Consumer Impact

I recently wrote a blog that told the story of a client who was shocked that the surgery his wife underwent was 40% cheaper in Seattle than it was in Anchorage. Two additional frustrating factors to this were: one, he discovered the price difference after the surgery; and two, his carrier informed him that it didn’t matter because the provider was out-of-network and he would have to have paid the higher co-insurance amount.

Typically, when we are faced with a large purchase, most of us will shop around. Multiple web sites and resources have been created around purchasing big ticket items like plane tickets, vehicles, and electronics. However, when you’re sick or in an emergency, price shopping is horribly confusing, inconvenient and troublesome to do…until you get sticker shock. At a time when we are at our weakest, who has the time or state of mind to perform a price check on a procedure that is beyond most people’s understanding? And, even if you did, what if something goes wrong?

Most of us have had a health care experience like this, either personally or with a family member, where we are subjected to an enormous bill after the fact that hits our pocket book deep. In fact, the majority of bankruptcies today are caused by medical debt, and most of those are insured.

If price shopping is so complex and unknowable, how is a consumer to choose the best one? And, if I “vote” with my dollar, how does the provider who offers better (or the same) care at a lower cost get my vote thus stimulating others to follow suit? Finally, how can the average consumer influence the carriers to consider covering out-of-network providers at the same co-insurance rate…wouldn’t they save money too?

These questions only scratch the surface of the issues around how a consumer can impact the cost of their own health care…once they’re in the system. Honestly, the best way to impact the cost at this point is to get involved in the conversation. As the new health care bill is shaped, now is the perfect time.