If everyone pays a unique and secret tab, no true competition can be going on between insurers or hospitals.

A recent visit to the Allen Pavilion for treatment of a burn blister on the index finger of a right hand was capped off with a bill for $1,162.28.

For the price of a down payment on a car, the patient got a four-hour wait, five minutes with the doctor, a dab of ointment and a couple of pain killers. What could be behind such insanity?

The answer appears to be both simple and complex, and explains why healthcare reform in Washington isn’t moving along as fast as President Barack Obama initially hoped.

The bill for hospital services arrived weeks after a trip to the emergency room — which sits at the foot of the Broadway Bridge, on the Manhattan side — often visited by Kingsbridge and Riverdale residents alike.

It’s not uncommon to hear complaints ranging from grumbles to outright accusations of incompetence over wait times of similar length. Nearly everyone has a similar story, or one that seems much worse. Five hours for chest pain, six hours for a cut that won’t close, eight hours for a broken leg … and so on.

On first blush, the length of the wait sounds like an indictment of the whole healthcare system. Sitting in chairs, waiting for your name to be called isn’t the way anyone would choose to spend their time. But, when things are going as they should, behind the wait is a simple explanation: in nearly any emergency room in New York, a simple, non-life threatening burn, or even leg break, isn’t likely to be the most dire case to be brought in.

Add to that wait with a mere 15 minutes of attention from all the personnel on staff, from administrative assistants, to nurses, to doctors and that final bill, and blood pressure begins to rise in earnest, and with indignation.

How the cost should be so high for so little — including 5 minutes with a doctor, a dab of ointment and an over-thecounter painkiller — boggles the mind.

The first bill that arrived offered no clue as to what was going on: it was a single line: $1,162.28, paid.

Below is a breakdown of the bill, which is wonderfully incomprehensible:

*$50 deductible, paid by patient using a credit card;