I got a bill in the mail on Saturday for a test that I had done at a hospital on Monday. It was for almost $3000. No big deal, right? Right.
That kind of a bill is a big deal for just about anybody I know. The first thing I asked, was, “Why the hell do I have insurance if I still have to pay all this stuff?” Naturally. This is what anybody would ask.
Now, I don’t need some know-it-all to pipe up and explain all the intricacies of insurance, etc. I’ve been in IT, Finance, and now Healthcare for a lot of years. I get it. I know all about deductibles, etc. It’s still messed up.
What’s messed up, though, is the contrast between how we normally make spending decisions versus how we allow insurance companies to make spending decisions for us. I’m not just talking about medical, but also about car insurance, or any other type of insurance you can think of. Medical is probably the kind of insurance you spend the most time talking about, thinking about, and actually making use of, especially if you have a family.
Over the last few weeks, I’ve also made another financial decision that was very different from the process that went into getting this test done. One of the tires on my car blew out on the way to work. Really, I wasn’t even out of the parking lot before it had lost all it’s air. The other three tires were also really worn. The tread was down to almost nothing on all of them. Obviously, I needed to get them replaced.
What started next was this process of researching via the internet to find the best tires that wouldn’t put me in the poorhouse. Unfortunately, they happen to be 17 inch low profile tires that tend to cost a little bit more than the average. So, I looked around a bit and found a few choices. I already knew where I wanted to take the car. I’ve had really good experiences at one of the national chains of tire specialists, Tire Discounters, so I gave them a call.
I ended up talking to a guy at my local shop a couple of times. He went through the various options available and the pricing. I made a choice and also asked that they allow me to split the purchase across two paychecks to make it a little easier on the budget. They agreed and I was able to get the first axle done and I’ll go back in a couple weeks and get the remaining two tires replaced. This works out great for me.
Let’s contrast this with how the decision was made to get the medical test done on Monday. My doctor said that he wanted me to get this test done and I said OK. He handed me a prescription for it and told me to call for an appointment. I did this. They asked me about insurance and whether I needed to have the test “pre-certified” before taking it to make sure it would be covered. After a few phone calls with the hospital, the insurance company, and the doctor’s office, they informed me that I was all set. The insurance company had “certified” the test.
Do you see the big difference? I understood that this was a test that was a good idea for me to have done. I knew that the doctor wouldn’t have recommended it unless it was a good thing. He wasn’t going to make any money off of it, but knew that it would help determine if I needed any sort of special medical treatment. This was a sound decision, medically speaking.
The big difference, though, is that I didn’t shop around. I didn’t negotiate. I didn’t even ask about pricing, options, etc. I didn’t get involved in the financial part of this decision at all. I trusted the medical professionals (with my knowledge and involvement in my own medical care) and the insurance company to handle everything. This is what’s messed up.
You should always be involved in your medical care. You should do your own research and ask questions, no matter how scared you are or stupid you feel. It’s vitally important that you understand what doctors and nurses will be doing for you and your family. Medical decisions are still your decisions. I think most people understand this.
So, why do most of us abdicate all responsibility when it comes to the financial aspects of medical care? Why don’t we ask about how much things will be and shop around for the best quality care as well as the most economical deal?
The answer is that the system is designed to insulate us from the money part of the deal. The insurance companies can protect their profits while protecting us from having to worry our pretty little heads about all the medical stuff. This is what’s messed up!
But, the worst thing is that, yes, we have given over this power. Little by little, we’ve taken a step back, because, frankly, there are just too many damn things to have to worry about and keep track of in our daily lives. We just have too much information we have to take in and process or discard, to filter through and make decisions and keep food on the table and a roof over our heads. Why not just let somebody else handle this one?
Why not? It’s just too important, that’s why. We can’t trust and at any rate, shouldn’t trust insurance companies to make all of these decisions for us. The answer to all of the problems in the healthcare industry begin with personal responsibility. We have to involve ourselves in the financial decisions. We have to know exactly what it is we’re getting for the dollars we’re putting into it. Only then can we make the best medical and financial decisions that work for us and our families and keep us all out of the poorhouse.