Healthcare

The $5.00 office visit – 1961 what happened?

I began processing health care claims for my employer in 1961; my first job in an employee benefits career that ended in 2010.

In those days gone by a standard office visit was $5.00.

If you adjust that $5.00 for the CPI, today you get $39.61. If you adjust the $5.00 for medical cost inflation, you get $97.51.

Today a Level 3 fifteen minute office visit with an established patient in my zip code is $156

What happened? img_0311

Fifteen minutes is still fifteen minutes, but I’m guessing the overhead to operate a small business such as a medical practice has gone up substantially in large part because of laws and regulations.

What do you think?

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8 replies »

  1. I don’t know what happen to the $5 office visit, but I am sure that the admin cost of providing insurance has skyrocket. Being that I wasn’t born yet, I would imagine that insurance coverage was for only major medical back then thus very little claim processing was done. You go to the doctor and pay him right then and there.

    Now every office has to have a billing department. When my wife worked in a large cardiologist office, the billing department staff numbered the same as the nursing staff.

    It is very rare that BC/BS pays any of my claims the first time. Blame could be equally spread between the coding submitted from the doctor’s office, myself, and twice as much blame on BC/BS because their EOB statement are never in plain English and you always have to call them to ask what it means.

    Yesterday I found out that if my primary care physician offices bills BC/BS for me seeing the office nurse practitioner, BC/BS considers the nurse practitioner a specialist and thus I should be paying the specialist co-payments. This is something that just started this year. So much time has been wasted on this issue not just by me but the practice billing department too for their other patients.

    BC/BS said that the nurse practitioner had special training and should be consider a specialist and yet is still less qualified and has less training than the doctors in the office. I guess that BC/BS wants less nurse practitioners handling minor patients issues and rather I see a more expensive doctor. I’ll always see a doctor now because my out of pocket expenses will be 60% less.

    And I paid only $1.00 for a loaf of bread today, why has that not gone up?

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  2. All things considered, healthcare has changed since 1961. Better tests and diagnostic equipment has resulted in much better outcomes for many. I just had surgery on my left hand for a ring finger that was bent 45 degrees at the first joint, not broken, because of a fall several years ago. My out of pocket – $300, insurance paid $900, that included co-pays for a couple office visits and x-rays. Equals $150 in 1961 dollars, not bad. One cost driver is all the required paperwork and support staff, that I do not remember, so much of in the past. I am just glad to have full use of my hand and be able to wear gloves again.

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  3. Hi Dick. I am under the impression that the Dr.’s cost for malpractice insurance is a major chunk of that increase. My Cardiologist spends close to $100,000. per year for insurance and he no longer does operations. Russ

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    • It’s a factor, but overall not as much as a factor as you may think and the major problem is concentrated in certain specialists, like on/gyn. The $5.00 OV was not for a specialist though.

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  4. If you are on Medicare, your family doc is $5.00, however, when you go to see a Specialist which most of us in our senior years need, the cost is a $35. co-pay. that isn’t what the Provider charges though, the Medicare provider picks that up so, yes, you are right, there isn’t any $5.00 co pay. This year the Medicare provider has also tacked on co pays for meds i.e. BP Cholesterol, so the $104.90 one pays for Medicare out of the SS check that is reduced by that amount hardly covers the costs. We as Seniors have a hard enough time trying to keep up with rising costs, insurance, values of housing going up causing insurance companies to raise the value it costs to rebuild the house, and the list goes on. We hardly need increases in Medicare costs of copays for RX’s and Specialists. Then of course, the Index is shooting all of us down to consider getting an increase in SS to help defray some of these costs. So, yes, you are right, there no longer is such a thing as a TRUE $5.00 copay.

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