PEOPLE
SAMARITANS In an extract from his new book, movie director Jonathan Lynn takes a swipe at the medical industry
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ax wondered if what Blanche had said was for real, or if Jesus was just part of her negotiating strategy. “So – uh – you’ve been born again?” “Yes.” “Then let me ask you a moral question,” Max said. He never tired of moral questions. “What do you think we should do if our uninsured patients can’t pay the bills?” “Same as your last business did, I expect.” “Break their legs?” She smiled. “No, silly. Use a collection agency.” “You mean, bankrupt them?” “If we have to. Otherwise everyone will want health care, whether they can afford it or not.” “You’re exactly right,” Max said. “People can’t have what they can’t afford. That’s what got America into this economic mess – everybody wanting something for nothing. There’s no morality in that, is there?” “None at all.” “Look into that please.” Blanche had passed the test. In the car, driving back to Samaritans, he asked her about the pricing in more detail. “Suppose a surgeon is removing a gall bladder. How much does he charge? Ballpark?” “Ballpark? Three grand? Maybe four. Plus the anesthesiologist, maybe another fifteen hundred.” “We need to get that number up. Way up. The hospital needs to bill far more than that.” Blanche hastened to reassure him. “Oh, we do. Far more! You asked me about the doctor’s fees. I didn’t include the assistant surgeon. And there’s so many other things we charge for.” “Like what?” “We bundle the bills.” “Explain bundle.”
“You’re exactly right,” Max said. “People can’t have what they can’t afford. That’s what got America into this economic mess – everybody wanting something for nothing. There’s no morality in that, is there?”
DIGITAL EDITION
Above: In Samaritans, the protagonist Max is a Vegas casino manager who decides he can make more money running a hospital.
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“I’ll show you.” When they got back to the hospital she took him straight to the ER. A smell of disinfectant mingled with vomit and urine. The color in everyone’s faces was drained by cold, flickering fluorescents in the waiting area and the corridors were crowded with listless, despairing people, waiting hour after hour. Occasional urgent-care patients – victims of road accidents, heart attacks or random shootings – were hurried in on gurneys and attended to more-orless immediately. Max was by nature an optimist, but even he found this a depressing place. “Look around,” said Blanche with enthusiasm. Unlike Max, she was exhilarated by the emergency room and its financial possibilities. “We charge separately for absolutely everything you can see going on. Evaluating the patient, use of the operating room, use of the operating table, use of instruments, use of instrument tray, use of sterilizer, dressings, anesthesia, IV, Band-Aids, biopsy, a second biopsy to make sure the first biopsy is correct, lab charges, use of wheelchair, hire of person to wheel the wheelchair, additional lab charges, recovery room, linens in recovery room, dressings on wounds, heating, lighting, the overhead… We can get gall bladder surgery up to sixty grand! We do it all the time.” “Nothing back door about it?” “Unethical, do you mean?” Blanche was shocked at the mere suggestion. “No way! We’re not hiding anything. It’s all itemized. Everyone does it. In Florida one hospital recently billed around forty thousand dollars to remove a gall bladder with minimally invasive surgery, but where a friend of mine works in Orange Park Florida they charged ninety-one thousand for the same procedure. That’s fifty grand more! We’re somewhere in between,
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