I thank you for useful suggestions concerning my ongoing efforts to obtain a diagnosis of my strange intermittent/acute infection and I ask that you accept this as full payment of your current bill for services rendered.
Although the personal check for $31.20 was cashed on March 14 2008, another bill from Dr Cenizal's office was received in mid-April for $188.20 and designated as 90 days past due. The accepted check was clearly marked "Acct#1131 Paul Wakfer IN FULL". We consider the services obtained from Mary Joseline Cenizal to be paid for in full and the entire transcription of written exchanges also serves as public notice of the same.
One of the main problems of the delivery and receipt of health care in the US and virtually all of the industrialized world is that the one-to-one patient-physician relationship has disappeared, having been replaced by intermediary health insurance companies and government, this last either directly or indirectly by way of literally hundreds of rules and regulations. The fact that prices for all types of services are ever increasing while the satisfaction of those receiving them very often is decreasing, is very much because the patient is not directly making payment for those services and therefore not interested in determining the cost vs benefit analysis such as s/he would do for the purchase of a new car in comparison to the repair of an older one, or the same prior analysis relative to buying a house or any other major purchase. Simply because a person's body is essential for one's continuation does not make this need for personal involvement in the analysis less important, but actually more - much more.
The lack of personal responsibility for one's own bodily health and the costs involved is undoubtedly a part of the reason behind the enormous growth in the percentage of the population who are obese and their ensuing health degeneration. It has caused the ballooning health care costs that are passed down to individuals via direct premium increases or reduced take home pay from employers who pay the premiums. It has resulted in enormous government budgets - and increased national debt - to cover health care costs of those individuals who governments have decided should be taken care of via tax money (often extracted from the individuals themselves and always from others). And finally, it has now apparently caused many hospitals (and perhaps some physicians?) to inflate their prices so that those who can pay are again, in addition to their payments through taxes, forced to support those who supposedly cannot pay, but are getting the services anyway, at least partly because governments compel the hospitals to provide them.
The purpose of our presentation here about our own difficulty with the local hospital, that has a deceitful practice of representing employee physicians as being in private practice, is not only to make clear to others that this is happening, but to encourage others to be responsible consumers of what health care they do decide to obtain. When individuals are taking measures to be responsible for maintaining their own vigorous health, they will have less need to depend on the paternalism of health care providers, whether in private practice or as employees of a hospital. Such individuals will seek consultations only as they determine necessary and will be responsible for the mutually agreed upon fees.
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As a resource for further information on re-establishing the one-to-one patient-physician relationship, I recommend The American Association of Physicians and Surgeons. http://www.aapsonline.org
