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How do you shop for health care when you’re already in the ambulance?

Mention “healthcare reform” and you’re opening a can of worms. Frustration, aggravation, and exasperation are some words you are likely to hear from those fed up with the red tape and bureaucracy that seems to permeate the field. It seems that everyone from the president of the United States to the president of most United States’ companies are urging Americans to become more efficient healthcare “shoppers,” although that feat is easier said that done, especially for rural patients who are faced with extremely limited choices.
Try walking into a medical office and ask for a price quote. Most hospitals and doctors cannot or will not quote a price for healthcare and in the unlikely event they are able to comply, the data provided is pretty much useless unless it reflects “charges” which few people pay, rather than actual negotiated rates.
I believe the recent healthcare reform bill should have hinged on publishing a standardized price list for doctors’ fees or medical procedures. It just doesn’t seem ethical to have drastically different charges for those with health insurance as compared to those without. In most cases the “underinsured” – those consumers who have some but not enough coverage – are receiving the brunt of escalating and sometimes mysterious medical costs. The “underinsured” group, who are made up of workers who pay taxes towards the massive government health programs and who also pay health insurance premiums that continue to rise much faster than their wages, are typically charged the “insurance” rate although their health insurance company will not be paying and the worker ends up footing the outrageous bill.
The dramatic increase in the cost of private health insurance over the past few years has been well documented. In response to these escalating costs, many employers are beginning to transfer cost increases to the consumer causing the American worker to pay more out of pocket for health care services than ever before.
In her testimony before the House Committee on Ways and Means Subcommittee on Health back in 2006, Robin Downey, Vice President and Head of Product Development with Aetna, a large health insurance company said: “as we begin to discuss the issue of health transparency, I’d like to illustrate why health care transparency is so important for you and your constituents. Imagine a world without price tags. You can buy that big screen TV that you’ve had your eye on, but you won’t know the price until your credit card bill comes in the mail. Sounds ridiculous, right? But that’s exactly the world the average American lives in when he or she seeks medical care.”
I read an analogy sometime back comparing health insurance to legalized gambling- i.e. you’re betting you are going to get sick, and the insurance company is betting you won’t and when you do, the healthcare provider presents a hefty bill, insurances pay out little, and the gambler is left holding the bag. The “house” wins and massive profits prove it. Many Americans can no longer afford to cover the gap between what their insurance covers and their medical bills demand, but is shopping around for healthcare the answer?
Opponents argue consumers should not base their health care decisions solely on what a particular procedure or examination would cost as higher prices don’t always mean better quality of service. It also raises the possibility of foregoing medically necessary treatment due to the inability to pay. Plus, sometimes patients can’t shop. It’s pretty difficult to do price comparisons when riding in the back of an ambulance or in a coma.