From $3 office visits to high-tech tests

Dr. Kenneth Bobb, Jackson County health officer, said the face of health care has changed greatly since he started practicing in Seymour in 1955.

“When I first came to town, doctors didn’t send out statements,” Bobb said.

When a patient left, Bobb said, the patient would ask, “How much I owe you, doc?” And he would answer, “Oh, $3, $2, or 50 cents.” He said he was the first doctor in Seymour to send out bills.

Since then, the insurance system has progressed to the way it is now, where bills are generally not sent to the patient but instead to insurance companies.

Bobb said there was a time when insurance papers were filled out and the company would send the money to the patients directly. After it turned out that some doctors were not being paid, the system changed so payment was sent from insurance companies to the doctors.

Then came the change of people wanting more coverage from their insurance providers. Bobb said labor unions convinced management to use what he called “first dollar coverage.”

“Go to the doctor, whatever he does, it’s paid for, 100 percent of it is paid for,” Bobb said of the first dollar program. “You can see how if the patient doesn’t have to pay anything, they don’t have any brakes on how much they spend, how often they go.”

To counter that, doctors recommended a deductible that a patient had to pay. Today, people appear to be going back to high deductibles, Bobb said, because of the increasing costs of health care insurance premiums.

Bobb increased his office fees with the price of the U.S. postage stamp.

“When I first started practice, I charged $3 an office call and the postage stamp was 3 cents. So when the postage stamp went to 4 cents, I charged $4; when it went to 5 cents, I charged $5, over the years,” he said. He said he always tried to keep his fee in line with the price of the postage stamp. He said doctors could raise fees whenever they wanted but had to be in line with what most of the other doctors were charging.

As as insurance companies started to pay, his office fee increased.

When the competitiveness was taken out of health care, Bobb said, he was able to hide behind the insurance company’s agreement to pay the patient whatever the bill was. “So then we always managed to make bills a little bit larger than what the insurance company paid and his office fees escalated,” he said.

“We’ve gotten to a place now where so many people don’t have insurance, insurance costs have gotten high, so high due to the inflationary pressure on the dollar, and health care costs have been the leader of the pack,” Bobb added. “It just can’t continue to go that way, so everything has to start going the other way.”