Doctors need a healthy private healthcare market more than global insurers do
Most Health Insurance readers do not live in Kent. So they can be excused for missing a Kent Messenger story headlined “Doctor pursued patient for fees after cancer op”. Of course, they may well have seen the same story covered in Health Insurance headlined "Anaesthetist's shortfall claim dismissed by court".
Either way, in a nutshell, a father of four, now 43, contracted bowel cancer in 2004. He was covered by Bupa. In 2005, he had two operations but in 2010 he worsened.
He needed more surgery.
Bupa picked up the costs, including paying £733 – its standard fee for the procedure and hospital – to the anaesthetist. This is in line with the scale from most leading insurers.
But once the patient was back home, the anaesthetist sent him a further bill, nearly doubling the Bupa scale fees. The cancer sufferer ignored this – as well as subsequent calls from debt collectors and threatening solicitor letters.
Finally, the anaesthetist sued the patient in the county court for £1,767 – a sum that included around £450 in debt chasing fees.
The patient, who is unemployed on health grounds, said: “He seemed oblivious to how I must have been feeling when I was trying to recover. He was paid what Bupa considered reasonable and fair.”
The judge threw the claim out. He concluded the debt collectors' fees “extortionately high”, and that he was not satisfied that the doctor was “entitled to levy a charge greater than that which had already been paid.”
The judge criticised the doctor as “elusive” saying: “Nowhere in the documentation prepared by the doctor is there any estimate of fees or quotation prior to the operation. He has advanced many reasons for this, none of which made the situation any clearer to me. I cannot see why he was so unwilling or unable to provide a simple estimate of time and hourly rate.”
I have not named the doctor because this is sadly not unique. Many consultants have decided that already generous scale fees are not enough. So they bill clients – often not well enough to know what is going on. It's an open cheque – and the tabloid potential of “Doc's extra cash demand as patient is wheeled into op” beats the £20 aspirin or the £10 sticky plaster (or in my own case six years ago the £27 sling for my arm). Most pay up.
George Bernard Shaw said “all professions are conspiracies against the laity” and nowhere is this truer than the medical profession. People can do law, accountancy, religion and – dare I say it – financial advice, on their own or at least shop around. Medicine with its life and death connotations is different as doctors well know.
Patients are rarely in a position to compare specialists let alone prices – and they assume health insurance plans will pick up the bill. The information is assymetric – patients know zero about procedures or costs. And virtually all are deferential to the medical profession, questioning nothing.
The system serves the doctors, who use phrases such as “my expertise is priceless as I'm saving their life”, not the patients. Costs never fall.