Ruth Kaufman - Award-Winning Author and Romance Writer

Ruth Kaufman is the author of My Life as a Star, My Life as an Extra, My Once & Future Love, The Bride Tournament, Follow Your Heart, At His Command and other books.

Healthcare Cost- Take 2

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Will new healthcare laws really help those who don’t have insurance?  How about those, such as myself, who pay hundreds of dollars every month but still have high deductibles?  Those who have insurance, but often when we need something, it might not be covered at all, much less fully covered?

For example, an online chat with customer service confirmed that Aetna covers a “routine” colonoscopy at age 50.  They don’t cover any pathology charges.  Who knows before taking the test if ours will be routine?  Whether there’ll be additional charges, or how much they’ll be? 

Also, Aetna won’t cover the full cost of the prep my doctor chose. With it, patients drink a lot less bad-tasting liquid can choose among assorted clear liquids for most of it.  Apparently I’m fortunate that they’ll even cover some…around 12%.  That leaves me paying appx. $83.  I can, but how many can’t?  How many will have to endure additional suffering for this and other procedures because their insurance companies won’t cover state of the art treatments or prescriptions?

I wonder how many of us feel like victims at times, little Davids or Davidas nearly helpless in the face of Goliath’s rules handed down from on high that often don’t serve those who are paying for service.  If we spend our time and make the effort to take on the insurance company, to question or appeal any decision or charge we don’t agree with or understand, is victory worth it on principle, or do we have a chance of actually saving money?  Or do we just pay the bill?  Should we be grateful to have any coverage at all?

What is the cost of healthcare?

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No one would walk into a store and buy anything without knowing the cost before taking the item to the register.  Can you imagine buying a pair of jeans and waiting weeks until the bill came to find out the price?  Many people, myself included, often wait for sales to make purchases.

Yet most of the time, when it comes to the cost of healthcare, we’re in the dark about what we’ll have to pay.  How many doctors’ offices post their fees?  Not long ago, I took a friend to an immediate care center. The initial visit cost was clearly stated on a sign on a wall; but it also said there might be additional costs. I went to a different one recently, and no costs were posted. When you’re sick enough to be at an immediate care center, are you going to spend a lot of time and effort finding out how much your visit will cost, or do you just want relief?

Of course, part of this uncertainty is because neither the doctor can’t be sure what services or in office tests you’ll need before examining you.  If he/she wants to do a prodecure while you’re in the chair, he/she probably won’t know how much it costs.  Nor are medical personnel likely to wait while you try to search the Internet on your phone for average costs. 

So what’s a patient to do?  The Healthcare Bluebook could prove useful if you know what you need in advance. Costs of many standard procedures vary widely, too, so doing due diligence on providers beforehand could save a lot of money.  Interestingly, the Affordable Care Act doesn’t seem to include provisions to help patients gain knowledge of medical fees or require care providers to be more transparent. Maybe I just couldn’t find them?

Sometimes, when the bill arrives, it’s difficult to figure out what all the itemized items are for. Or there’s just a lump sum, with no explanation. 

I have insurance (the already high premium is going up 5.6% next month), but also a high deductible. My last visit to a specialist will cost me $938 for less than 15 minutes of the doctor’s time. I hadn’t researched probable costs.  But if the symptoms persist and I go for another appointment as he suggested, I will.