An encounter with our health care system is worse than going to a used car lot. In the latter case you more or less know before the purchase what your cost will be, albeit the route to the final price is galling.
In the U.S. healthcare non-system the sky is the limit as providers hide prices and arbitrarily raise them without consulting with the consumer. Needless to say the buyer of services is ultimately liable for the full price.
“Laub opted for the methotrexate injection. After getting the shot, patients need certain follow-up blood tests for several weeks to confirm that the pregnancy is ending or has ended. Laub returned to the emergency department for bloodwork and an ultrasound three days after the shot. She returned again three days later and was given a second shot of methotrexate since the pregnancy hadn’t terminated. The following week, she repeated the treatment in two more follow-up visits. On July 20, after 12 days and five emergency department visits, Laub was scheduled for laparoscopic surgery to remove her fallopian tube.”
“The total charges to date for the medical treatment: an eye-popping $80,000. Because her health plan had negotiated discounted rates with the hospital and the other providers, all of whom were in her provider network, Laub’s out-of-pocket cost will be a fraction of that total. It now appears Laub will owe a little more than $4,000.”
Medicynical Note: When I lived in a third world country years ago, little kids would approach me at the open market and ask for baksheesh. Every time, every single time. They’d ask whether or not I gave.
Our healthcare system is a rabbit warren of rules and regs a little like that open market. Providers always ask for the gift and diligently game the system to maximize billings. Hospitals hide prices and years ago learned that they made more by itemizing every little thing and overcharging for each item rather than by providing a comprehensive price for a service. Adding to the confusion, prices charged insurers vary widely are often tiny fractions of that charged to customers without insurance.
And yes, the multimillionaire CEO’s of healthcare companies and health insurers could care less whether you get affordable care or whether you survived your encounter with the healthcare system For them it’s the company’s income not patient outcomes that is important. That’s America.
The insured medical consumer must be constantly vigilant, as well. Necessary medical tests can be denied making appeals the only option. I have gone through that process and it is not for the faint of heart. It can be especially stressful and time consuming, if your doctor refuses to help. Often appeals are not made and the consumer suffers, because, of the complexities of the process and the inability of the consumer to amass the information needed, to file and win an appeal. Also, coding issues can get in the way of receiving necessary tests and treatment, thus the insurance company, not the patient, makes out. Even with insurance, the deck can be stacked against the patient. So far I have had the where with all to deal with the above, but, given aging, my time may be running out, pun intended. Mary Knowles