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So What Is the Cost of Health Care?
By Christina Mulberry
I worked in healthcare throughout my career. In management postions we struggled for years to accurately look at costs to help us better budget each year, to assist us to make cuts when necessary, to identify the feasibility of certain programs, and so forth. The disjointed nature of how health care is often provided adds a great deal of complexity to this task of course. Recently however, I got a look at it from the other side. From the perspective of a patient. I developed bunions on both of my feet some months ago and decided I wanted to have them fixed during December of this year so that I could walk more comfortably, avoid having them get worse causing a more costly repair in the future, and to accommodate my schedule which includes caring for my aging mother. Time was tight for getting this accomplished. It was important that I be back on my feet by January when my mother would require more doctor visits herself. Since leaving regular full time employment, I had opted for a high deductible medical insurance plan that was relatively affordable, but pays nothing until I have satisfied a $5,000 deductible. The advantage was that I got affordable premiums, coverage that would prevent a financial catastrophe if something really big came up, and a significant discount for the care I did get as long as I stayed within "the network". For many of us with medical insurance, if care is covered, we tend to ask few questions about the cost for care. The important thing is that it's covered. When you're in the position to pay out of pocket however, you suddenly become much more curious. Or at least if you're smart, you want to be sure you know the cost before you make your decision about an elective surgery. My recent experience however, tells me that you might have to spend quite a bit of time doing your research to figure out the true cost. When I first inquired about my bunionectomy, I was told the cost would be $950. Not bad, I thought. Then, with further questioning, I found out that was the cost for one foot, not two. Ok, so the total would be about $1,900. Well, no the second foot would only be half, so the total would be only $1,450. Of course, then I had to call insurance to find out what kind of discount I would get. After several phone calls, I got an "estimate" that they wouldn't really commit to but it would give me a reasonable reference point. But then they reminded me, there would be other related bills. A bill from the surgey center, the anesthesiologist, and so forth. Then of course, there are the medications and post surgery devices, like boots, crutches, and so forth. So this required more calls to the surgeon, more squirming on the part of those who do the billing, and finally, another estimate left on my voice mail. A total of $2,850. I called my insurance again, to inquire about the discount. Just as before, they didn't assure anything, but gave another estimate. Based on this I went ahead and scheduled the surgery to occur the following week. When I went in for my pre-op visit the next day, they taught me about the procedure and all of the potential risks and side effects. They covered all the precautions I needed to take following the surgery. During the discussion, I verified the costs. The total cost was actually going to be twice the "total" that had been left on my voice mail, because we were doing two feet. Then they backtracked and said, well, not really twice, after all, they only charge half as much for the second foot. So, I wondered aloud, does the surgery center and anesthesiologist charge half as much for the second foot? They weren't sure of course. In addition, the surgeon indicated I needed to have a pre-op physical by my family physician to clear me for the surgery. Great, another unanticipated cost. Luckily I was able to get in to see my family physician for the physical in time. Then, two days before my surgery I had to call the surgery center to verify the costs on their end for the second foot. In reality, I never really got a strong estimate of the total cost. It's still a question. I can understand their difficulty in answering such questions since there are numerous providers involved in the procedure. For those on the receiving end, it's difficult to know all of the pieces and parts, all the various things that will be billed in order to know what to even inquire about in regards to the charges. It would seem to me, it would be wise for health care providers to assure that they can give patients a better estimate of total charges since more and more people have to pay out-of-pocket for their care. I can't imagine buying a car without knowing the price. If buying a car were like paying for a surgery, you would either have to call the manufacturer of the axel, the manufacturer of the steering column, the tire manufacturer, and so forth to figure out the cost yourself or simply trust the dealer to charge you appropriately after you drive off in the sedan of your choice. Needless to say, if you ended up not liking the cost, you wouldn't be able to return the sedan. ADDENDUM:
4/2/10
As a follow up to this article I wanted to state that the final bill for my surgery was actually over $8,000. With my insurance providing discounts to the services, I ended up paying just over $4,000. However, the estimated cost prior to the surgery was only $2,850 prior to discounts. Not very accurate. I would suggest getting written estimates so that you have some bargaining power after the fact. |
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Obviously the lobbiest, that spend millions conviencing our congressmen to leave health care alone, have a bigger contribution in the congressmen's pockets then the voters.
I was a car salesman for years and I'm well aware of the consumer rules.
Great intel.
Frederick
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This intel was contributed by mulberry
mulberry
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May, 2012
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