Health Care in U.S.: Hostile to Consumers


Would you buy a car, and drive it off the lot, not knowing its cost, just hoping for the best when the bill arrived in the mail? I didn’t think so. But that is exactly what the U.S. medical community seriously expects you to do when consuming health care.

American medicine operates within a totally dysfunctional economic system. Patient accounts do everything possible to avoid price quotes. If consumers are patient enough to wait on line to speak to an actual human being, many of whom are impatient, condescending, or just downright rude, they will at best hear only vague meaningless “estimates.”

If a written letter is issued, and it actually states an “estimated” price for a procedure, the following paragraph will qualify the cost, and make it totally meaningless, through additional language that states: “this does not include any potential facility fees, anesthesia fees, lab or pathology fees, or supply charges.”

Don’t they realize “estimates” followed immediately by language that allows billing for of a whole host of additional expenses, renders them absolutely worthless? How is the consumer to know even a ballpark cost? What is the reasonable consumer to think?

But let’s not accuse the relatively well-off medical community for creating this terrible American system we have. Let’s keep the blame where it belongs, on the consumer, for they are the ones who deserve ridicule. How dare they even seek price quotes in the first place? Just who are these peons with the audacity to request information on costs? Don’t they realize they’re addressing the medical community? Don’t they know those in medicine simply don’t dirty their precious hands with costs, that is, until it is time to collect, and the wretched consumers are fully expected to pay every nickel, under a one-way highway billing system.

Personally, I was priced out of the private health insurance market long ago. No, I am ok. I can walk, talk, and get around just fine, but my parents had diabetes and heart disease, so on the assumption I would also succumb, my premiums started galloping upward with each payment, until the private carriers finally got what they wanted, and pushed me away without insurance. So, now I pay cash for health care, and must shop around.

Although the online price for a cataract procedure was an average of $3,300 and up, when I tried to nail something down this week, I was unable to do so. The Dean Clinic gave me an “estimate” of $5,686 with all the qualifying language mentioned earlier in this article, which amounted to no price quote at all. Anderson and Shapiro started at $2,999, “with no hidden costs,” but then after I was switched to the next operator, I was told I needed a physical and EKG, since I was over 55, even though I was symptom free. The “estimated” cost online for the unnecessary EKG was around $2,000. So, I was left with truly no idea what the cost of a relatively simply out-patient 10-minute cataract procedure would be, except that it would be starting somewhere above $5,000.

I don’t mean to single out just two clinics, as almost all of them have created problems over the years. When I set up an eye exam at the University of Wisconsin Eye Clinic earlier this year, I was quoted $246, but when the bill arrived, it was $358, which was $112 more than the quote. I just laughed, because I knew they would not honor their own quote. Since their ophthalmologist “estimated” cataract surgery at around $6,500, I definitely didn’t return there, due to their history of billing more than their quotes.

There is no reason the government could not simply order health care providers to post their prices for each procedure, somewhat like those visible at gas pumps. Yes, each patient is unique. We all know that. But while treatment may differ slightly from one to the other, there is no reason we could not mandate a public disclosure of all-inclusive singular prices, so consumers could be informed, and could begin shopping in a competitive market. For the uninsured, the current pricing system is totally dysfunctional.

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