An Idea to Control Medical Expenses
Everyone talks about medical expenses spiraling out of control. While the notion is not entirely true for a variety of reasons, it is certainly true that medical expenses — even with insurance — can be very high. Let me first hedge by saying that I am not an expert on this subject. On the other hand, the experts certainly haven’t done us any good in a long time. So let me offer my idea on how to control medical expenses.
About a week after I tore my ACL, I went to the UW Roosevelt Medical Center for an MRI of my knee. At the time, I asked how much it would cost. “That will depend on your insurance,” came the quick, prepared answer. Yes, I pressed, but what about a ballpark? Again, “It depends on your insurance” with a little edge this time. Not wanting a confrontation, I accepted that and went on with it. The MRI itself was almost pleasant — listening to Pearl Jam and laying supine, I almost drifted off to sleep. I soon forgot about it.
Then came the surgery. It seemed so necessary at the time that I didn’t even think about asking the question of how much it would cost. Besides, I had insurance, so I was covered, right? Well, then the bills started showing up.
As it turns out, the MRI and Radiologist’s opinion cost about $1800 — most of it paid for by insurance, but not all by any means. Then there were the other bills. UW Medicine. UW Sports Medicine. UW Medical Center. Hospital Bill. Physical Therapy Bill. Bills for each of the two braces I now possess. A separate bill for the Cryo Cuff (which I thought I paid for at the time with a $95 bill to my credit card, but after much finagling, apparently not). The list goes on and on. I’m not quite sure at this point how much I have paid out (Quicken is my next activity), but it is certainly well above $1000 at this point — most of which I had absolutely no idea was coming.
Had it been fully disclosed what each part of the process would cost before making the decision to go forward, I may have still chosen to go through the process. But maybe not. And this, in my opinion, is why medical expenses are so high — people have no idea what they are getting in to when they go in for a procedure, and the people who might know either don’t know (because it really does depend on the insurance) or don’t care enough to help everyone figure it out.
Take, for example, a convenience store. What if no prices were marked on anything, but everything you put into your basket seems necessary to your health. Then when you check out, no amount is shown. The cashier simply tells you that the store and each supplier will send you a bill later on. Sounds pretty good until the bills start arriving and you find out that you’ve paid $30 for a book on exercise and $300 for a thermos. If this is how most stores worked, then everyone would be paying huge amounts of money for even trivial things. Without the foreknowledge of cost, rational economic decisions cannot be made.
So, my idea is simply this: state all medical expenses up front. Before the patient signs anything saying that he or she will pay, the form should say how much. There are enough paper pushers in every medical establishment to make this happen before the exam or procedure instead of happening only after the procedure as is now done. This way, people know what they are getting into before it is too late, and people can make better decisions about their own medical care.
But it gets better than a go or no-go decision. When prices are stated up front, the customer (like me) can then shop around. If I don’t like the $1800 MRI offered at the Roosevelt Clinic, then I can go down the street to Seattle Sports Medicine and see if they offer it for $1700. Or maybe $600. Who knows? By enabling customers to shop around, up-front pricing introduces market forces to the medical services world in a way that they have not had to deal with in a long time. The competition will force prices down, just like it does between QFC and Safeway. The consumer of medical services will be better off.
While this approach won’t work to lower the costs of products protected by government-granted monopolies (ie, patents on drugs), it will, I believe, reduce the cost of many medical procedures. I would not be surprised by a drastic reduction of up to one half of the current cost. Furthermore, it will let blokes like me know what they are getting into before they get there.
