Wednesday, January 27, 2010

They don't know the cost, but ask anyway

Last week I took my daughter in for a pediatrician’s office visit. One of those many last minute, scary appointments you make when you have an infant screaming with a fever and you don’t know why.

After her examination the diagnosis was apparent: ear infection, and something else -- abnormal test results on her kidneys. It sounds much worse than it is (I think something like 70% of kids come back with these findings), but I was told that I did need to follow up with another test sample (you don’t want the details).
I learned from the staff that no matter what the results are, there is nothing they can do for her anyway until she’s older.

So I asked how much the tests were going to cost, and the lab techs looked at me, stunned. They didn’t know. And neither did the lady that worked the front desk. This baffled me – wouldn’t you know the prices if you worked at the lab?
After going home and thinking about it, I called the doctor’s office and asked when I would find out the results, and if they came back abnormal, would they do anything? I was told no, but they would send my baby to a specialist.

I was ok with that, but if her last results already came back abnormal, why am I repeating them – so that I can be sent to a specialist, have the test out of date again and then have to do it all over again?

The nurse acted as though I was speaking Russian in Spain, but somewhat agreed with me. But the deed was done. Just for kicks, I asked how much this test was going to cost. No one in the doctor’s office seemed to know – I was told they don’t bill for it, so they weren’t sure.

I’m not criticizing the doctor for taking care of my daughter – if she needs a test, then run it. But why do it over and over again, with no new action in between? And why isn’t anyone clear on the costs of these procedures?

The whole thing reminded me of something this doctor wrote in the Seattle Times. http://seattletimes.nwsource.com/html/opinion/2010867306_guest24stitham.html

Maybe something like this has happened to you?

Thursday, January 14, 2010

Isabella's story

October 14, 2009 I woke up at 5:30a.m.frantically shaking my husband and shrieking, “I think it’s time!” He was as surprised as I was – I wasn’t due for our first child for another month, and I was scheduled for a c-section in November. We had no idea that my water would just BREAK in the middle of the night. So with no bag packed or baby “essentials” put together in our home, we left for the hospital.

In the midst of the hustle and bustle of delivery preparations that followed over the next few hours, I asked several medical personnel for assurances that although the baby was early, she would be healthy. They all told me not to worry, she would be fine.

And four hours later our beautiful Isabella joined our family! I can’t remember the details following delivery (the pain meds make it a bit of a blur), but Isabella had some breathing issues from the start. Within two hours she was taken to the Neonatal Intensive Care Unit (NICU) for pneumonia. Several breathing tubes and IVs later, she was in treatment.

About a week later, the breathing tubes came out and a week after that, the IVs – Isabella was on the mend! But as any parent will tell you, just when you think you’re cruising along, your kids throw another curve ball at you. That was when Isabella decided to start “forgetting” to breathe sometimes. Medications were administered and time passed, and nothing was working. She just seemed to get worse every day, not better.

After consults and many treatments, and time for her to “grow out of it,” she was sent home a month later on a breathing monitor. We couldn’t be happier to get our little girl home.

All this time, medical bills didn’t even cross our minds. We would willingly be in debt for the rest of our lives if it meant that she had what she needed to get better. But should we have been more responsible in at least asking, “How much is this going to cost?” If for no reason than assuming that someone else was picking up the tab? Maybe, but we didn’t.

After we were home for one week, medical statements started showing up in our mailbox. The bills for Isabella alone were $80k! That didn’t include the extra $10k for my c-section, hospital stay, and meds. Or the $1k per week home breathing monitor rental (which she is still using).

Thankfully, I work for Regence and my husband is in the military – so as for insurance, we’re covered. I wonder if others who share my insurance carrier have seen premium increases even though they didn’t visit the doctor more than once or twice last year. The same pot of money they paid into was tapped to care for my family and others with medical difficulties. Thank you—I will be here for you, too.

But coverage has its limits, especially in the world of high-dollar, high-tech health care, and many people still end up owing thousands out of pocket. (Read more - http://www.boston.com/business/personalfinance/articles/2009/02/18/pleading_your_case_on_medical_bills_is_a_sound_policy).

And none of this begins to address the hardship faced by those without coverage at all.

As we watch how health care changes shape up in our country, I wonder if some of the fundamental issues are being addressed in our reformed system? For example, when will the actual costs of medical services be addressed, and more importantly, when as consumers will we collectively become more informed, and ask “how much does it cost?”

And I’m not the only one wondering (Read more - http://www.nytimes.com/2010/01/11/health/policy/11health.html).