Join me now for wondrous a ride in the Way-Back machine as we visit that time in the distant past when I built boats. Boat building is a wonderful business, full of some of the nicest people you’d ever want to go broke with.

Selling boats, not so much.

Like most folks in the business, I subscribed to several of the trade mags including Boat and Motor Dealer. It’s a good rag, full of how-to articles as well as profiles of the successful traders who would sell my wares to the unsuspecting public.

The advice? Emulate a car dealer.

Have you bought a car recently? After arm wrestling the salesman to a draw, you’ll be presented with a contract that is for a wee bit more than you might have thought the F&I manager promised.

Oh, the price of the car won’t have changed but that ain’t the amount on the check they want you to write.

Car dealers have mastered the hidden fee and the mysterious charge in the sales process: Some are inevitable, some are questionable, and many are just plain bogus.

Sales tax: There is no escape from death or taxes.
Title fee: It’s a tax. You’re stuck.
Vehicle registration (the license plate): Ditto.
Vehicle registration, part II: Florida residents adding a vehicle are assessed an additional $225 fee. Just because we can. Bogus but it’s a tax so you’re stuck.
Doc fee/conveyance fee: This so-called “documentation fee” pays for the paperwork every other business calls the overhead to record a sale. Dealers have just figured out that you should pay their overhead. Bogus.
Prep fee: The dealer preparation fee is assessed to cover the cost of preparing the car to hand over. The factory covers the prep fee. Really bogus.
Delivery charge: The factory already adds a “destination charge” to the invoice. You’ll notice that if you buy a model car from Wally or a kumquat from the grocery, there is no “destination charge” to cover freight. Other businesses eat that cost. Many car and boat dealers tack on an additional delivery charge of their own. Doubly bogus.
Advertising fee: This one’s extra tough because you’ll notice again that if you buy that model car or kumquat, there is no “advertising fee” to cover the cost of enticing you to the store. What, are they nuts?
Facility fee: This is a really, really good one. You get to rent the chair you sit in the waiting room. B-O-G-U-S.

The Airlines definitely read the playbook. They charge you for your ticket. Fine. They charge you for your meal. Ehh. They charge you to check your bag. Not so fine. And now they charge you for your “better” seat on top of charging for your flight.

Hospitals apparently read Boat & Motor Dealer, too. Here’s what the Miami Herald had to say yesterday on page one, above the fold:

Like baggage fees for air travel, healthcare may come with hidden costs called facility fees, and not all insurers pay them.

The Herald story details the unpleasant surprise a Miami woman had with the University of Miami’s network of clinics and hospitals. She had some testing done at one of their outpatient clinics. Her insurance paid for the tests but not the $210 bill from UHealth for “hospital services.” The hospital labeled it “Room and Board – All Inclusive.” She never set foot in any UHealth hospital or spent the night at the clinic.

She probably did sit in a chair in the waiting room, though.

Not all insurers pay them? Why should an insurer pay a new, extra facility fee? Why should the patient pay a new, extra facility fee?

Our South Puffin hospital owns several physician practices and has an urgent care center. Our North Puffin hospital has also bought or started physician practices, built a rural health center network, and a new urgent care center. I don’t know if either charges a facility fee. I’m afraid to ask.

I do know that SWMBO had to visit the North Puffin urgent care center over the weekend. She tangled with a piece of sheet metal in the barn and needed four stitches.

They did a great job.

They didn’t give her a bill.

Doctors have no idea how much a “procedure” costs. Hospitals can never tell you what it will cost to visit them. I do not understand how any business can get away with that.

“We’ll just bill your insurance,” they said.

Not giving her the bill may have been wise. See, I won’t pay a “facility fee” and do typically argue a bill line by line because the overreach of government and the malfeasance of the insurance companies aren’t the only reasons U.S. health care needs to be burned down and rebuilt from scratch.

If they had given me the bill, her insurer would have never even seen the bogus charges.