Saturday, December 6, 2008

Consumer Medicine is Broken

How can you expect the patient to make good health care purchasing decisions if they can't find out the price of a service?

My patient has a $2500 deductible before insurance will pay anything. She is young and mainly needs preventive care so she is paying out of pocket for everything until she hits $2500 (which certainly didn't happen this year).

She was charged $308 for a blood test for Vit D level. Yes $308 for one test. (Vit D found to be abnormally low so supplements prescribed by me)

$308 is no small hunk of change for a working girl. In fact it is an outrageous charge for a simple blood test. She needs a follow up test to see if her levels are improving and she has been calling around to other labs to price compare.

SHE CANNOT GET A PRICE QUOTE! I am serious. The labs are annoyed at the question and said they need a "client number" and a "request from a physician" and they will not give her a price estimate so she can be a "good consumer of health care".



Anonymous said...

I ran into the same problem trying to find out the cost of running a celiac panel on my 4 kids. I spent HOURS on the phone with the lab, pediatrician, and insurance company, bouncing from one to the other.

Finally got told by a representative of the insurance company (with a disclaimer that "this is only true at this precise minute, things could change") that insurance would cover all of the cost.

Took my daughters to get the blood draw that afternoon, took my sons to get theirs 2 weeks later.

About two weeks after that I got billed by the lab--insurance said I needed to pay $37 per child, so a total of $148, which is not small change for me either considering that I had just gotten laid off (thus why I actually had hours available to try and find out the cost) and the testing was something I could have put off.

GGGGRRRRR. Essentially it is like going to a grocery store with no prices displayed, filling up your cart, going to check out and being told "we'll send you a bill in a month, after you've eaten everything."

Anonymous said...

I emailed this link to a physician I know that knows labs/costs and this is his response:

"The Medicare reimbursement is $60+, depending on the various assays performed. I am not surprised to see people billing $300 if she is not covered under some insurance “discounts.” I cannot under comment on how broken the entire US medical care system is, and those who use the system are the only ones who see the problems that insurance companies contribute"

David MD

Anonymous said...

To: Dr. David Thanks for your info. from your friend that knows the prices and charges.

This was what the lab was charging for the Vit D test before being processed by ins. for a possiable discount so they are part of the problem and that the Lab doesn't make their charges transparent to the patient who has to to pay themselves.

To First Anom. Loved your grocery store description that is so very true and a clear way of putting it!!

ERP said...

Yes, try calling a hospital and ask what it will cost out of pocket for a total knee replacement. I can't even find out from the hospital where I work!

Anonymous said...

For a while, immunizations for our children were not covered by our insurance plan (crazy, huh?) so we would go to the public health clinic in our county. They have a sliding scale, so you end up paying full price, but its still less than normal.

Jonathan said...

So here's my annual blood work-up and costs:

Complete CBC $ 48.29
Complete Metabolic 55.29
Assay Vitamin D 282.29
Assay PSA Total 118.29
C-Reactive Protein 79.29
Lipid Panel 97.29
Total $680.74

Our insurance paid for all but $30.63 of this. Given the other comments on this post, I feel fortunate.

One question: why do the costs of all of these tests end in 29 cents?

Fredrick said...

Thank you for your article, really effective piece of writing.
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