What's your health worth?

A few weeks back I went to the doctor and in the waiting room I overheard a patient ask the front office staff how much his colonoscopy would cost him. The reply - “I don’t know, ask your insurance company.” But what if instead the answer was, “How much is it worth to you?”

That’s exactly what some doctors in California tried, just for a day.

These primary care doctors didn’t accept insured patients or those on Medicare and Medicaid for one day – only the uninsured. Patients were asked to give whatever they could afford or whatever they thought the care was worth.

While the docs felt great helping the uninsured community - patients didn’t come near covering what the services actually cost and the doctors ate the costs for the day – so this experiment turned into something unsustainable. The patients didn’t really know how much the health care really costs.

So this got me thinking… what if health care worked that way – offering what you could, and not worrying about the real cost? Unfortunately that’s not reality in any sector of our economy. Otherwise we would all live in nice homes, drive nice cars, and enjoy great restaurants, among other things.

But how much should we pay for health care? Well, unfortunately we have to pay what it really costs, and this experiment also demonstrated that no one really KNEW what it costs, which is part of the problem fueling rising health care costs.

None of us really know what it costs because “someone else” is covering it. In reality, we’re all covering it though – through rising premiums and higher doctor and hospital bills. Because when one person fails to pay the whole bill, the money has to come from somewhere, and everyone pays the rest.

Read more about physicians asking patients to pay for their care. And maybe you’ll think about it during your next treatment. I know I will.

Speed Dating: The New Way to Shop for Health Care

Last night I was chatting with a good friend of mine who is single and dating. She’s tried it all – online, blind dates, meeting guys at work, charity events – you name it, she’s been there looking. Some end nicely, others in disaster. But next week she’s going to try something different: Speed dating.

For those of you unfamiliar, groups of men and women attend and meet for 5 to 10 minutes with one another to get a general feel for the other. I must confess, I wish her all of the happiness in the world, but can’t wait to hear about this next installment in her dating diary.

So how does this relate to health care? Well, there’s a hospital in Texas that takes this same theme – speed dating – and puts it to good use in health care. The hospital invites physicians by specialty and patients in need of specific care to an event where they “speed date” to determine if they are a good match.

Patients love it because they don’t have to schedule various appointments with numerous doctors to find the best doctor for their pregnancy, or to care for their children, or whatever other service they are seeking. Physicians looking for patients love it. And the hospital uses it as a recruiting tool. Basically, it’s a win-win for everyone.

Think about the possibilities – shopping for health care – meeting with doctors to ask about their quality standards, practices and costs… something we should all be doing more of in health care.

Want to learn more about speed dating with docs? Read more on the Bedford Hospital on the cutting edge.

New Trend Emerges in Reducing Health Care Costs

A few weeks back I visited family in New Orleans, and the massive oil spill in the Gulf came up at a family party. My uncle works for a large oil company (I won’t say who, but it’s not BP), and since he is related in the oil industry, he was bombarded with questions about causes, clean up and costs. Suddenly, he was the oil spill “expert” at the party (despite the fact that he works in an entirely unrelated department of the company).

As a health insurance company employee, I am often peppered with questions at parties and family gatherings – everyone wants to know my position on the latest health care reform legislation. As if I’m suddenly an expert!

So when I was asked questions about health care at a function I attended last night with my husband, I was armed with an interesting perspective, after reading a great article about a new trend in reducing health care costs. Not only did I find this concept innovative, but so did the other party guests.

The premise is simple: pay doctors based on good care, instead of the number of patients they see. It’s quality versus quantity. Through this system it’s believed the sickest patients will get more coordinated care and attention. Not only are health insurers behind it, but so are a good number of physicians as well.

I’ve known about Regence’s support for this concept, and that our members can access nurse managers that will help guide them to stay on treatment plans and get health coaching - but in the midst of the doom and gloom of the economic news lately, and the persistent rise of health care costs (that will never seem to go down) – I was pleased to see someone else taking the initiative, and excited that doctors were on board.

Tackling rising health care costs will only benefit all of us. Are you a trendsetter? How will you bring down health care costs?

When Free Isn't Free

About two months ago I took my six month old to the pediatrician because she is allergic to every single brand of formula we had tried (and we tried every kind on the market). No matter the brand or base, her body’s reaction was terrible.

The doctor gave me a free sample of a new special type of formula – available only online, not in retail stores. So we tried it. The results weren’t perfect (let’s be honest, no formula is perfect), but bearable for our family.

So I went online to order some and the prices made me gasp – over $200 for one case! That’s eight cans! And one can goes in less than a week. You do the math.

Sound familiar? Maybe you haven’t ordered formula, but certainly you’ve tried a new prescription sample at your doctor’s recommendation – and once you’re hooked you find out the true cost of the medication. Apparently we aren’t the only ones. Check out this post on KevinMD.com.
I’m not faulting the doctor – he solved a major problem for our family. But maybe we should understand the high costs of everything, including medications, before we order them. This time the money came out of my pocket so I found out the real cost pretty quickly, but had my insurance been billed, would I have known what that cost my health care community pot? Probably not.

With costs on medications and special treatments as high as they are, no wonder health care costs are out of control.

Share your experiences. I want to hear what you think.

"Free" Health Care and Other Myths of the New Health Care Bill

The Patient Protection and Affordability Act (commonly referred to as PPACA – pronounced “P – Paca”) passed Congress and the President signed it into law. Being that this was the largest reform since Medicare and Medicaid in the 60’s, this was big news to me, but what made it even more important was my status as an employee of a health insurer.

Living and breathing the various components of the law daily, it shocked me when I was in my local grocery store and overheard the couple behind me discussing purposely dropping their employer-sponsored health insurance coverage because now they didn’t need to pay for it “the government would provide it instead.”

After the shock wore off, I thought about it – why wouldn’t average Americans think this? For months all we heard about was how “everyone would be covered” and it would even be cheaper. The new law was compared to Medicare and Medicaid – and all in rhetoric that was hard to decipher.

But this is a myth. No health insurance is free, no matter how you slice it. Somehow, you’ll pay for it – whether it’s in taxes or in raised premiums or health costs elsewhere – it’s just like my mom always says, “Nothing in life is free except love, and you even have to pay for that sometimes.”

So what are some other common myths? Check out this opinion in Portland’s newspaper, the Oregonian. This guy has some interesting takeaways.

To learn more about PPACA and what’s really in the bill, there are resources available to help.

MRI for $3000 or $350 -- Price matters

If you think there’s no reason to shop for health care, check out this doctor’s blog post – her patients were skipping needed care because of high costs, even her own mother. http://www.kevinmd.com/blog/2010/04/price-transparency-improve-patient-care.html

Affordable care was available, as the examples here point out, but it’s hard to find prices and comparison shop for health care.

Dr. Leslie Ramirez decided to help out, at least if you live in the Chicago area. She’s compiling her own list of affordable care providers. Wouldn’t it be great if every town had a list like this: http://www.leslieslist.org/index.php

Skip that $3000 MRI and get one for $350, as long as your doctor says it will do the job. It takes a little legwork, but for somebody like me with a high-deductible health plan, there’s an immediate payoff.

Even for those who have only a $20 co-pay for unlimited MRIs, CTs etc., if we all did this, we would be shrinking the number of our health dollars needed, bringing down the cost overall. That’s the power we have as consumers.

It’s like that saying, “When the going gets tough, the tough go shopping! And believe me, shopping for health care prices can be tough, but I dug up a few more places to get started. -- Susan at Regence

MRI: http://www.comparemricost.com/
Common health screenings: http://www.costhelper.com/cost/health/

See if your hospital has information like this:
http://www.cnn.com/2009/HEALTH/09/10/health.care.price.comparison/index.html
Find a low-cost clinic: http://findahealthcenter.hrsa.gov/
Check local community and information referral services: http://www.airs.org/i4a/pages/index.cfm?pageid=1

Compare quality too: HHS.-- www.hospitalcompare.hhs.gov
Medication – comparative effectiveness and cost: RegenceRx

Some states and regions are helping consumers find good health care:
Puget Sound (Wash.) Health Alliance – community check-up
http://www.wacommunitycheckup.org/?p=home
Oregon hospital costs: http://www.oregon.gov/OHPPR/RSCH/comparehospitalcosts.shtml
Provider quality: http://www.partnerforqualitycare.org/

Confessions of a Health Care Use-aholic

Last night I received some “Explanation of Benefits” forms in the mail from my primary health insurer (Regence). And what I found surprised me. Of the last five doctor’s appointments my daughter has been to, only one has yielded any diagnosis worth following up on.

Each office visit was at least $200 plus, and two appointments called for tests that ranged in price from $500 to $7,000. The result of each? Normal diagnosis.

I work for Regence and I’m constantly researching and writing about the increasing cost of health care, so you would think I would be a bit more sensitive to “unnecessary care” or “overuse.”

Instead, I have not once questioned my daughter’s doctors or their orders for tests. When it comes to her, in all honesty, I don’t really care what it costs the health care pool that I (and my co-workers) pay into. But isn’t that the attitude of most Americans? When it comes to our health, or the health of our family, we just use it –necessary or not.

Just the other day I read an article about “The Power of No” – how much economic sense does that make in medicine? I encourage you to read it. Like his opinion or not, the writer has an interesting take on how to reduce costs, something that I have long said has been missing from the health care debate.

Coming from a fellow health care “useaholic,” I admit that we must find ways to save money in our health care system – whether it’s “The Power of No” – or some other way that we feel comfortable with.

Our culture of use needs to change. We need to question more, research more, and treat the health care system “bank” as our own. Otherwise, rising costs will never get better. In the long run, I want my daughter to have a functional health care system in her future. And if we don’t really address costs, and fix it now, I’m afraid that won’t be possible.