This is good advice, though the article also mentions that self-paid drugs don't count toward deductibles. In addition to shopping around, patients should calculate their deductibles and estimate how that might impact their spending.
...which is a messed up, Byzantine system. I'd love a single payer system just to crush this inefficiency out of the system and make patient's lives easier. I would have thought healthcare is all about saving lives but in the U.S. it seems like a dirty busy.
I'd love for us to so some market-based reforms to the current system before we blow it up - I concede that Single Payer is likely the only workable answer in the end.
We need to do things like tort reform, the current system presumes that a doctor making a mistake is an extremely rare thing - its not, doctors are human like any other mechanic. Instead doctors over diagnose, and over treat out of fear of liability (which in most states is unlimited). we could limit liability to 2x the actuarial predicted lifetime earnings potential, and limit damages for pain and suffering to 1x that.
We need to allow insurers to pool together to purchase drugs to force the price down - medicare should also be unshackled and be allowed to negotiate pricing on drugs as well.
We should require cost transparency in healthcare - try asking how much a procedure is the next time you go to the doctor, you'll get a bunch of blank stares. People cant make reasonable choices if they cant perform a cost benefit analysis.
Those changes alone - while they may not reduce costs would stop the increases from occurring as quickly.
try asking how much a procedure is the next time you go to the doctor, you'll get a bunch of blank stares.
That's probably because the people you can ask who fully understand the procedure you need don't know what the prices for you are or everything you're going to need, and the people who know the prices aren't doctors and couldn't determine what exactly the procedure will entail. This is by design, of course, but it means that the people you might try to get a price from aren't able to tell you, even if they really want to.
Take your car to a mechanic, and ask how much a repair is before they look at your car. They can tell you typical costs, but can't tell you what your repair will cost yet. So you let them look the car over, then come back to you with an estimate. But that's still not the final cost, because once they start working something else might come up, and they'll have to stop to talk to you about the additional work. You don't know the final cost until all the work is done. That's the way it is with medical procedures too, except most of the time you can't stop midway through to discuss options and costs when something unexpected happens. The doctor just has to take care of it, and let you know about it afterwards.
If a doctor wants to give me a vaccine for something, and I'm paying cash - they should be able to tell me how much it is. They can't. My mechanic can tell me how much a new alternator is and labor without looking at my car.
Yes, they should be able to tell you, but they can't because they don't know. There is a secret list of prices that are over-inflated which is used to send claims to insurance companies, with the understanding that the insurance companies will reject these prices and "allow" lower ones so they look like they are saving the patient money. The insurance company pays some portion of that, and passes the rest onto the patient. That's the number most patients want to know when they ask how much something costs, but the only way to find out is to submit the claim.
If you're paying cash, you're going to get charged that over-inflated price. It's up to you to negotiate a reduced "allowed" price, like the insurance companies do, except you have no clout. You're also not allowed to know what those prices are; they're secret because if they weren't the whole scam would be a lot more obvious and would probably fall apart. (Eg: get challenged in court)
Building on your car analogy, many auto repairs are common enough that their prices can be listed on the menu. Oil changes, tune-ups, tires, brakes, etc. Known quantities and easy to price. I'm sure the same is true for many non-emergency medical procedures. I don't understand why a doctor can't tell me how much it costs to put a broken arm in a cast, clean out earwax, or treat a rattlesnake bite. Well, actually, I do understand--there is a gravy train of money that comes out of hiding the expense of a service from customers until after the service is rendered.
Those prices don't include a bunch of things you'll also need, which makes them a little misleading. Some of those things are predictable, and some, like your housing costs for the duration of your recovery, are not. In a typical hospital setting you're paying to stay in a hospital bed, and they can't tell you how much that'll cost ahead of time.
It's probably a lot easier to determine all of these costs on average rather than per-patient. Medical staff could be paid a salary, and hospitals/etc could set a budget based on average costs and workloads. Then a single-payer system could collect the money needed into one big pool and pay it out based on those budgets.
Yeah, when it comes to really expensive stuff they'll know the minimum, because then they have their own incentives to make sure you can pay, and will be in a financial position to be able to do the post-procedure upkeep. This is especially true when it's stuff with scarce resources like transplants. It's gonna cost a fuckload, you'll have a lot of recurring costs, and they're going to evaluate if you'll be set up for success or not because otherwise there are other people who could use the organs.
There's a whole host of tests and services where price transparency would be easy. Billing simplification too (if the hospital picks the radiologist, they should pay the radiologist out of the fixed fee they charge for the xray...)
For the most part, generic drugs are cheap. It's patented drugs and out of patent drugs with only 1 producer that have high costs. Widely used drugs that aren't protected by a patent are pretty inexpensive.
Would single payer cover prescriptions though? Canada has single payer, and you still have to pay something whenever you get a prescription at the pharmacy.
It could. In France (which has a mixed system), single payer cover around 70% of prescriptions costs. And you usually have an additional private plan that will cover the rest (and if you're too poor to buy one of these plans, you can be eligible to get it from the state).
The NHS covers almost all drug costs. In Sweden drugs are free for kids under 18, and others have a yearly cap at ~$200 for drugs, at which they become free (partially subsidized a bit before that).
Let's see. Under single payer system, it's illegal to purchase medicine or health care. Only the government can do it. The government does not get sick, and so is primarily focused on cutting cost. Government picks generic drug that works for most people and has no incentive to worry about the 5% - 10% of people it doesn't work for. Oh, well.
This is pretty much what we have now, except with an oligopoly instead of a monopoly. Not really seeing how going even more in the direction of a monopoly helps.
When people can make choices, thats when things change. People actually get sick, so paying for healthcare is more than just a cost, it can have a value as well.
At least with the current oligopoly system, there is a small amount of choice, and you can choose to purchase a drug on your own if what your insurer has on offer does not work or is more expensive. We should be going in the opposite direction - away from monopoly instead of towards it.
Instead of a single payer, we should have a single market.
> Government picks generic drug that works for most people and has no incentive to worry about the 5% - 10% of people it doesn't work for. Oh, well
Generally, this isn't true either. Government picks generic drugs, because it frees up the most amount of money for them to treat other people with.
But if the government covers medications and there's a real medical reason to need a name brand drug over a generic, they'll usually prescribe you the name brand one automatically. Here's a list of that happening in the UK, for example - http://www.nhs.uk/Conditions/Medicinesinfo/Pages/Brandnamesa...
And of course, as always, your still welcome to buy any name brand drug yourself, if you like.
"Under single payer system, it's illegal to purchase medicine or health care."
<2 mins of googling, can easily prove you wrong on this. I personally know from experience you are wrong.
...which is a messed up, Byzantine system. I'd love a single payer system just to crush this inefficiency out of the system and make patient's lives easier. I would have thought healthcare is all about saving lives but in the U.S. it seems like a dirty busy.