Paying the Piper
For most of us, cost is always a consideration in a myriad of our endeavors. Be it minor: new toaster, tuning up our garden, wardrobe enhancements - or big: new car, new house, big vacation... Cost matters. My own beloved toaster died, and although I found one online that looked dandy, $150 was not coming out of my pocket to brown bread. Instead, I found an attractive and serviceable one at Costco for under $20. I'm also shopping for a new vehicle. Some of the models are to die for. Yet, someone else will have to die for 'em and sigh as they sit in their garage. No way this driver is ponying up $80K for transportation - especially when there are some handsome and well made autos in the upper $20K to $30K range.
So. Why should our health care be any different?
But, of course, for many of us, it surely is. Particularly if we have some robust employer-paid health care plan, who thinks about cost with health care? You show up at the doc, pay your $10 or $25 co-pay and then sky's the limit. Whether the cost of that care was $100 or $5,000, you are not writing the check. So, you don't inquire about it and the bottom line barely crosses your mind.
What happens, however, if suddenly you are more intimately involved with the cost of that MRI, that treatment, that visit to a specialist? A writer at Time Magazine tells us.
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At the beginning of the year, Time Warner changed my health insurance—which, for the record, I am grateful to have. I used to be charged co-pays. About $25 a pop for office visits. Now I am under a system of co-insurance. After my yearly deductible, I pay 10% of all my health care costs, up to an annual out-of-pocket maximum.
This has immediately changed my behavior. I hurt my ankle a while back, but how I did that and what is ultimately causing the pain is a mystery. My first foot doctor was stumped. I went to see another one a few weeks ago and when I checked in, I asked how much the office visit would cost. The desk clerk told me I didn't have to worry about it since I had insurance. I explained that insurance didn't cover everything. She came back with "about $700." That would mean $70 directly from my pocket. I was floored, but I had no way of knowing if I was overpaying. Who could possibly know that?
Then one of the technicians fetched me for an X-ray. I asked how much the X-ray would cost. He said he didn't know, but he could try to find out... or would I just like to wait and see the doctor first? I said I'd wait.
The doctor came in and asked me a few questions. I explained that I'd been to another doctor. I repeated what that doctor had told me about the X-ray I'd had at his office. My new doctor examined me and told me that another X-ray wouldn't tell him what he needed to know. And that was how I prevented my very first unnecessary medical test. I still don't know how much that X-ray would have cost, but I do know neither I nor my insurance company had to pay for it.
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I know the feeling. When my husband sold his business, our nice "employee provided" health care went away. I'll never forget soon thereafter when I went to pick up an antibiotic for my husband. The phamacist took the doctor's prescription, then told me, "$334, please." What??! $334 for a one month supply of an antiobiotic?! "Uh, is there anything else a bit cheaper that might work?" I inquired of the pharmacist. A few minutes later, I was paying $19 for a medication that did the job just as well.
Needless to say, if I'd still had the "you-pay-the-$7-copay-and-we-pick-up-the-rest" plan, my insurance would have paid whatever the additional freight was, for I would not have had a clue that this particular drug cost an arm and a leg. And that, my friends, is a large part of why our health care costs become more and more monstrous with every passing year. Too many of us have zero clue what they cost - nor do we care.
If you argue that we must help the poor, and that not doing so is unconscionable, I will agree with you. Nevertheless, no matter who we are and what our pocketbook might have in it, all of us must be more cognizant of costs and have some "skin" in the game. We assist people who have needs for it with food. Yet, we have limits on what they can purchase with their aid. If we didn't, I know what would happen for me if someone else were paying the bills. Forget macaroni and cheese, budget soup and lentils. Filet and lobster, smoked salmon and other delicious luxuries every day!
As Ms Kiviat states:
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One thing I do know about is the price-setting power of the enlightened consumer. I know about the effects of price transparency, and I know about what happens when you give Americans the tools to hunt for deals and value. Think about Wal-Mart. Think about going on Expedia to comparison shop airline tickets. Think about the first question you ask when you are considering buying a particular house.
Now think about health care.
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