Seeing as your anaesthesiologist was unable to explain your bill let me try. First thing: there are no "medical aid rates" any longer. Every practitioner and medical aid must determine their own rate (Competition commission ruling 2004). Your medical aid pays you out at the rate they determine according to the plan you take with them. Save money on a cheaper plan and you get paid out at a lower rate. (Like car Insurance). You have actually been charged at a medical aid rate the Discovery Classic rate which is their middle rate (which is 213% of the 2006 medical aid tarrif adjusted for inflation). In addition every bill now has to charge VAT as the government decided that healthcare is a value added item and they added 14% to each acccount. Your account: An anaesthetic account is made up of 4 parts: 1. The preoperative preparation (called assessment in this account) which is a basic consultaion of less than 10 minutes and the preparation of the anaesthetic part of the theatre (Mixing drugs, checking equipment and monitors. (You don't want a Michael Jackson scenario here). This can take the anaesthestist up to 30 minutes and the fee covers this time. 2. The complexity of the operation. In your case a fracture of the radius and ulnar which is given a value but also recieves a skeletal modifier for difficulty. This is a modifier for additional complexity. I am sure you appreciate that the complexity of a fractured radius is less than that of a fractured hip or open heart surgery and is charged as such. 3. Anaesthetic time. You are charged for every minute that you are under the care of the anaesthetist. This is because your anaesthetist is monitoring you continuously throughout the procedure. 4. Other modifiers: Additional procedures, or risks are then added depending on the patients health status or type of operation. In your case as this procedure was done on a Sunday you have been charged a set of emergency modifiers for taking the anaesthetist away from their family or their ride. Other modifiers are charged for things like obesity, ICU admission, pain control procedures, strange operating positions and controlling blood pressure. Anaesthesiologists are specialist medical doctors having done a full medical degree and then specialised for at least 4 years (just like surgeons) allowing them to anaesthetise you for any operation you may need and as a result charge fees commensurate with highly qualified specialists. Just because you do not see the work they do does not mean they do not contribute significantly to your well-being during an operation. If you doubt this you should try having your next operation without one.
