Do you see things a little differently?

Wednesday, January 27, 2010

Am I missing something????

I continue to hear politicians espouse the need for health insurance reform, and that everyone should have health insurance.  I am starting to wonder if people have forgotten what insurance is?  Wikipedia seems to have a good definition.  In a nutshell insurance is the transfer of risk from one party to another in exchange for a premium.  Don't get me wrong, I think that insurance can be a very valuable tool.  What I don't understand is how requiring me to purchase risk transfer, is going to help with my health care?

I recently passed my 41st year, and due to family history, went to get a physical.  This is a basic medical check, looking for obvious anomalies, which may indicate a forming problem.  My family has a history with diabetes, cancer, high cholesterol, and other miscellaneous health problems.   When I went to my appointment, I was asked for my insurance information.  I happen to be fortunate, and I have an insurance policy through my employer which transfers a lot of financial risk away from me.  I gave them my information, and asked what my checkup would cost me if I didn't have insurance.  The immediate response was somewhat baffling.  I was told that the accounting department had already gone home for the day, and they didn't have that information.  Remember... this was just for a run of the mill checkup.  A couple, of questions, some pokes and prods, and a blood test.  I let it go, and the receptionist said she would have the accounting department call me later.  Fine with me, I wanted to finish the tests and get on with my evening.  I continued with the appointment, and nothing strange or out of the ordinary  was needed.  Nothing that hadn't been done a million times before was needed.

The next day I received a call from the medical office's accounting department.  The individual with whom I spoke, politely informed me that they did not have a chart of fees, and could not provide me with a cost for my physical.  She went on to explain that for people without insurance, they were willing to help, and typically could offer up to a 30% discount to those people.  At this point, I'm thinking I've lost my mind and was not understanding the world.  I am thinking to myself that a discount for those without "risk transfer" is a wonderful thing, but how can they offer a 30% discount, when they couldn't seem to come up with a price from which to remove said discount.

Let's step back for a moment and review the basics.  I was asking an expert to review the chassis and verify nothing horrendous was happening.  If I was talking about a car, then an estimate listing the most common tests and procedures would have been provided up front.  If something beyond those procedures had been identified, they would have given me an update to the anticipated costs, and asked if they should proceed.  A standard set of procedures and tests with standard pricing, and the option for me to say yes that sounds great, or no, you charge too darn much.  I am going down the road to see if the next guy can provide this at a better price.

Somehow in the world of health care, I lost the ability to seek out competitive sources.  I lost the opportunity to know what something was going to cost.  I seem to have lost the ability to manage my own health, and I don't know that the insurance company can be blamed for that.  Somewhere along the line we became complacent and allowed the control for our own personal care to be outsourced.  We transferred more then just risk, we gave them full ownership of the billing and in some cases, the allowed care.

Personally, I plan to try and push back a bit.  The next time I have a medical appointment, I plan to ask what it will cost up front.  I will try to put myself back into the process and regain some of that control.  I still have my transfer of risk to utilize, but maybe if I get back in the process and say no occasionally I can start to get costs back under control.

This is my first blog, and I know my writing is polished, but hopefully my point isn't too muddy.  I would love to hear your thoughts.  Feel free to put down some comments, maybe we can find a way to improve the management of our health, and at the same time help to reduce the cost of insurance and the cost of health care.