Midnight Pensees on Bill-Paying Night


When my wife and I had our first baby in 1986, my mother whodelights in deluging me with useless paraphernalia from my childhood, dredged up the hospital bill for my own birth in the late Fifties.

It cost $245 -- for the birth, Dr. Miller's fees, medicine and 10 days in the hospital.

Our son's routine birth cost nearly $3,500, and they had my wife packing in less than 48 hours, despite the fact she was still bleeding from an episiotomy, and our baby was bright yellow from a temporary, but worrisome liver problem.

Now it's five years later, and I'm sitting in front of a three-inch stack of medical bills. My 5-year-old had some warts removed. My 2-year-old daughter had a well-baby check-up. I had a well-grown-up check-up. My wife, who works at a local hospital, had a $50 blood test taken when she was poked with a needle in the line of duty. The total cost -- I think -- comes to almost $400.

I say ''I think'' because I've got at last three separate bills for each visit -- from radiologists, the hospital, labs, doctors and clinics.

On each bill, which come in different colors, sizes, formats and payment schedules, I've scrutinized the blocks of codes numbers, microscopic instructions, deductibles and percentages covered trying to find the line that says: ''Pay This Amount.''

Some say I'm supposed to send my own insurance form, others say that they've sent it already, and still others that I'm required to fill out a complex sheet with insurance information I know they already have. One says I owe $22 from a previous office visit because I failed to return a yellow and maroon form in the allotted 30 days. Some have phone numbers to call if one is confused, others don't.

I tried calling one of these numbers and got a very pleasant woman named Denise who told me my group medical plan is actually two group medical plans, and that I was calling the wrong one. When I told her there was one phone number on my bill, she said to call back next week, when her supervisor returned from vacation.

I've got a suggestion for saving money on medical costs. Fire the people who design these bills. As the national debate about health-care spending reaches a crescendo in the heat of the summer, and we debate about billions spent here and tens of billions there, national health insurance, outrageous doctor fees and magnetic-resonance images that cost $5,000 a pop, I'm trying to find a line on my bill that says: ''Pay This Amount.''

It doesn't seem like too much to ask. The phone and electric companies send confusing bills, but after the fine print of rates and fees they always tell you, in bold letters: ''Pay This Amount.''

That's all most of us care about when it's midnight on bill-paying night, and Johnny Carson is over, and you've still got a dozen more checks to write before you can go to bed.

David Ewing Duncan is a Baltimore writer.

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