OP-ED

The Cost of Care

Do you have a story about a medical bill that was higher than you expected it to be? Or a time when you wanted to know how much a medical test or treatment might cost and couldn’t find out?

Costs of Care, a nonprofit group based in Boston, is offering $1000 for anecdotes like these that illustrate the importance of cost-awareness in medicine. Judges will include former U.S. Health and Human Services Secretary Michael Leavitt, Boston surgeon and New Yorker writer Atul Gawande, and former Massachusetts Governor and Democratic Presidential Candidate Michael Dukakis. According to Dr. Neel Shah, who is directing the contest, “Using everyday examples from across the country, these stories will highlight the need to make healthcare prices more transparent.”

Submissions should be no longer than 750 words and are due by November 1st. More details are available here.

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Chinese medicine MelbourneSteve S.Lynda TNateJane Recent comment authors
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Chinese medicine Melbourne
Guest

You have plant a very significant concern. What you said really spoke to me and I hope that I can learn more about this. I am yet to find anything as enlightening as this on the web. I am completely convinced with his thoughts.

Steve S.
Guest
Steve S.

In response to “Practice Admin’s” post shown below:
“Why not do the same thing with the total cost of a car purchased at your local dealership?”
Posted by: Practice Admin | Sep 14, 2010 10:05:52 AM
BECAUSE REGIONAL AND CONDITION ADJUSTED INFORMATION ABOUT HEALTH CARE PROCEDURES AND RELATED SERVICES ARE NOT FREELY AVAILABLE FROM OUTFITS LIKE EDMUNDS, KBB, CRAIGSLIST AND THE WEEKLY NEWSPAPER. NOR REMOTELY COMPARABLE TO AUTOMOBILE PRODUCTS. THAT’S WHY.

botetourt
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botetourt

I could make a living by getting a cut of what I could save people by advising them, sending them, reviewing bills, etc., but that is not the point. We are trying to solve the problem caused by about 300 million people wallowing in a medical cost swamp of totally unforeseen proportions. You have to overlay the political reality of our world onto the situation–so you are not going to have your 3-5 years to straighten this mess out (have you offered your services to Dr. Berwick)? What do you propose that can make a change given the political realities… Read more »

Nate
Guest
Nate

“and my point is that the mess is so egregious that the free market no longer has any chance of fixing it.” I would disagree, the free market could clean this whole thing up in 3-5 years. I could fix Medicare in 6 months. It’s political inaction and incompentence that made and exasperates the problem. Free market hasn’t been given a chance since 1965, how do you know it won’t work? “My point is simply that these efforts will not make a meaningful difference in our overall cost structure.” Every year I add clients where I cut their cost 30-40%.… Read more »

Lynda T
Guest

I know how expensive prescription medication can be. I just want to tell people out there that there are ways that you can save on the cost of your prescription medicine. http://www.Medicationcoupons.com is a website where you can search for your particular medicine and download and print a corresponding coupon. This website is free to join and they list both otc and prescription meds.

ExhaustedMD
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ExhaustedMD

Here is a cost of care story:
http://www.baltimoresun.com/news/maryland/baltimore-city/bs-md-ci-shooting-hopkins-20100916,0,1885569.story
Think it will win a $1000? Offer it to the surgeon shot by a patient’s son because the doctor did not fix the mother’s terminal disease!
This is a poster child for things to come, unless we all repudiate it as what it is: expectation and entitlement gone wild!!!
People get sick and will die. This story pisses me off for several reasons, the biggest being family members who think they can dictate the course of care! Pay attention to this crap, colleagues, cause there will be copy cats until proven otherwise!

Ted
Guest
Ted

If the doc documents the patient refused to follow-up, then how is that not removing the risk? Self-pay upfront, recommendations documented, and if the patient follows them fine. If not it is on the patient–not the MD. Where is the personal responsibility anymore? It is like a bunch of children in adult bodies.

botetourt
Guest
botetourt

Nate–I have as much history as you-maybe more. Agreed that public policy created this mess–and my point is that the mess is so egregious that the free market no longer has any chance of fixing it. The market’s chance of operating with any potential for efficiency went out the window long ago. There is nothing wrong with shopping for the best deal, as your anecdote shows, and I also agree that many are insensitive to the costs. My point is simply that these efforts will not make a meaningful difference in our overall cost structure. We have too many physicians… Read more »

Nate
Guest
Nate

“Often times it is the patients that bear the brunt of Health Care expendentures.” You don’t read much do you Gary? in 1965 americans paid 50%+ of all their healthcare bills. in 2007 it was down to 18% or less. It has been decreasing constantly, so no gary it is not the patient paying the bill. They pay premium and next to no bill. As an example of how Neel’s thought does actually play out I suggest to someone they order their very expensive MS drug through Canada. Originally their Cleveland Clinic doctor went nuts making up all sorts of… Read more »

Margalit Gur-Arie
Guest

Big problem actually. Paying upfront will not remove the perceived risk discussed above.

Jane
Guest
Jane

Simple. Pay by credit card or cash upfront and then you get service. No problem.

Margalit Gur-Arie
Guest

“My wife was just refused an appointment with a specialist for a consult because we are “self pay”.”
“My office will not usually accept “self pay” patients-. ”
Considering these statements, would any “free-market/personal-responsibility/consumer-driven” advocates care to explain how exactly is the advocated solution supposed to work?

botetourt
Guest
botetourt

Barry–you are spouting things that won’t happen, and don’t make a lick of difference. Price competition will not bend the curve when the supply of healthcare in every corner of this country is so overwhelming (a few exceptions, maybe). If market forces were legitimate in this industry, the curve would have “bent” years ago. Bending the curve will take very tough public policy changes that are still many years away. What does transparency mean–charges? costs? insurance reimb amounts? net or gross of co-payments, deductibles? What about other bills in the pipeline-might affect deductible or co-payment? They haven’t invented the computers… Read more »

bev M.D.
Guest
bev M.D.

Docserious; Wow, what do you do with patients with an HSA and high deductible plan? I have a 10K deductible, for instance, and my HSA is pitiable enough so I just pay for most stuff out of pocket and yes, I do question tests ordered. So far I have not had trouble; perhaps because I am an M.D. and maybe the docs think that makes me both reasonable and able to pay. (: I do think a physician should be able to articulate a reason for ordering a test before I will agree to have it. (For instance, what about… Read more »

Docserious
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Docserious

My office will not usually accept “self pay” patients-.
They often refuse to go for extra tests like CT’s when necessary (noncalcified pulmonary nodule) leaving you liable if it turns out to be malignant. If you need a consult many specialists will not see them, leaving you treating something (a fracture or arrhythmia)that you are not comfortable treating.
Most of us feel it is too risky.