One hospital visit, two bills

I went to dinner the other night, ordered a nice steak and salad, and a glass of fine wine. Once the bill arrived, my eyes grew slightly and my eyebrows creeped up and away from the table. The price was not the shocker; the two individual bills, one labeled “food prep,” another labeled “food service,” confused me.

I don’t see my waiter, so I grab the attention of another waiter, asking, “Excuse me, but I think you brought out someone else’s check with mine.”

“Sorry about that, sir. Which item didn’t you receive – the steak, salad, or wine?”

“I received them all – they were delicious.”

“Great. Glad we cleared up the confusion then. Shall I take your credit card?” the waiter replied, with no confusion over the two bills each with different amounts of money on them.

“Well, hold on… I think I got someone else’s bill. I only ordered the meal for myself, so I should have one bill.”

My waiter gave me the expression of a patient grade school teacher, explaining, “The restaurant bills you for the ingredients for your meal, storage of the ingredients and tools to cook your meal, and the time it took to cook your food and prepare your meal. Your waiter, however, is an independent contractor, and bills you separately.”

I sat there, fairly confused.

“So… I have to pay each of you separately? You can’t just combine it and split it yourself?”

“No sir.”

“Huh… can I speak with a manager?”

“Certainly, sir.” A manager came over shortly, reiterated that’s how the restaurant does business, and I eventually ended the meal by paying two bills. The strangest restaurant paying system I’ve ever encountered!

Okay, confession time: the above didn’t happen.

But the below did, and it’s essentially the same scenario.

I went to the hospital earlier this year.

Later, I got the bill. I got MANY bills.

I paid the bills, but over time I kept getting more bills. And I was confused, since I paid these already.

Turns out I was indeed billed twice for one single hospital visit.

Bill 1: for the doctors and staff directly employed by the hospital.
Bill 2: for a doctor who is on contract to the hospital.

All the doctors (I saw 4 of them in one evening!) looked the same.
All of the equipment was in the same room.
Yet one of those doctors was not a regular employee of the hospital, but somehow was a contractor.

Why is this happening in health care? And will it be coming to other businesses soon?

A company is like a child

A company is like a child.

In order for a company to be successfully created, conditions have to be just right. Try making a company too early or too late, and there won’t be a conception. There’s a window to making a baby, and a window to making a company.

Even before conception, there is lots of planning to do, including:

  • discussion about how the company should be guided over its lifetime
  • the company’s religion – not talking about deity worship, but what are the important values that will form the company’s core beliefs
  • will you push the company into doing certain things, or will you let your company find its own way depending on what its strengths are (hint: it’s probably wise both for people and companies to do the latter)

The company can be conceived in all kinds of ways, too:

  • Company conception can be the result of a number of bad decisions.
  • It can be done under duress. You didn’t want to make this company, but you think somehow it will hold your relationship with the other person together, even though you secretly think it may not be wise.
  • It can be a thoughtful creation with the best of intentions

Whatever the family situation is like for a company or a child, it grow up to be happy and successful, or end up broke and penniless. But conditions among the parent(s) are important in determining the odds of a child being the next Lebron James, Karl Rove, Barack Obama, or Whitey Bulger; your opinions of these (in)famous people will likely determine how you’ll raise your child or company.