HEALTH ISSUES: Dealing with rising health care costs

Searching for a cure to rising health care costs? Know where to shop!

Have you ever gone shopping and picked up an item you wanted, or may have thought you needed, until you saw the price tag and quickly put it back on the shelf? I am always confused at how people will look at the prices as they weigh their options, yet when it comes to health care expenses, we all seem to blindly follow along and pay the MSRP sticker price without hesitation.

As a health professional myself, who is well aware of the costs and options, I chose to overpay – more for convenience at the time, but looking back, had I been a thrifty consumer, I would have had the fishing kayak I wanted this past spring.

What did I do wrong? I chose to be lazy and have my labs and x-rays done at a local hospital. Yes, after my health insurance (The Don Corleones of health care) paid on my tests, I still owed hundreds. For just one lab test, I was charged $180 when two blocks away I could have paid $28; my cholesterol panel was $145, but it is $44 at Labcorp. What was I thinking by choosing a hospital chest x-ray at $200 plus the cost of the radiologist reading the test rather than paying $75 with no radiology fee had I driven 30 minutes farther?

As I looked deeper into the medical bills, I noticed an emergency room visit at a local hospital charged $60 for one tablet of medication – a medication I have given for zero charge at my practice.

In perfect timing, the office staff member asked me why I wanted my bills. I explained about the costs; she shrugged and said, “Every place is different.”

Indeed it is. If only we, as consumers, had other options and would know what is the price for the service we are getting.

Well, good news – you can! While it may not be easy to travel the maze of insurance companies, medical coding and billing or the hospitals/urgent cares that say, “Yes, we accept your insurance,” but may not tell you they are not in your network leading to higher fees or other hidden costs of the emergency room doctors. You could sign in at the hospital or urgent care and use your insurance, then ask the exact price you will pay. The answer: nobody knows… until you get the bill.

I certainly have learned my lesson, but I hope other consumers of health care realize that for every sick visit, lab, x-ray, MRI or ultrasound, you do have an option. Don’t be so quick to use health insurance and shop around. You may find that self-pay pricing can save you hundreds if not thousands, whether you have a high deductible or what you might consider to be good health care insurance.

Remember, by law all hospitals are required to post a price list. The disparity in pricing is unexplainable. For example, need an MRI? Go to the hospital and pay $2,000-3,000 or drive 30 minutes to Advantage Diagnostics and pay $350. Needing a lab? Labcorp offers rates on self-pay that are a third of what hospitals charge.

Lastly, when you are in need of health care and the first thing you are asked for is your insurance card, you could be offering a blank check and loss of your rights to cost control. For example, if you have a surgery and find the anesthesiologist is out of network, then speak up. In many cases, if you don’t have direct control, you are not liable for out of network billing.

Ask how much your visit will cost, but don’t be surprised if no one on staff can say. But once the professional billing coders are done, you might find yourself with all types of surprising fees. Ask and expect an answer to pricing. You are the consumer and should have a say in what you pay. Demand transparency, look at your bills and understand the basic terminology of health insurance and the trickery of the families that are the hospitals, urgent cares and physician services that salivate for your insurance card.

And if you see me fishing along the bank in my kayak, feel free to ask me for alternatives to the hidden ridiculous cost that is our health care system.