My daughter got her hand X-rayed the other day. No big deal — thanks for asking — they were just checking her growth plate. And all was good. Until I got the bill.
My daughter got her hand X-rayed the other day.
No big deal — thanks for asking — they were just checking her growth plate. And all was good. Until I got the bill:
That was the cost — and since I haven’t met my deductible — it’s coming out of my pocket.
I wouldn’t mind if it were a market-value price. It wasn’t.
Had I went to another radiology center two miles away — one that also “takes” my insurance — the bill would have been $26. For the same X-ray.
The charges are based solely on how services are reimbursed.
And therein lies the biggest problem with health care.
We can talk about mergers. We can talk about alliances. We can talk about health care plans and tiers (trust me, there’s plenty of that in the pages ahead).
But until services are priced fairly for consumers (and with transparency), none of that really matters.
In my case, the huge financial difference was a result of the first office being a part of a large system and the other being independent. And let’s be clear — both are freestanding buildings not attached to a hospital.
The insurance company, because it desperately needs to be in-network with the large system, agrees to pay more for simple procedures as long as they are at a facility that is owned by the larger network (a price that’s passed onto me until I meet my ever-growing deductible).
The independent office, meanwhile, desperately needs to be able to accept insurance to get customers. But it is only thrown a few bucks by the insurer, who is fine with or without the independent office.
I’m not going to name the insurer or the health system. It really doesn’t matter; I feel they all make similar deals (ones that are never known to the consumer because it is proprietary information).
And spare me the idea that the X-ray at the health system was with state-of-the-art equipment that only a big system can afford. Systems gobble up practices all the time; the level of care doesn’t change, just the rate of reimbursement.
After all, if the system acquired the independent office, the cost of the X-ray would change overnight.
Here’s my request: Let me know the cost ahead of time. Don’t tell me if you accept my insurance, tell me how much my insurance company is scheduled to pay.
And don’t try telling me how it’s too difficult to tell the cost because there are so many different plans. Every other product sold in the country manages to tell me the price before I make a purchase.
Let me decide if I do or do not want the “benefits” of going to the bigger system. Let me be the judge of the perception of quality vs. price.
It’s what happens when I go get a burger. I know Zinburger is at a difference price point than Wendy’s. Let me decide what I’m in the mood for. That’s fair.
A price of $184 vs. $26 for a basic X-ray. That’s not fair. And it’s not right.
It’s the biggest problem in health care today.
And the reason I won’t be going back to Zinburger anytime soon.