Have you ever tried to price out the cost of a colonoscopy? It can’t be done. Having just turned 50, my PCP (that’s code in the health insurance business for “primary care physician” a/k/a your family doctor) said I should get one done. For anyone who has had a colonoscopy, you, fellow soul mates, know that the actual “procedure” is one that you have no memory of, thank goodness, because of the mixture of anesthesia used which includes some sort of amnesia drug. However, I will spare you, dear readers, any further description of the “prep.” Look it up on Google. It’s no fun. Suffice it to say, be very close to a bathroom at all times.
But I digress. Back to the costs of medical procedures, Google, and health insurance reform. One of the great mysteries of our time, as far as I am concerned, is we as consumers can obtain the price for just about any product or service before we make the decision to purchase. There may be some negotiation in price, for instance in buying a car, but you go in at the very least knowing what the asking price is from the dealership.
When I asked the gastroenterologist's office who was going to do my colonoscopy what the cost of the procedure was, they couldn’t tell me. They provided vague answers dependent on the type of insurance I had. That’s curious to me, because, I, as the consumer of products and services, could not obtain an actual price before I purchased. All I was told was that I had a deductible to pay. What if there ended up being a dispute between my health insurance carrier and my doctor’s office, or the anesthesiologist’s office, or the surgicenter where I was having the procedure done? If I were eventually on the hook for the bill, I sure would have liked to know the costs beforehand. Assume I had no health insurance. Pricing would be much more important.
Come to think of it, whenever I’ve had an X- ray, MRI, or that ACL reconstruction on my right knee, no one ever gave me price information for the test or procedure. Of course, we all know that when we go into a medical provider’s office we sign an assignment of benefits. That allows your doctor to bill and obtain payment from your insurance carrier. But it also says that if payment is not made, your doctor bills you.
Now, of course we don’t choose our medical provider based on the fees they are charging. Usually a host of other factors are involved, including expertise, experience and so on.
John Cogan, in his Wall Street Journal piece, “The Millionaire Retirees Next Door” (5/12/11), argues that
Under the federal government's fee-for-service Medicare program, every time a senior citizen meets with his physician or health-care provider for a check-up, lab tests or surgery, somebody other than the patient foots most of the bill. That such a program should produce runaway costs is hardly surprising. Over the years, the government has expanded the type of services covered, such as prescription drugs, and it has assumed a greater portion of the program's finances. Medicare premiums paid by senior citizens once covered half of the cost of physician and related services. They now cover one-fourth. Copayments once covered nearly 40% of these services' costs. They now cover only 20%.
In the case of non Medicare recipients, we all know that private health insurance is not increasing the amount of the tab that they are picking up. Rather, we as the consumers are. Nevertheless, think of how much more competitive healthcare in this country would become if we knew the cost of care going in?
