Diet, Day 19 - Rant About Health Care Costs

Wanna know why health care costs so much? Ask a doctor and he’ll tell you it’s those fucking lawyers and tell you about some shyster that recovered $10 million for a family because a doctor fucked up and killed his patient. Never mind that it was the doctor who committed malpractice; the lawyer still gets blamed.

But the real reason for high medical costs is the doctors themselves -- not only do they sometimes fuck up, they often overcharge. A few weeks ago I went to a dermatologist to have him look at a couple of discolorations on my skin. He did and gave me an Rx for an ointment. He also took the opportunity to check my head for skin cancer and froze a few “benign lesions”. There were no more than a half dozen of them. I paid my co-pay and thought all was fine, but in a week or so I got a letter from the doc’s office saying my insurance hadn’t paid the whole bill and he wanted to collect the rest.

This caused me to examine the bill, and I discovered something known as CPT codes. These are codes established by the US government in connection with Medicare reimbursement. They are the Bible in terms of what Medicare and insurance carriers will reimburse to a doctor for particular services performed. Each number corresponds to a specific service and a specific amount of money that will be reimbursed for that service. You’ve seen these numbers on your doctor’s invoice and probably didn’t pay much attention, because they’re usually just numbers with no explanation of what they mean. There’s a reason they don’t provide an explanation – they don’t want you to know that they’re screwing you or, more accurately, they’re screwing your health insurance carrier.

Here’s what they do, or at least what my ex-dermatologist did. CPT code 17003 is for the treatment of 2 to 14 benign lesions. It pays $6.86. CPT code 17004 is for the treatment of 15 or more lesions and pays the doc $162.72. Which one do you think he billed the insurance company for, even though he treated no more than 6 or 7 lesions? To make matters worse, he also billed under CPT 99202 (new patient visit – 20 min.), which pays $67.57. I wasn’t in the doc’s presence for more than 10 minutes. He should have used CPT 99201 (new patient – 10 min.), which only allows $39.81. The insurance company paid based on the CPT codes and gave the guy $230.29 minus my co-pay. If he’d billed properly, they would have paid only $46.67 – a whopping difference of $183.62! To make matters worse, he billed me even more than the CPT codes allowed, and his letter was to collect the amount the insurance company didn’t reimburse. Upon my calling his attention to the “mistake” in billing, he “graciously” agreed to write off the balance; but he didn’t offer to reimburse my insurance carrier for the extra 180 bucks he’d swindled from them.

Let’s put this in perspective. According to the 2000 Statistical Abstract of the U.S. there were 76,000 practicing dermatologists in the US in 1998 (that number has undoubtedly grown). Let’s assume that a mere 10% engage in this scam and further that each only does it with one patient a day (conservative assumptions without a doubt). That means there are 7,600 instances of improper billing every day. Normal people have about 245 working days in a year after accounting for weekends, holidays and normal vacation times; but let’s give doctors the benefit of the doubt and say they only work 200 days each year. Given those assumptions, there would be 1,520,000 instances every year where a dermatologist fucked a patient’s insurance company. If each screw job resulted in an overbilling of $183.62, as did mine, that amounts to $279,102,400 that insurance companies overpaid in just one year – and that’s assuming only 10% of the dermatologists engaged in the scam and that each one did it to only one of the many patients he or she saw during the day. And that’s only the dermatologists!!!

Word to the wise -- examine your doctor's bill and look up the CPT codes (they can be found on the internet).

By the way, there’s still zero visibility with my dick even though I’ve steadfastly remained true to the diet and have worked out 6 times a week.

Diet, Day 13 - Performance Criteria

A few days ago I suggested that dick visibility was a better measurement of diet progress than the scale, but it occurs to me that there must be objective standards to make this test meaningful. For example, quite different results can be observed merely by testing the dick while it is turgid, rather than flaccid. What if the shower temp is too cold, resulting in the George Costanza problem? Are you allowed to hunch or lean when looking for it? Is it permitted to suck in the gut to achieve greater visibility? I’ve considered these important issues at length and have decided on the following testing rules:

• Test cannot be taken during or after a cold shower - water must be lukewarm to avoid unintended shrinkage

• No hunching, leaning, thrusting forward of the hips – body must be erect (not the dick, the body) and you must look straight down without bending anything other than your neck

• Dick must be in a flaccid state. Turgid would probably result in a more consistent measurement, but I fear that it could result in my achieving the visibility goal prematurely (that is, before I’ve really lost any weight). More importantly, if I have to get a leaner every time I undergo the visibility test, I’ll either be exhausted or there will be many days when testing is not feasible.

• You are allowed to suck in the abdomen. After all, if you’ve improved the abs to such an extent where this means anything, then you deserve some credit.

Any questions? By the way, today I achieved 0% visibility (with a chance of thundershowers); but the scale indicated a weight of 258.

Diet, Day 10 - 21st Century Workout Tunes

A few days ago I received a comment suggesting that playing rock from the 70’s and 80’s still placed me firmly in the old fart category. To quote my friend, Dr. Jude, “You should try some music from this Century.” Well, I am an old fart, a genuine baby boomer and teenager during the Sixties. When I was growing up, my parents listened to Mancini and Lawrence Welk. When they got real daring, they’d throw Belafonte on the turntable. I found the Beach Boys and Four Seasons more to my liking. Given that background, it certainly seemed like Van Halen and Def Leppard were a huge move forward. Nonetheless, I acknowledge Jude’s comment has some validity, so I went to Billboard’s “Hot 100” and tried the top three tunes in the country. “Love the Way you Lie” by Eminen (with Rihanna) was firmly entrenched in first place, both this week and for several past weeks. Watched the video on U Tube and read a review -- “Rihanna’s hook portrays the deep emotions of the female in this situation,” and “Em simply kills it across all three verses.” I actually thought it was pretty good - liked the contrast of Rihanna’s soothing voice with Eminem’s staccato rap. But “portrays the deep emotions of the female”? Gimme a break! More importantly, it’s not workout material, at least for me. “Dynamite” by Taio Cruz was next. It had a decent beat, so I might be able to incorporate it in my workout tunes. However, I have no idea what the fuck the lyrics are and don’t really like the music. Then there was “Teenage Dream” by Katy Perry. Much too teeny-bopperish and definitely not a workout song. So I got out of the top hits and found a song I thought might have possibilities – Lady Gaga and Beyonce singing “Telephone.” It had a pretty good workout beat, but was interrupted too often with silly sound effects and trying-too-hard-to-be-clever spoken word. Will admit I liked the half naked video - the beer can curlers were an especially nice touch - but I’ll take a pass. Sorry Jude, I’m open to suggestions, but for now I think I’ll stick with Metal as my workout vehicle. Oh, by the way, today I was at 262 and my appendage was still not visible (no surprise there). Disappointing progress, given the daily workouts and diet. Yesterday, for example, I had nothing but a steak and salad all day, supplemented with a carrot for a snack.