I recently suffered an injury to my foot. I got in to see my doctor the next day. They took and x-ray and confirmed no broken bones, just damaged soft tissue that should heal in a few weeks. I saw the x-ray image less than 2 minutes after it was taken. I was amazed at the clarity.
I expected to pay hundreds of dollars from my HSA account for that care, since I had not reached my deductible for the year. But, I thought it was worth it to know that I had no broken bones. I was pleasantly surprised to receive the bill. The total cost for the doctor visit and x-ray: $83.
Some say, sure, that’s the rate your insurance company had negotiated. I say, that’s closer to the rate you’d see in a competitive market where more costs are paid by patients out-of-pocket and that’s similar to what we pay plumbers and HVAC repairmen for a basic service call.
But, our expectations are different for those services, shaped by decades old market distortions of tax-deductible employer plans and third-parties paying the bills.
We might grumble about paying for plumbing or HVAC repair, but we haven’t adopted the expectation that some third-party insurance company pay that cost for us.
On his show this radio morning, Chris Stigall made great points about medical care. Like my employer, it sounds like his employer is encouraging associates to move to high deductible insurance plans combined with a Health Savings Account.
For those who claim Republicans are playing health reforms critics without offering solutions or having made any changes while in power, Health Savings Accounts were made possible by Republicans made possible in 2003.
Stigall described a scene in his company’s benefits meeting where associates hyperventilated about having to take more responsibility for their health care. He made some excellent points that we shop and compare on almost everything else – cameras, auto repair work, restaurants – but, we’ve grown accustomed to not thinking about health care costs.
I’m about to finish my first year on high deductible insurance with an HSA. I recommend it. I feel more empowered. I ask better questions and make sure I understand my treatment options better. I also find myself a tad bit more interested in articles with titles like, “Controlling Your Health Care Costs”, “Alternatives to Emergency Room” or “How to Save Big Bucks by Paying Your Doctor Cash”. I find myself, strangely, thinking through my options about what I would do in an emergency and discussing those options with my doctor, wife, family and co-workers looking for good solutions. I’m a little more motivated to stay healthy. I find myself comparing the cost to visit my doctor to the cost of the CVS/Pharmacy Minute Clinic (he’s priced well against the Minute Clinic, I like him and will take him over some stranger).
Milton Friedman said that we spend our own money on ourselves more carefully than any other way money is spent. The changes I’ve seen in my own behavior with regards to health care over the past year highlights that point for me.
I believe that if we let health insurers go back to being health insurers – that is insuring us against high, unexpected medical costs – that many problems in health care would work out.