Healthcare for Dummies

Miska has endured foot pain for a couple months now. Multiple appointments (and shots with very large needles) later, they’ve scheduled her for an MRI. We have a high-deductible insurance plan, and so we will be responsible to foot (sorry) the bill. Of course, this means I want to know how much it will cost. How much do I need to come up with by next Tuesday? Sounds reasonable, wouldn’t you think?

However, after three phone conversations, no one – no one – can tell me what the charge will be. In the words of the last agent I spoke with, “We can’t follow that paper trail. It goes too far.”

Can you imagine anyone doing business with a Chevy dealer who said, “Just sign the contract. We’ll tell you in a couple weeks, after you’re home and have already put the first ding in your fender, what you owe us.” Nothing good could come of such an arrangement, other than a fatter paycheck for Mr. Car Dealer.

I’m no economist (really), but I have enough brain noodles to know that this scenario has inflated prices written all over it. If I have no incentive to watch out for my costs and (more unbelievable) if medical providers have no responsibility to tell me what in the sweet name of Mary I’m going to be charged for something, no wonder my insurance rates go up 20% a year.

The next time I receive an insurance premium bill, I’m going to write them back: “Just keep providing me insurance. I’ll tell you in a few months what I’m actually going to pay.”

9 responses to Healthcare for Dummies

  1. Ugh, I'm sorry Winn. I went through this same EXACT scenario about 3 years ago when we were also on a high-deductible health plan. NO ONE could tell me how much the procedure would cost. 🙁

  2. Our carrier decided that they do not pay for therepies for Dane now that he's over 6 years old. So when I started receiving bills close to $400 dollars an hour of course I called and said "what the HEY?". They actually told me that I was being charged $259 dollars just for sitting in the room even though I was not using any equipment or items and then additional charge of $156 to see the doc for an hour. So of course I told them it was ridiculous…soooo, their solution was, "let it go to collections and they will only bill you for half"…WHAT????? Inflated costs? Yes. Sorry you guys are getting the run around. Tell sweet Miska I hope her foot feels better soon and that the pain is NOT transferred to your bank account. 😉

  3. Oh this is my daily life! There is all kinds of craziness with how much is billed and how much the hospital actually expects to get paid based on contracts with different insurance plans. So I can see someone telling you they don't know what the bottom line will be (I'm not saying that's reasonable or appropriate though). But, what the hospital should definitely be able to tell you is what the actual charge is for the procedure, before they extend any network related discounts and "maximum allowable" and the like. I know what the charge is for the codes I bill.(Then you'd at least know what the max would be.) The disparity between what is charged and what is actually reimbursed based on the funding source is shocking.

  4. I can only imagine your life, Tanya. Yes, they can tell me a maximum, but that isn't tons of help because it is so different from the actual charge.

  5. Harrison Brookie June 4, 2010 at 7:56 pm

    Great personal example of the muddle that is American health care. Perhaps it might be easier if your wife was a dog, literally.

  6. Wish I were there to look at her foot and offer some small advice…:( Tell Miska I am thinking of her.

  7. Shannon, we would take you up on that. We need some Hayes-time anyway.

    Hey, Harrison, first comment here, I believe. Thanks. Thanks for the Atlantic link.

  8. I believe this example is a tell-tale symptom of the underlying cause of the runaway health care costs in this country: there is an alarming disconnect between those receiving services and those paying for them. Unfortunately everything I've read about the recently passed health care reform bill makes me think that while it will insure a great many people who were formerly uninsured, it will do very little to control costs. Here is a great article which speaks to this, also from The Atlantic.

  9. Dang, could I have written this piece for The Atlantic????

words have a way of making friends. drop a few here.