By any measure, Bill Anderson's unpleasant encounter with the health-care system, including nearly $13,000 in bills for a minor operation, is not unusual. What's unusual is that he's fighting back.
"The hospital shouldn't be screwing people over like this," says Anderson, 24, who's employed as the cheese buyer for Fromagination on the Capitol Square.
Like 47 million other Americans, Anderson does not have health insurance. Luckily, he's a pretty healthy guy. But this February he needed a hernia repair operation; he says it was an hour-long procedure, for which he spent a total of four hours at St. Mary's.
Anderson was billed $6,924 by Dean Health System for the doctor's "professional services" and $5,869 by St. Mary's/Dean Ventures for use of the facility. Surprised and shocked by the amount, he contacted a medical expense advocate and, on his advice, sent a letter disputing the charges.
That brought a reply from Michael Hommel of Dean Health System, asking him to "please clarify on what basis the dispute is based." (Really.) Hommel also noted, without the slightest contrition or apology, that Anderson's original billing statement "reflects an incorrect charge." He was asked to pay $2,980 instead of what should have been $296.20. His new doctor's bill, thank the Lord, was just $4,258.20.
Anderson, again on the advice of his advocate, to whom he must pay a portion of any savings, requested a 25% need-based reduction, which Dean granted. This brought his physician cost down to $3,193.65, for which Anderson has worked out a payment plan.
Still, Anderson says, "It's ridiculous to have to pay someone to make sure the [provider] is being honest." If he'd paid his bill without challenge, it would have been nearly twice as high, including a $2,684 error.
The advocate, Steve Kay, who runs the Michigan-based Anderson, says Kay, is "expected to reimburse the hospital more than six times the going rate." When he asked Tate why this was so, "he dodged the question." Tate, while unable to discuss specific cases, notes that St. Mary's/Dean offers need-based community-care discounts as well as a 10% discount for prompt payers. But why should the charge for some be so much higher than for others? "Let's say everybody paid us at the Medicare rate," answers Tate. "We wouldn't be in business." Bobby Peterson of ABC for Health, a Madison-based public-interest law firm, says Anderson is being made to subsidize the costs of others' health care, including Medicare patients, as part of the nation's current system of "under-the-table socialized medicine." Still, he deems the amount sought in this case "a bit excessive," which surprises him because St. Mary's, more than some other local providers, is "usually very willing to negotiate." Anderson has his own take on what's wrong: "Because I don't have insurance, they think they can discriminate against me." It's as good a theory as any. Holding back info on Edgewater plan Madison Mayor Dave Cieslewicz has used his city-sponsored blog ("Edgewater Plan Secret, Suspicious," 7/3/09). Specifically, the mayor claims the paper suggested that his meeting "several times" with the project developer was "the crime of the century." Tellingly, the mayor did not link to the actual article, a basic rule of Internet etiquette. If he had, readers could see that he was misrepresenting the article, by Jay Rath. At issue was that the project developer, Hammes Co., has met with Cieslewicz at least 10 times since last November, well before it registered to engage in lobbying, an apparent violation of city lobbying rules. These meetings took place as Hammes Co. was stonewalling citizens seeking information on its plans. Asked by Isthmus for the opportunity to respond to his post, Cieslewicz says this is "not possible." Last Wednesday, Bob Dunn of the Hammes Co. called Isthmus to offer a deal, similar to the one he'd offered Rath. Dunn said he'd purposely "held back some information" about the project, but was "willing to work with someone on an exclusive basis" to reveal these details. "You guys may be the ideal channel." Or maybe not. Fountains of sorrow The water fountains on the Capitol Square, installed less than four years ago, have suffered a series of catastrophic breakdowns. In early spring, as part of routine maintenance work, it was discovered that the dual fountains at the entrances of East and West Washington Avenues had "electrical systems failures," says Laura Whitmore, spokesperson for the Madison Parks Division. After these were repaired, says Whitmore, it emerged that the fountains' mechanical systems were on the blink. Then there were problems with the plumbing. City crews tried to get the fountains working, for the first time this year, by the July 4 weekend. But as of this Wednesday, two of the four were still dry. "Fountains are high maintenance, but these units have proved most difficult. I think everyone involved is frustrated," says city engineer Larry Nelson. "Engineering will be working with Parks with a goal to make them more reliable." And from now on, annual maintenance for spring will begin in the fall. According to a 2005 article (by Jay Rath) in the Wisconsin State Journal, the city spent $810,275 on new fountains and planters, in part because the old fountains, said one city official, "required a high degree of maintenance." At least they worked. We're using less water For each of the five years between 2003 and 2007, the Madison Water Utility pumped between 11.1 billion and 11.97 billion gallons of water. In 2007 it was 11.4 billion gallons. But last year, that number was down, way down, to 9.5 billion gallons, "the lowest in at least two decades," says Water Utility spokesperson Gail Gawenda. And in the first six months of this year, water usage seems comparable to the same period in 2008. Wha' happened? Gawenda and Ken Key, the Water Utility's customer-service manager, cite improved conservation and the advent of toilets and fixtures that use less water. But last year's number was also down because the torrential rainfalls of June undercut the need for lawn watering through much of the summer. This year it might be higher, even allowing for the decline in fountain usage. Doesn't a 1.9 billion-gallon decline spell trouble for a utility that bases its charges on usage? Key allows that it does, which is one reason the Water Utility is now seeking an 18% rate increase. There are of course other factors, notes Water Utility general manager Tom Heikkinen: "We have many infrastructure needs we have to address." By any other name... Last week in Washington, President Barack Obama toasted one of his audience members for helping launch a national mayors group: "I also want to thank Dave Cieslewicz - I want to make sure I say that properly - of Madison, Wisconsin." The $64,000 question: Did the prez get it right - Chess-LEV-itch - or not? "He was close," says mayoral aide Rachel Strauch-Nelson of a pronunciation that put the emphasis on the "Chess" instead of "lev." Shrugs Mayor Dave: "When the president of the United States doesn't quite pronounce your name right, you're just happy he was trying to pronounce it in the first place."
