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Cooking  the Books 2  Bottom line building  Like everyone else with an email address we get loads of spam. Most go straight into the trash can, but the subject of one – “Crack Patient Paying Problems with these Helpful Hints” – caught our eye. It turned out to be a plug for an audioconference in America on “Tried-and-True Ways To Get Chiropractic Patients to Hand Over Their Dues”. The message began: “Getting patients to pay their bills at your chiropractic office isn’t always the most successful part of the visit. And even a handful of patients who don’t pay their bills can start adding up – and hurting your practice’s bottom line. But you can learn less-stressful way to collect pays, deductibles and co-insurance in this 1-hour session. Your expert speaker, Marty Kotlar, DC, CHCC, CBCS, will provide strategic advice on everything from gathering patient information to forming an office policy explaining the patients’ financial obligations. Don’t miss this bottom-line-building session . . .” Chiropractics is an “alternative medicine” that is regarded by most conventional doctors as quackery (it is based on the idea that by manipulating the spine you can deal with ailments in other parts of the body, a bit like reflexology claims for manipulating your toes). But that’s not the point since no doubt teleconferences also take place in America about how conventional doctors can boost their bottom lines too - except that it does not fit in with the caring image that “alternative medicines” seek to cultivate as a way of attracting paying customers. In Britain NHS doctors – and patients – are freed from this stress since the doctor’s fees are paid to them directly by the government. Not a solution, we imagine, that Marty Kotlar will be proposing in his teleconference, even though chiropractors in Britain would dearly like to get in on the act and even though doctors’ practices in Britain are, with government encouragement, going the American way and converting themselves into profit-seeking businesses. Of course to the extent that they take on private patients these medical businesses do face the problem of getting patients to pay up, as do unrecognised “alternative” practitioners and NHS dentists. So perhaps, after all, they could learn something from listening in to Marty Kotlar’s “bottom-line-building session”. Most people, in Britain at least, find it abhorrent that people should have to pay for medical treatment and health care. And they’re right; if you are ill, you should get treatment whether or not you can afford to pay for it. Socialists go further. We say the same as-of-right access to what you need should apply across the board, to housing, heating, electricity, food, clothes, transport, entertainment. But this will only be possible once the means for producing these things have become the common property of the community as a whole instead of being, as at present, provided by profit-seeking businesses owned by rich individuals, corporations or states.

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Socialist Standard January 2008