, any routine doctor visit is entirely on my dime. But because I have insurance, LabCorp was willing to make an "adjustment" in the bill of $217.75, resulting in a net charge for the tests of $40.25.
I’m not great at math, so let me explain that another way. Even though they were billing $258, LabCorp was willing to accept a total of only $40.25 as full payment for the services. There was no payment from the insurance company. Blue Cross didn’t pay a cent. The total payment LabCorp received for the blood tests was $40.25. The other $217.75 just went to money heaven (or Congressional campaign donations). Presumably, LabCorp is not a charity, and is still making a profit when charging $40.25. Most people whose blood they test will have some kind of insurance, so only the really poor or sick pay the $258 rate.
My point is that the system is so messed up that LabCorp can get away with charging the guy who has no insurance more than 6 times as much for the same services. I don’t think his blood test was 6 times more complicated. They are just plain price gouging. And they get away with it because the uninsured customer will never see what the bill would have looked like had he received the Blue Cross discount. He’s getting screwed and doesn’t even know it.
The standard excuse for this despicable behavior is that LabCorp is guaranteed payment if there is insurance involved, and runs a substantial risk of non-payment when testing the cholesterol levels of the uninsured. That, of course, is a stool sample if I ever saw one. Since my insurance coverage contributed nothing to this, they are depending entirely on me to make the payment. My checking account isn’t as flush as Blue Cross’s, and I could just as easily have stiffed them on the bill as the uninsured guy. Of course, if they had gouged me for 6 times the going rate for the service, it seems like that alone may cause a collection problem. I bet charging the uninsured the same rate as the Blue Cross customer would increase the odds of payment, as it is always easier to shake $40 bucks out of somebody once than it is to shake it out of him 6 times.
If this is happening on routine stuff, imagine what is happening on exotic tests, or somebody who is really sick and has to have multiple tests over an extended period of time. LabCorp is making a perfectly acceptable profit on this at $40, or they wouldn’t be doing it at all. So while Obama is suggesting a windfall profits tax on the oil companies, he’s looking in the wrong place. LabCorp makes Exxon look like Mother Teresa. Tony Soprano would be embarrassed by these business practices. So while the management and owners of LabCorp are surely going to hell, it can’t happen soon enough to provide any real benefit to the uninsured customer who is paying $258 for $40 in services.
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