4 ms·
There is a huge additional set of decisions that are not made under duress, but are made in an information vacuum. Two recent examples from my own health histor
by bunderbunder 8y ago
There is a huge additional set of decisions that are not made under duress, but are made in an information vacuum. Two recent examples from my own health history:
My optometrist wants me to try a new kind of contact lens. She cannot (or will not) tell me what they will cost. She can't tell me what they would cost me personally because she just doesn't know - all they can do is send a bill to my insurance company and find out how much they pass on to me. Which is essentially asking me to write a blank check. Nor can she tell me the sticker price on these contacts so that I can at least know the upper bound, because she simply does not have (easy?) access to that information - the billing department does. Probably I'll stick with the same brand I've been using for years, because at least there I can safely assume they'll cost about the same now as they did last year.
Similar story for my doctor offering me a flu shot while I was getting a checkup. She couldn't tell me the price, she didn't know the price, she couldn't get access to the price, etc. I usually go to the pharmacy, where they bill $30 and insurance covers it all. So I figured, "How bad can it be? And it'll save me some time," and let her give me the flu shot. Big mistake - the doctor's office billed $300, insurance (quite reasonably, TBH) only agreed to cover a portion of it, and I got stuck with a $200 bill.
There's two problems there. One is the lack of price transparency. The other, though, is the prevailing attitude - in both cases, the doctor's opinion, which I think is most everyone else's opinion, too, was, "Who cares what it costs? If the insurance covers it, it's basically free to you." Which just ain't true, especially for routine care stuff like this. The insurance company isn't getting their funds from some magical fountain of money. From a "see the forest not the trees" perspective, they will have to pass every cent of these costs (and more) on to me.
Both of these problems are solvable.
- Domenic_S 8y agoRe: the flu shot story — that’s called balance billing and it is illegal if the provider was in network and the procedure was covered. https://www.healthinsurance.org/glossary/balance-billing/ https://www.healthinsurance.org/glossary/balance-billing/
- CaliforniaKarl 8y agoAt least for dentistry that is changing: I had a filling recently, due to a cavity identified at a prior checkup. At the end of the checkup, a front-office staffer went on to Delta Dental’s web site, pulled up my record, and requested a treatment estimate. The answer was returned within a minute. A few days later, I got a copy of the estimate in the mail for my records. I didn’t have any other dental events (which might’ve affected the estimate), so on the day of the filling, I paid the amount as part of the office visit. A few days later, I got the Explanation of Benefits for the procedure, confirming the amount paid was correct. If I had chosen to, then I would’ve gotten all that over the web instead of on paper. As far as I’m concerned, the dentist’s office is where I want them to be, in terms of billing processes. My eye doctor is able to do something similar, looking up lens & frame benefits etc. on computer, no I don’t have to be billed after the fact.
- munk-a 8y agoThe flu shot cost is really terrible, up here in Canada my doctor asked if I wanted a flu shot last time I went in and there was no cost passed onto me directly. There are pharmacies that dispense flu shots for money but it's also pretty easy to qualify for a discounted shot if you need one and people not having the flu makes all of society run better. Charging 200$ for you to be healthy and able to work the full season while also avoiding being a carrier of a disease is absolutely terrible.
- Izkata 8y agoI don't know what order your experiences happened in, but one thought in the first is wrong because of the second: There is no upper bound. It's something I've seen in other comments here in the past, too.
- kbenson 8y ago> My optometrist wants me to try a new kind of contact lens. My optometrist wanted me to as well. When I wasn't sure, he was nice enough to offer a prescription for both, so I could make the choice later. That obviously doesn't work in every case of unknown cost, and doesn't really change your point, but I thought it was worth pointing out as a nice tip for anyone in the same situation in the future.
- nradov 8y agoAppeal the flu shot claim. Most insurers cover vaccinations at zero cost to members. Your doctor may have coded the claim incorrectly.
- Sohcahtoa82 8y agoI want to know why the doctor charges $300 for a procedure that a pharmacy offers for only $30. Is there any reason for it besides just wanting to extract more money?
- mcv 8y agoYeah, that kind of extreme lack of transparency makes a free market utterly impossible. Particularly if you ask explicitly, they should be able to tell you a price, or you should be able to tell them up front that you'll only pay the part that's covered by the insurance. Springing costs on you that you never agreed to and aren't covered, should be illegal. you're literally being forced into a transaction you never agreed to.