Day 486: (Psst – Sam sent me.)

Got a bill in the mail today. It was from the doctor. Well, not exactly the doctor. I’m pretty sure my doctor never saw the bill. It was from some collection of bean counters who manage such things for dozens of doctors in the area – maybe thousands of doctors all across the country. There’s no way to know.

I scheduled an appointment with my doctor a couple of weeks ago because I was running low on a couple of diabetes meds and the rules say that without a nod from my doctor the druggist won’t refill the prescriptions.

When I checked in at the front desk and presented my Medicare card I caused a bit of a stir. The receptionist wasn’t sure how to handle my record on her computer since it was the first time I had seen the doctor since I had become eligible for Medicare a year before. She asked accusingly, “Why haven’t you been here earlier?”

I told her because I hadn’t been sick. That didn’t seem to cut the mustard. “We’re going to have to call this your initial Medicare visit.” That sounded fine with me. A few minutes later a nurse came out and led me to an exam room. She took my weight and height (I’d apparently grown a half inch taller since my last visit), took my blood pressure and temperature, and reviewed my meds.

I had increased my daily Metformin dose from three tablets to four (the same amount Janice takes) because my blood sugar was drifting upward. The nurse asked, “Who told you to do that?” I answered that I did. She shook her head and said now she had another form to fill out.

Twenty minutes later my doctor came in. To actually call him a doctor is a bit of a stretch. He’s a pleasant man with a gentle manner who looks to be in his forties. He only takes appointments four days a week. Presumably he spends the other three days enjoying the benefits of a six figure salary. He smiled, asked how I was feeling, and scanned the notes from the nurse. I said I was feeling fine and asked how he was feeling. He was feeling fine too.

I told him my Plantar Fasciitis had somehow disappeared, I had passed no new kidney stones, and that my sciatica seemed to have corrected itself since the last time I saw him. None of those maladies had benefited from any medical intervention.

That was that. The doctor hit a few keys on his laptop, shook my hand, and left. Six minutes of smiles and head nods. Modern medicine had come a long way from when doctors had to poke you and peer into various orifices with flashlights to see how you were.

So today I got this bill. $305.00 – just a tad over $50 a minute for nods and smiles. The good news is I don’t have to pay the full amount. With Medicare I have Uncle Sam on my side. He picks up $113.61 worth of nods and smiles. He also waves a magic wand and tells the bean counters to give me a $162.99 discount. It’s called a Medicare Adjustment. Why? Maybe because Uncle Sam has tanks and most accountants don’t. Truth is I have no idea why I get this discount. But I’m not complaining.

Before I was on Medicare the Medical Mafiosi would expect me to pay the full $305.00. But now that Uncle Sam has made them an offer they can’t refuse they’ll settle for $28.40 – which still sounds high to me for six minutes of nods and smiles. But I suppose someone has to pay for med school and lawyers and all those bean counters.

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