
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: THURSDAY, July 15, 1993                   TAG: 9307150434
SECTION: EDITORIAL                    PAGE: A-14   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

OPEN DISCUSSIONS OF MEDICAL FEES

THERE ARE many reasons for the high cost of health care in the '90s. Labor intensiveness of the industry, sophisticated technology and highly trained providers are coupled with an aging, sicker and more complicated clientele than in years past. Unfortunately, the patient (consumer) sometimes can be burdened with an unacceptable debt from these health-care costs, especially when a significant difference exists between charges and insurance payments. (Example: April 8 letter to the editor by Roxanne Hill, "Physicians need to practice restraint.")

While open discussion of health-care fees is encouraged by the American Medical Association, the Medical Society of Virginia and the Roanoke Valley Academy of Medicine, this dialogue unfortunately is seldom opened and the result can lead to dissatisfaction and friction between physician and patient. Fees for medical services should be reasonable, and should be based upon the complexity of evaluation and management necessary to render appropriate treatment. Insurance companies' "usual and customary" reimbursements do not always reflect the degree of complexity involved.

Much of the responsibility for knowing health-care costs rests with the patient, especially with elective (non-emergency) treatments. Would you purchase any other goods or service without first knowing the cost? Why is health care any different? Do not assume insurance will pay all of the fees and know the limits of your insurance coverage. Ask questions, and don't be intimidated by the physician or other providers.

Physicians must be responsive to the problem. We should share cost data with patients, especially when insurance assignment is not accepted and when dealing with indigent patients, if these patients are to be charged. Consider posting, or making available, fee schedules in the office. Work through the medical associations to relax antitrust laws and allow for more competition for health-care services.

With open discussion of fees, market forces will become more of a factor in controlling health-care costs, and will allow for less bureaucratic or governmental interference. The net result would be what we all want from our health-care system: affordable, quality health care with the patient's freedom to choose the best possible physician, and the physician's autonomy to practice the best possible medicine. F. JACKSON BALLENGER, M.D. President Roanoke Valley Academy of Medicine ROANOKE

by CNB