Healthcare, no matter where I am or what I do

I have been silent over the last few weeks, intentionally, growing weary of arguing all the time despite having facts and logic on my side.

But as the title implies, no matter where I go or what I do, the challenge our vertical creates seems to be omni-present.

A little short story which motivated me again to participate in posting again.

A couple of days ago, I had some free time, and I wanted to golf, (it is a favorite pass time of mine). It was last minute and I went to Golfnow and found a great deal on a course near me. I booked a single and went to the course where I was paired with a stranger. Young man, decent golfer and off we went to the first tee. As usual in this setting we began to share what each of us does, and once I shared what I do the following story came spewing out, one far too typical. Mind you this is a middle class, employed family man.

He proceeded to tell me of an experience he had just gone through, with a University owned system here in my area. He needed surgery on his neck, when he went for the first visit, he was told this, he scheduled it, was told it was covered and proceeded to have the procedure done. To his surprise he received a $3,500 bill he was responsible for. After sharing his confusion, between facility charges, versus professional fees, versus deductible, co-pay and co-insurance, he was finally told too bad you owe it. He asked the facility why he was not told he was going to owe this money out of pocket prior to and the system told him they could not calculate this till after the procedure.

And it gets more interesting, he needed follow up procedures, so he asked before agreeing to use them again, and they told him they could not tell him what he would owe. So he told them no and contacted a non system owned ortho surgeon, and over the phone their office told him what to expect in terms of his financial exposure, how much the most it would cost him if nothing changed, they were who he chose to do the follow up procedures.

I shared how the system works and how he should ask for a cash price on everything. But a point he made to me which is salient, is that his doctor was paid the least of any within his bill. He finally agreed to pay the first group $50 a month to pay off the $3,500 out of anger knowing it would take them seven years to get paid. Now I hope readers will absorb this. By the time this bill is paid, they will have generated at least 84 statements at a minimum of $12 each or $1,008 in billing costs,and they will have lost the time value of money. Whereas they could have identified what he would owe, negotiated an upfront payment at a reduced rate and both patient and provider of services would have come out financially better off.

This is just an example of how an insured patient, with a reputable company (BCBS) who pays 18K a year for insurance, has to deal with healthcare.

Does everyone see the problem with this as I do?