If you have been following my blog you know that I was trying to pivot my start-up. The following is the story behind the latest pivot. If you want to learn more about my start-up check it out: RetraceHealth
My wife and I had our first child, Enoch in December 2011. Like most kids Enoch got sick. My wife and I have a high deductible health insurance policy coupled with an HSA. So whenever we took Enoch to the doctor we would get a bill for $144 or more. Over the course of one month Enoch went to the doctor four times (each time the nurse on the nurse line had instructed us to bring Enoch into the clinic. Each time we took Enoch to the doctor it had been preceded by a few days of anxious debate as to whether now was the right time to take him in.
Below the text of this blog are scanned images of the bills from the pediatric clinic with some helpful commentary to clearly show the absurdity of the events I will describe below.
On the first visit the doctor sent us home without doing anything except wasting more than an hour of our time if you include travel time, waiting in the lobby, check-in, etc. On the second visit Enoch was diagnosed with pneumonia. The third third visit occurred because the nurse on nurse line was concerned with a persistent fever, still yet the doctor did nothing and informed the us that Enoch would recover naturally. The fourth visit occurred for the same reason and ended the same way the third visit did. Take a look at the paper trail below.
Why in God’s name should it cost $144 to tell a patient to go home and rest but then when a prescription is written the cost suddenly skyrockets by 50% to $215 for essentially the same service? That is like going taking your car to the mechanic because it is making a rattling noise. If the mechanic finds no problem he charges you $50, if he finds the problem he charges you $75, if you want the problem fixed (i.e. a prescription) he charges you an additional $100. This analogy reveals the absurdity of the current healthcare system. The current healthcare system with its relationships between doctor’s and insurance companies sucks (like a vampire) and must die.
The three visits where no diagnosis was made were coded as 99213, this is one of the most commonly occurring types of visits. It rarely lasts 15 minutes. The visit where Enoch was diagnosed with pneumonia and given a prescription was coded as 99214. The 99213 costs $144 at this particular Fairview Clinic, the 99214 costs $215. From my perspective as a health care consumer there was no difference in the services Enoch received between the 99213 and 99214 except the writing of the prescription.
There is no reason that this entire episode should have cost more than $50. Unfortunately, this adventure cost the us over $600. Frustrated by this I decided that no one should have to endure the mental anguish of not taking their child to the doctor. Furthermore I decided that no one should have to wait an hour and pay $144 just for a doctor to tell them to go home and wait it out. That is why RetraceHealth was born less than two years after Enoch was born. By cutting out the waste in the healthcare system created by health insurance companies, paper records, and archaic systems; primary care and preventative medicine can be made affordable to every man, woman and child in this country.
I have over 12 years of work experience in the health care industry. Half of my experience was spent on the health insurer side and I have seen first hand how broken the healthcare system is and what can be done to begin to repair it. If you are reading this, and live in Minneapolis MN go to RetraceHealth and subscribe or prepay.