Complete Lack of Common Sense and Basic Math

Are we really trying hard enough to reduce healthcare costs? In my job, I talk all the time about how we as a country are working sooooo hard to eliminate waste and reduce costs from the healthcare system. But I think I might be lying . . .

Backdrop: In an effort to raise awareness and do our part to control healthcare costs, KLAS moved to a high-deductible health savings account for our insurance in 2014. This turned me into a cost-conscious healthcare consumer. I was actually spending my money for the first several thousand dollars of my healthcare instead of living off the insurance dole. For the first time in my life I was looking at medical bills and the numbers meant something to me. It was a real eye-opener.

Here are three experiences I’ve had in the last six months that lead me to believe we may not care that much about reducing healthcare costs and convince me that there is a complete lack of common sense and basic math in our healthcare payment system.

1. SKIN CANCER: I had a little spot of skin cancer removed from my hand and learned that it costs $150 to have a dermatologist cut your hand open and remove the cancer. Not bad. However,it costs three times as much ($450) to have them sew up the hole they just created. It seems you would want your doctor to be paid to be really good at removing the cancer. Being great at stitches seems more optional. . . .

But I guess once they’ve cut you open they can charge whatever they want to put you back together. I paid the $600 dollars.

2. SIMPLE MEDICATION REFILL: My son, who has Crohn’s disease, needed some medication refilled. He had been taking this same medication for years, but I had no idea how much the medication actually cost (beyond the $10 copay we previously had been paying). So we called the pharmacy and learned that medications were $300. Yikes. . . .

Since I am spending my own money now, I decided to check around and I found the same medication online for about $150. But if I bought it online I would have to pay. No problem since I was going to have to do that anyway. The catch was that if I bought it online I would really be paying my own money and would not get any credit toward my deductible. I paid the $300.

3. LIVER ULTRASOUND: My wife needed a liver ultrasound. Her doctor’s office offered to schedule the ultrasound with the local hospital. That was really nice of them, but since we were spending our own money, we called around to find a way to reduce the cost. We were successful, sort of. . . .

We found out that having the ultrasound done at the hospital imaging department would cost $450. However, the imaging center a few blocks from the hospital would charge only $300 and it was approved by our insurance. Sweet! But wait . . . there’s more. If we bypassed the insurance company, it would only be $150. So we checked with the insurance and were told that if we paid the $150 we would not be able to send the insurance company a receipt and have the money count toward our deductible. Again, we were incented by the insurance company to spend more than we really had to. We paid the $300.

By the end of June we had already met the family deductible, but in order to get there, the system incented us to spend $300 more than we needed to. Now, for the rest of the year, our insurance will cover everything 100%, and I couldn’t care less what the costs are. It’s not my money anymore. . . . Does anyone else see the problem here?