Does healthcare have an actual cost? Medical bills are among the leading causes of debt in the United States, a discrepancy the government is hoping to repair. At the Center for Medicare and Medicaid’s urging, Kathleen Sebelius, U.S. Secretary of Health and Human Services, launched a study to learn about the price differences of hospitals throughout the country. Released on May 8, the study compared the costs of the 100 most common inpatient procedures. The study then compared prices to what hospitals charge Medicare for the same services, and the results were alarming. According to Sebelius’ findings, Medicare is billed a fraction of the cost. The reason? When Medicare determines the “actual” price of a procedure, they subtract the overhead costs that the average patient is expected to pay: things like administrative fees, staff salaries, supplies, etc. are factored out of Medicare’s bottom line. Unfortunately, patients without Medicare don’t have the same option.
So, why is this study good news? Why should we be happy to learn that hospitals charge more than they should for medical care? Although the study’s findings are grim, they are hardly surprising. Anyone who has read an itemized medical bill knows that healthcare costs are out of control. The good news: Sebelius’ study is the beginning of healthcare transparency. Allowing patients to compare prices allows them to indict the system in the process, demanding answers about why their peers with Medicare coverage are charged far less for the same care.
There is hope that change is on the way for the American healthcare system. Until then, keep the following tips in mind to minimize your medical costs and protect your bank account.
Find a good doctor.
What distinguishes a good doctor from the rest? If you ask me, a physician’s worth extends beyond qualifications. While it’s true that medical professionals must work within the current healthcare system, a good doctor will keep your financial needs in mind as well. Consider the following example:
Mark’s family has a history of blood clots. To protect himself, he asks his doctor, Dr. Strawn, to find out if he also has the underlying genetic condition. Dr. Strawn suggests a thrombophilia panel, a collection of blood tests. “It’s expensive, even with insurance,” Dr. Strawn says. “Each test costs about $600. If you haven’t hit your deductible yet, you’ll probably pay at least $700 for the combined tests. If you like, we can order a few of the tests today and wait to order the rest. There’s no need to run them all at the same time.”
Sure, it’s not Dr. Strawn’s job to manage Mark’s budget, but it is his job to provide the best care possible. By providing Mark with the knowledge that it isn’t necessary to perform all the blood tests at once, Mark can make an informed decision about his health and his budget. Mention your money concerns to your doctor and ask about your options. A good M.D. will be happy to help.
Refuse repetitive or unnecessary tests.
As we just learned, a good doctor will give you all the necessary information. If you haven’t found an advocate yet, it falls to you to be assertive about your healthcare needs and costs. Consider the following example:
At 10 weeks pregnant, Annie is scheduled for her first OB appointment. Although she had a positive pregnancy test at home, her doctor insists that she take another in the office. Shortly after, the doctor confirms the pregnancy again with an ultrasound.
What’s wrong with this picture? You’re probably wondering if it was necessary to confirm Annie’s pregnancy twice. Annie wonders this too when she receives her first medical bill: $27 dollars for a pregnancy test and $1,500 for the initial ultrasound. Without insurance, Annie is looking at a long and expensive pregnancy.
The moral here: The medical industry isn’t interested in saving you money. It’s up to you to ask questions and decide what you’re willing to pay for, and why. Ask for justification next time your doctor wants to perform unnecessary or repetitive tests. If they can’t provide a reason besides “It’s standard procedure,” then it may be time to find another practice.
As Secretary Sebelius found, the cost of healthcare is variable. When you need inpatient medical attention, why pay more for the same services? Prepare for life’s accidents by getting the skinny on competitor costs. Call the hospitals in your area and quiz them about their charges. For example, ask,“If I came in with an allergic reaction to bees, what would it cost to see a doctor and receive a shot of epinephrine?”
Every hospital should be able to quote the price of an ER visit and a specific drug. Use this and other questions to use as a baseline to compare prices.
Do not touch the Kleenex box.
Or the “free” mouth wash, bottled water, slippers, etc. In a hospital setting, everything comes with a price tag. Not only will these extras drive up the cost for you, the expense increases the overall cost of U.S. healthcare as well. If you can, plan to bring an overnight bag with necessities instead of relying on the hospital’s supply cart.