John Hunt, MD
Chief Medical Officer, Liberty HealthShare
In an era of constantly growing government, what can physicians and patients do to avoid getting abused and poorly treated by our politicized medical system? The answer is simple: NOT what physicians and patients have done for decades.
What physicians did wrong was to stop advocating for their patient’s finances. What patients did wrong was to stop asking how much their care will cost. After all, why bother to ask if some faceless, distant insurance company, or the government, is footing the bill? And what are the results of this thinking on both sides of the medical equation? Unpredictable, astronomical costs.
When patients and physicians don’t insist on getting the best value for their money, there is no price competition. Medical facilities do two things in this environment: first, they raise their prices, and second, what prices they do have available are clouded with layers of bureaucratic fog. Essentially, prices at the facilities skyrocket because neither of the most important people involved—the physician and the patient—are balking at rising costs. In emergency situations, this is understandable, but look how high emergency medical costs have risen over time! Fortunately, most medical care is not emergent.
Let’s put this into context. It is possible that someday you will need a medical procedure–something beyond a doctor’s visit–at a health care facility. Perhaps a colonoscopy or a surgical procedure of some kind. You will call to schedule the procedure at whichever facility your doctor suggests. But did you know that prices for the same procedure can vary by up to 10-fold between facilities? Furthermore, did you know that the quality of care often varies inversely with price, meaning the more expensive facilities, such as large medical centers, quite often provide lower quality care and poorer patient experiences than at community hospitals and outpatient surgical centers?
It’s an economic fact: when the buyer doesn’t care about the cost, prices will rise. It’s the dominant reason why health care costs have become so profoundly hyper-inflated. Many have bought into the thinking that says, “When it comes to health care, price doesn’t matter.” That’s baloney. Price has to matter because if it doesn’t matter, it will rise until it finally does. And guess what? We’re at that point. Medical costs are adversely affecting many of our neighbors, often to the point of bankruptcy. This is what the third-party payer insurance system has wrought.
I urge you to do what is in your power now to help fix the medical system. I urge you to involve your physician in the process of saving you and your community money anytime you interact, and particularly if and when the time comes to have a procedure or surgery.
First, ask your doctor to choose a facility that charges the lowest price for the quality. The simple act of asking will encourage the doctor to start caring. Unfortunately, most doctors no longer know how to help you steward your own (and your healthshare community’s) resources. They have bought into the thinking that price doesn’t matter. As a result, we must do the majority of that work ourselves. After all, our health and our resources are our individual responsibilities.
In order to shop around, start by asking the doctor for the CPT codes that will be used to bill for the planned procedure. Then call the facility to find out what anesthesia and facility fees will be added to the physician fee. Don’t let them get away with saying, “The price depends on what insurance you have.” Instead, request their best-discounted price for a self-pay patient. Then with that CPT code and price information in hand, shop around for other facilities (and other physicians) to provide the service you need. Don’t feel you need to stay within your city or state, either. If it’s doable, plan a trip or take an opportunity to visit family, and undergo your procedure where the pricing is better.
At Liberty HealthShare, we consider price-conscious shopping to be an essential component of making health care better for all. Indeed, price-consciousness is one of the stewardship responsibilities each member takes on by being a part of Liberty HealthShare.
Am I reminding you of this so you can help us avoid wasting money? Absolutely! Because we are a non-profit, all money saved is community money, which is then available for our members’ medical needs. But even more importantly, this cost-consciousness is precisely what we must adopt at the individual patient level to resolve the problems that the system has caused for every American. It’s essential for the future of healthcare. It’s essential to preserve your medical liberty.
Ask your doctor to help you get the best value for your dollar and start shopping around yourself.
Price and quality–together–both matter.
If you can’t or don’t know how to shop around, Liberty Healthshare’s newly-created Member Stewardship Assistance Program is here to help. Simply call 888-604-4337, and one of BowTie Medical’s representatives will be happy to assist you.
Click here to learn more about the Member Stewardship Assistance Program.