How much will my care cost? It depends…

If you are reading this you might be feeling the same way I do. Recently, my son broke both his ankles going off a motorcycle jump. While registering him to be seen by my local urgent-care, the registrar asked me to pay my copay. I was happy to do so.

I asked him “How much?” he responded, “Your insurance copay is based on a percentage of the total visit.” (Now this wasn’t the response when I too my daughter to different urgent-care a week later for kidney stones).

I said, “Okay, how much will my visit cost today?”

It went silent, then he said: “I don’t know, we’ll just send you a bill.”

This really made me think how “blind” we have gotten to not knowing the cost for health care. I wouldn’t get new tires on my car without knowing how much it will cost, yet we have no problem doing this for our health care.

I could continue my story as I pressed on the imaging costs at the specialist, but my point isn’t to complain, just know that the costs questions I raised continued to be an unknown element with my care providers.

Let me share a perspective from a doctor (since I work in health care). I was in a leadership meeting once talking about transparency of costs to the patient. A surgeon made the comment that when they do surgeries she has no idea how much these packs (a common set of tools for a particular procedure) costs. When she found out that it was over 2000.00, and she only used 1 or 2 tools from the pack, she immediately worked to change that to less expensive pack.

If our doctors knew the price of the supplies, tests, and medication upfront and could agree on standards of care practices, I believe they would be a great help in lowering costs for the patient.

The really complicated thing about the inability to provide a cost of care up front (not an estimate) is the fact that costs are generally negotiated on a fee schedule between the care provider and insurance companies, all different prices for the same thing. The cost for an x-ray depends on what insurance you have, or if you don’t have coverage. Billing has to get involved during the upfront care process to work with the insurance company to figure it out, a huge delay in care especially if it’s a life threatening one. Some fee schedules used for billing could be a flat rate or a percentage in the charge, now this really makes it crazy to manage and figure out. The consumer (Patient/family member) has no idea when they go get care.

Imagine a buy 3 get one free x-ray posted on a billboard along side the local interstate. I can’t.

Insurance companies are trying to educate and drive where people get care at a lower cost. They know how much these services and supplies costs and the least expensive place to go is. It is against the law for them to take choice away from the patient, they are trying to help people make more informed decisions.

Our health is the most important thing to us and our loved ones. We have some of our most joyous and devastating experiences in life within the walls of our a health provider. Our health system is asking people to blindly rack up costs they and their care provider don’t know about. The thing that is most disappointing is that we send people into bankruptcy over it. Providing care and sending people into financial ruin doesn’t add up and what we aren’t about in America. The Dodd Law Firm shares The top 3 reasons Americans file for bankruptcy:

Of all the different reasons Americans ultimately end up finding themselves filing for bankruptcy, the primary one is because of medical expenses.

Health care isn’t free either. There are extensive challenges health providers face like the “frequent flyer’s” that can fake a health problem to get medication, then disappear from an ER bed. Writing off millions of dollars in unpaid services. These are complicated issues and we can do better. 

It’s time to start coming together as care providers, I mean insurance, health systems, doctors, and Medicare/Medicaid to restructure this overly complicated financial piece in health care. Consumers have got to have transparency on their medical costs to better make decisions financially without sending people into financial crisis. We are doing this to ourselves and we need to collectively figure this out and set a course, otherwise, I’m afraid that we will be forced to.