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Steve B. wasn’t going to be fooled twice. He’d recently seen an ear, nose, and throat specialist for a “tickle in the throat” that wouldn’t go away. He’d forked over a co-pay at check-in, but then the doctor said he needed “to put a scope down there” and check his throat. He later received a bill for $250, reduced by his insurance company to “only $190.”
He was irate: “If my doctor would have told me: ‘Steve, I think we should scope you, but that is a $250 service that isn’t part of the office visit. I don’t know what your end cost will be,’ I could have made an informed decision… I didn’t get that option.”
So a few weeks later when he was seeing an allergist, Steve made sure to ask whether his insurance company would cover the cost of allergy testing. The doctor replied “I never heard anyone complain it; it’s something we do a lot.” Steve agreed to the test and (you know where this true story is heading) received a bill in the mail requiring him to pay $800.
Steve has every right to be pissed off. When he shared his story with me, he speculated that physicians are reluctant to share price information with their patients in part because sharing such information would cost them business. For example, Steve wouldn’t have received either of those tests if he’d known their cost up front. So he’s probably right that some physicians avoid cost conversations to promote their own bottom line.
But I don’t believe such bottom line thinking is the main culprit here. We have a healthcare system that was built on high and opaque prices. Steve’s allergist? They probably didn’t know what those tests would cost Steve, and was probably being honest about receiving few complaints about the cost of those tests. Most of their patients probably didn’t face the kind of high out-of-pocket costs that Steve did. Moreover, those with high out-of-pocket costs might’ve sucked it up without complaining. It’s hard to tell your doctor you are mad at them for ordering an expensive test. The mistake the allergist made was thinking that the lack of complaints they'd received about the cost of their services meant that few patients were upset about those costs.
I’m angry about the way our healthcare system has been shifting costs to patients, often without informing people of those costs in advance. If you are angry about high and hidden healthcare costs, you should tweet your state and federal representatives. Tell them you support healthcare price transparency legislation.
Here’s something else you can do: Contact me if you have a story to share. I am determined to help rein in the costs of American medical care. As part of that effort, I want to spread stories of people who have had first-hand experience with our high-cost system.
I want to hear your horror stories. I want to hear about:
- Surprising out-of-pocket expenses
- Your efforts to find out the cost of care before deciding whether to receive it
- Confusing insurance coverage
- Maddening difficulties working with copay assistance organizations
I also want to hear your success stories:
- Helpful interactions you’ve had with clinicians, insurance companies, or others who helped you reduce your out-of-pocket expenses
- Creative ways you’ve discovered to lower the cost of your care
And I want to know your questions about our healthcare system:
- What still confuses you about the cost of American healthcare that you’d like me to write about in future essays?
Send your stories to me at: healthcarecoststories@gmail.com
I’m always happy to tell your story anonymously as long as I have confidence in the truth of what you tell me.
I’m very excited to hear your stories.
