Wednesday, December 12, 2012

Of Hamburgers and Healthcare

How much does a hamburger cost and what do you get with it? Of course it depends on whether you're buying from McDonald's or a high end restaurant where it is served with fried truffles, but most people would answer somewhere between two and eight dollars. They'd also say that a hamburger comes with a minimum of meat between two pieces of bread. The meat is expected to be cooked and presented to you in or on a reasonable container.

Now how much does an x-ray cost and what do you get for your money?  If you're like me that's a much more difficult question.  Even if you've recently had an x-ray you probably don't know the total amount the radiologist collected since he received payment from both you and your insurer.  You may not even know how much he charged since the charge was very likely reduced due to a contract with that insurance company.  In the end you may have paid twenty dollars, your insurer paid thirty dollars, the radiologist billed a hundred and twenty dollars and really wanted forty dollars.

So what's the difference between hamburgers and x-rays? Obviously most Americans eat a lot more hamburgers in our lives than we experience x-rays.  Not only that but when we order a hamburger the price is clearly presented to us and the transaction is simple and straightforward.  When we get an X-ray on the other hand we generally aren't told how much we owe until well after the procedure is complete.  Even then we work through several intermediaries, such as insurers and collections departments, to pay our bill.  It's no wonder Americans love fast food and abhor visits to the doctor's office.

We have nearly endless resources when it comes to learning about our potential dinner.  Even before we choose a restaurant we have the recommendations and anecdotes of family and friends to guide us.  Dozens of internet review sites inform us of prices, food quality and even staff friendliness. On the way we might hear or see advertisements enticing us to try the latest menu item or indulge in a limited time price reduced favorite. When we arrive a large menu prominently displays prices right next to various selections and while ordering the prices display right in front of us on the register.  Afterwards we're given an itemized receipt which clearly spells out what we've paid for each component of the meal including the government's share.

Compare this avalanche of information to your healthcare provider.  I challenge you, call your provider and ask them the cost of any procedure you'd like. X-ray, blood panel, prostate exam, anything that comes to mind.  For most of you you'll be shocked at just how little information they're able to provide you.

Many Americans spend several minutes each evening trying to figure out how to get the best value for their money out of dinner. Yet the vast majority of us simply go the the healthcare provider we're recommended to or choose randomly.  Given that procedure costs may vary widely between providers it's odd that we think so long regarding one meal while completely ignoring a choice which could net savings worth hundreds if not thousands of fast food dinners.

Ultimately the problem is one of information accessibility.  The fast food industry wants to clearly communicate to you their prices so you can easily compare them to the competition. Undoubtedly,  if Burger King changed all their menu prices to read "a bargain" instead of an exact value they would lose a great deal of market share. However, in the healthcare industry such practices are the norm.  Prices and costs are concealed from the consumer at every turn. Perhaps even more disturbing the customer often doesn't even know what services they'll receive.  I freely admit that if I were to receive an x-ray today I have no idea whether the person to examine the film would be a trained physician or the office receptionist.

Perhaps it is our vary reluctance to pursue options rather than accept the default that has led to this scenario. Maybe if Americans as a whole decided that we were going to shop around for healthcare prices would be clarified and easily accessed.  Maybe if we simplified insurance so that the insured and uninsured alike were billed at the same rate doctor's could actually inform us ahead of time how much medical care would cost.

Until then you may want to lay off the hamburgers. You never know how much you'll have to pay for them later.

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