The View From Your Sickbed

by Patrick Appel

A reader writes:

I wanted to second the reader who identified the non-transparency of health care costs as a huge part of the problem.  He recited the issues with his wife's pregnancy receiving minimal coverage even though they had private health insurance.

My sister recently had a similar situation, when a needle she used for her insulin injection broke off in her thigh.  She had to have it removed surgically in a brief outpatient procedure.  She has good health insurance through her husband's job, but she wanted to know the cost of the procedure, to determine her copay.  She asked the doctor's office how much the procedure would cost and was told between $5,000 to $6,000.  (Don't have your heart attack yet over the insanity of $5000 for a simple outpatient surgery plus xray or scan to determine the location of the needle.  As Dylan said, "Now ain't the time for your tears".)  She had her uneventful surgery and got the bill for $15,000.  For an uncomplicated outpatient surgery.  After being quoted a price 1/3 that price.

Why did she even ask the price of the procedure if they were going to be off by 250% or more?  If my sister wanted to call around to surgeons to get a better price (and she would, to reduce her copay, if nothing else), what would be the point?  What if my sister had been uninsured - how would she plan to reduce her costs based on such misinformation?  The price of health care procedures is nothing but a dart thrown at numbers on a dart board.  The insurers, the doctors and the hospitals all have blame in this process.   Unfortunately, the uninsured and the poorly insured - and both groups are gaining in numbers daily - pay these outrageous prices.