The co-pay for my routine blood work rose from $20 to $30 on my last visit. I paid it with a small sigh and later checked out the new co-payment schedule from Human Resources to ensure a mistake wasn’t made. And no surprise, the co-pay did rise. And so did my co-pay for my prescription medications. I understand that what I pay for each medical service is really low and is the result of negotiations between my employer and healthcare providers, including hospitals, doctors, procedures, and pharmaceutical companies. I also understand that these costs are only a fraction of what people without medical insurance would pay. For example, I noticed that those blood tests actually were billed for $700. That is too much! No wonder people without insurance risk losing their homes, having their wages garnished, or going bankrupt if they seek medical attention. It’s why many choose to forgo medical care until they are at death’s door when the cost is even higher and the public will foot the bill. In our capitalistic nation, greed in the healthcare field is out of control and needs fixing. However, I’m not entirely sure that Medicare for all is the only way forward.
The problem is how do we fix our crazy system. Early Saturday morning, C-Span interviewed Dr. Marty Makary, a John Hopkin’s cancer surgeon who writes on the subject of medical costs. His most recent book is, “The Price We Pay: What Broke American Health Care and How to Fix It.” During his interview he exposed the fact that 48% of federal spending is on health care. He explained that when we combine what we pay in federal taxes and insurance premiums, most of us are already spending about 1/3 of our income on health care. He attributes these high cost to price gouging by hospitals, insurance companies, and pharmaceutical companies. We often don’t know what a procedure or hospital stay will cost until after we get the bill. Why is that?
He argues that we are gouged because we don’t know the cost of a procedure before we undergo it. The same procedure can be much more costly depending on where you go to have it. He gave the example of one hospital charging $20,000 to deliver a baby and a cross town hospital charged $7,000. Same doctors, same level of care, but very different prices. A self-insured employer gave free diapers and baby wipes for a year to his employees who elected to have their babies at the $7000 hospital. I never considered which lab to visit to have my blood work done because my out of pocket would be the same. However, the cost to my employer who might be self-insured could be impacted. Employees like me should be educated to understand that when my employer’s cost rise, my co-pays will also rise. Some sites that allow for cost comparisons include MDsave.com; clearhealthcost.com and healthcarebluebook.com
The total cost of doctors’ services to the system is about 4-6% while the cost of hospital stays is 44%. Before undergoing a procedure, we should be asking what it costs because about 60% of medical procedures are in fact shop-able. Who knew? I certainly didn’t. I just try to stay in network by following the insurance plan laid out for me. However, for the uninsured or under-insured, the prices are also negotiable by individuals, not just by private insurance companies and government insurance policies.
On top of this, Dr. Makary explained that 21% of our medical treatments are actually unnecessary. The epidemic of over-treatment is driven by a combination of greed and patient demand. The opioid epidemic was fueled by greed. Some surgeries are also fueled by greed and the realization that there is a paying customer. My husband was given a choice recently to have surgery to repair his knee or continue with physical therapy. He is on Medicare and has supplemental insurance, so he is a paying customer. The surgeon, the hospital, and the drug companies all stand to gain from a surgery. He was never given a price tag to consider.
Not having to consider or compare prices for medical treatments or drugs or hospital stays is a problem if we continue in this market driven medical system. The cost of insurance premiums, hospital stays, and drugs keeps rising because corporate greed has taken over. I don’t know that I am for Medicare for all as the cost would be outrageous, but I do know that I am not for a profit driven medical care system. We need the full picture before we can make a wise decision.