Healthcare Costs - A Little Transparency Could Go A Long Way

I had to have an MRI on my left knee for unidentified pain.  I was written a prescription for a partial MRI.  Because my doctor was at Stanford, of course the MRI was written to be done in the Stanford Radiology Department. I didn't think anything of it really. I came back a week later and the MRI went great.  What they found were Baker's cysts, which I later got successfully drained.  There was no pain until last week.  Last week I got the bill for the MRI!  $3000.00 for the partial MRI on my knee.  Now I didn't know at the time if this was expensive or not until Patti compared a full MRI that she had done at Mills-Peninsula.  For her full body MRI, it was $1300.  Now, that seemed like a big difference.

I did send a note to my doctor at Stanford who appreciated my speaking up as a patient (who according to him carries more clout when it comes to pricing decisions than what the doctors think).

What would have have worked though, saved me money, saved the insurance company, and contributed positively to the overall health care cost dilemma we face, would have been a little transparency.

Imagine that at the bottom of the prescription - actually for any prescription we were to get- would be the price of the procedure, or pills, etc. Since the healthcare provider already knows what insurance plan we are on (as they go to great effort to ensure we are all insured), it would be a no-brainer to actually quote the gross cost of the procedure/prescription and what the net, out of pocket cost that we will experience.

This can't be that hard so why doesn't it happen already?

Could it be that we aren't supposed to know that much information, because if I saw the difference between $3000 and $1300 (or less because my MRI was a partial procedure) that I might have left Stanford and gone to Mills?

Hmmm.

I suspect this level of transparency will be hard to garner without regulations and rules to make it so.

I am not advocating greater government intervention, but any form of influence that would force greater transparency into healthcare costs should not be fought.Without external forces we know from our own experiences to date that the system isn't set up for consumerism. 

I support full transparency here.  What would it take to just be able to see what we are going to be charged before we purchase? 

Until this happens, let's each have the courage to ask the question before we act.  It's a simple set of questions; "How much will this cost me?", "Are there other lower cost alternatives that are just as effective?"
If we don't ask, we won't be told.

60-40...The Rope-A-Dope Vote

I stayed up with C-Span last night to watch the closing arguments and the Senate vote on cloture for the Healthcare Reform Bill. I was not surprised, but once again disappointed with the 60-40 vote. I listened to both sides say why the vote had to be 58 Democrats - 2 Independents For and 40 Republicans Against. As best I can tell from my citizen caring and citizen involved vantage point, the Republicans wanted to stall the vote because they believe that most Americans don't want this bill. What is disappointing is that they don't refute or fight on the point that in the entire time the bill has been moving they have offered only four amendments. I am sure there is some good reason for this, but from this vantage point it feels like they are so afraid that if they make contact with the bill that they are going to catch something that makes them sick. I can understand that, I just don't respect it. When in any other part of life you believe in something that strongly, then you are willing to do anything to take care of something you care about. When your child is sick and you can't get a straight answer from the doctor you don't just stop asking, you go get a second opinion and you keep going until you have the answer, even if that means you may get sick yourself. I feel like the Republicans, were afraid of what they were going to catch and gave up on this one and are now wanting to sit in the corner and say, "I told you so.". If that is the case, then what Senator McConnell said last night about this bill changing the course of our nation forever, is correct. If the 40 votes of no last night were being passive aggressive and wanting to sit back and arm-chair quarterback, then this vote may have been the end of the Republican party as we know it. What it seems has failed to dawn on the R's is that the party that I grew up with were Republicans who came with smart, well-thought out, responsible solutions. But even when they didn't have the best solutions, they always brought their ideas to the table, no matter the obstacles, the public ridicule. They were not known for sitting back and letting someone else tell them what to do. Ronald Reagan and Barry Goldwater didn't know the meaning of sitting back. Something has gone terribly wrong with American politics when the men and women who go to Washington choose to sit back versus fight for what they believe is right. Mr. McConnell, a man I have admired since I was growing up across the river from Louisville, Kentucky took a trick from his and my fellow Kentuckian, Muhammad Ali, and fought this fight with the rope-a-dope, hoping that he and his party have enough stomach strength to take all the punches and wear the other guy out. The problem with this tactic on healthcare is that no matter the cost of the bill, no matter the problems with the pork that resides in the 2000+ pages, no matter the issues that will come up down the road, in the short term it is going to feel like to working people, regular people, that they are feeling the effect of change in Washington and getting much needed healthcare coverage reform. And while, I do agree with the Republicans that there is too much spending, too many side-deals, federal spending on abortion, etc. that are hard to live with, let's also not forget that the bill does not have a public option plan in it and many other concessions that if they had been at the table, instead of under it, they could be talking about what they influenced and what they could still influence going forward. I am afraid, Mr. McConnell, that the 40 Rope-A-Dope Vote this time just won't work for the whole fight.

Two "Practical" Healthcare Fixes

Here are two "Practical" ways to fix healthcare.

There is nothing wrong with a public option as long we as taxpayers are not burdened with the cost running the public healthcare. We have a good analogy on how to set up a government agency that is run by the government; everyone uses it, and no taxpayer dollars are used to fund it. It has competition from the private sector and it has been around longer than any of us have been alive. It is called the United States Postal Service. No taxpayer dollars go to fund or run the Postal Service. They make it work on a $0.41 minimum unit price. It is a large infrastructure, that while it may not be the most sophisticated, runs, works, is dependable and is a good alternative choice to FedEx, UPS, etc. It employs lots of people and we all have come to depend on them. So, create a public healthcare program where it pays for itself, is provided and used by government employees, and give me the choice to participate. Create the United Stated Healthcare Insurance Service.

Secondly, make healthcare mandatory for all people. In every state in the U.S. if you are going to drive a car you have to carry car insurance. Of course, there are some people who drive without car insurance, but these are the same people who drive without licenses. When they have an accident, they are penalized, fined and sometimes jailed. It is a law to have car insurance and the same can happen with healthcare insurance. The reason that there is affordable car insurance options is because the insurers have a market where everyone has to have it so it invites competition of service, coverage and price. The same would happen with healthcare insurance. If everyone had to have it then good business people would stratify the market and come up with the minimum coverage required at a price point where those who could afford more would get more and those who can only afford the minimum would be able to buy the minimum coverage affordably. Up and down the supply and service chain, costs would come in line and we would get past all of this arguing.

These are two "practical" ways to think about the problems. We need more "practical" thinking and more "practical" solutions. This plea is directed to all us, including President Obama, Mr. Reid, Mrs. Pelosi, and Mr.McConnell.