It’s time again for me to use my bad back as a case study in why American health care has such crazy incentives.
About a month ago at the HLTH conference in Vegas, over the course of a few hours I developed debilitating leg pain. To quote from my earlier twitter thread on my time in Vegas, “After 3 days of excruciating pain, my wife insisted I went to the ER. The public policy person in me was horrified but we had already spent our deductible, so the cost was actually lower than paying cash for an MRI”
What actually happened was that after 3 days of dreadful pain & inability to walk (including getting myself home from Vegas using multiple wheelchairs, and being that guy who crawls off the plane onto a wheelchair), I got in to see my chiropractor. He said, you need an MRI to figure out what’s wrong with you. The alternatives were
1) Get insurance to pre approve the MRI. His guess was that that would take a few days or more. I actually called One Medical‘s urgent care video line and the PA I spoke to told me that usually insurance would only approve an MRI after I had done 6 weeks of physical therapy.
2) Pay $500 cash for a free standing MRI that could probably get me in during the next few days
3) Go to the ER
Now the “incentives” part of this starts to really matter.Continue reading…