A moral hazard in medical practice

Since I needed new pair of glasses for renewing the driver's license, I have been to an ophthalmologist this afternoon. The clinic was pretty crowded with dozens of patients. Even though I have written in the quetionair before examination why I visited there, I was told to have thorough examinations for from cornea to retina. I didn't tell them that I was a MD. It took me an hour and a half to complete all the tests. Eventually, it cost only a bit more than 30 USD for my payment. It means the total cost was around 100 USD. If it were not my 1st visit, the cost would have been 60 or 70% of this amount.

I felt it was so cheap for that tests and examination. Some tests like visual acuity test were just routine. The others were done with high tech new euipments. Nurses or other personel were doing tests for me. I could hardly believe that the total cost would pay for the procedures and the work cost of the personel in addition to the examination by the doctor itself. If the doctor would run the clinic without any red, he should see and examine as many patients as possible. He could spend only a few minutes for each patient.

No wonder the doctor has done such numerous tests for economical management, even if, from medical point of view, it is quite questionable to do that way as routine. I just wondered how he submit the bill paper to the public social insurance agency. Won't the agency deny accepting the bill because of inappropriate indication of the tests etc?

Evindently, there is a moral hazard in this practice. As a doctor, I could hardly blame this ophthalmologist for this practice. I fully understand how this situation occurs. Not due to the doctor's greed at all, He won't run his office without practising in this way. He needs to pay for the staff, for the test equipment or the primary investment for the office building etc.

On the other hand, our government would cut the budget for the medical insurance. Their slogan is that they would rationalize the medical system and would provide a better medical service. Impossible. They should be more honest as for why the budget should be cut, that is, too much expenses for public enterprises since 1980s by a series of LDP governments. They should have prepared for the society of old people. The government should apologize the people that they should downsize the medical services from now. Less services and more payments are necessary for now. Or the moral hazard would be worsened, so that the medical system would be destroyed in the very near future. 

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