09/01/2009 05:12 am ET | Updated Nov 17, 2011

Upper East Side Ethics

"Ethics is nothing else than Reverence for Life."
--Albert Schweitzer

This most basic wisdom came home to roost in my life today in a personal and palpable way.

My daughter is starting college in the fall. A routine physical exam is required - and a State law requires a Meningococcal Conjugate Vaccine in addition.

We've used one pediatrician since the day my daughter was born -- a yearly check-up for which she has always received a well-baby diagnosis and a hefty bill to follow.

The bills have always been shocking in their heft -- but de rigueur as Upper East Side, Manhattan, New York City doctor's offices go. But this time - my camel's back broke and the straw was the cost of a single shot of Meningococcal Conjugate Vaccine.

The charge: $225.00 for the vaccine, and $25.00 more for Immunization Administration.

My usual, complacent acceptance of inflated prices in my neighborhood, my city, my life, turned to outrage. I felt compelled to research online the actual, wholesale cost of that one dose. I discovered that the average cost for a single dose varies between $82.00 and $119.00.

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Even though I have paid these UES prices so many times over the years, this time, I brought the egregious price inflation to the pediatrician's Office Manager. At first she was just plain defensive, but as I sat in her tiny office, face-to-face, while twenty squirming, squealing babies, toddlers and tweens jammed the waiting room for their various vaccines and shots, she paused and back-pedaled.

"I'm not responsible for setting the price."

I asked who was.

"It's set between the physicians and the insurers."

"But it's unethical," I said, (my outrage growing by the second.) "It's everything that's wrong with healthcare in our country!"

The Office Manager sat back in her chair and looked me right in the eye.

"My daughter just graduated college and is going to work for the uninsured in D.C.," she said.

"Ah! - so that's how you sleep at night," I replied.

"Can you make some adjustment?" I asked.

"I can't possibly charge you only $82.00 or even $119.00...I have to offset the cost of storing the drugs, accounting for them..."

I'm not asking for that -- just some adjustment, I implored, now fully engaged in a conversation that went far beyond the vaccine at hand and surprised at my degree of moral outrage. (I am probably one of the very few without insurance in this notoriously expensive and popular UES pediatric practice.)

"We can't make an adjustment for one person and not for another. Our lawyers won't allow it. The whole system would be vulnerable then."

And then it dawned on me -- laser sharp -- our whole system is vulnerable. In my own little corner of the world, I had stumbled over another truth at the root of our collective, unbridled greed. It's the $10 here, $25 there, $75 for this Lipid Panel or Automated blood count.

That's how business gets richer in this great democracy of ours...little acts of continuous stealing, price-fixing, and adjusting of personal ethics. It's not new, nor confined to any one industry - doctors, insurance companies, lawyers...but rather it's a faceless, rampant, rapacious attitude that a little bit of unethical behavior is okay.

Nobody cares what it costs as long as somebody else pays.

Nobody cares that the price the market bears is inflated beyond all reason.

Nobody can find a face to pin it on - a place where the buck stops and finds a truer value.

We've misplaced our reverence for the very life we are living and serving. It's fundamentally a spiritual imbalance that cheats, robs, and is greedy. When people fear - they hoard.

"The essential element in civilization is the ethical perfecting of the individual as well as society. At the same time, every spiritual and every material step forward has significance for civilization. The will to civilization is, then, the universal will to progress that is conscious of the ethical as the highest value."
--Albert Schweitzer

I paid the bill, but I won't return again to this Pediatrician's practice.

It's the only ethical step to take.