Posted on May 24, 2008 | Category: Uncategorized
By Jan Greene
There's a really interesting column in the Wall Street Journal this week by Dr. Benjamin Brewer, who writes regularly about his experiences in the American health system. He talks about taking his daughter to an emergency room for stitches and getting a surprisingly high bill. His comments address what this blog is all about:
Nobody I know would be willing to buy gas at an unknown price, only to
find out the damage when the tab comes a month and a half later. But
between the mind-numbing complexity of health-care charges and the
reluctance of many in the health system to reveal their prices up
front, you don't have much of a choice.
Yeah, exactly. He goes on to talk about being on the other side of the billing process:
Some patients with big deductibles or health savings accounts try to
negotiate fees with me. I'm not offended, but as a family doctor in
Illinois my margins aren't that high to start with. A $65 to $85 office
call carries $45 to $50 in overhead.
This is instructive because it goes to one of my main pieces of advice: Know which medical services have a high profit margin and negotiate harder on those. It's pretty well known that primary care doctors such as family physicians aren't making a lot of money on office visits, so there's not much point in dickering their prices down much (though it's always worth asking). I'll be devoting future posts to the profitability of other common medical services.
There's an interesting string of comments after Dr. Brewer's column in the WSJ that get into a debate about how much medical services cost and what should be done about it. If you have a subscription to the WSJ you can read all about it (though someday soon the journal is rumored to become free of charge).
Some of the comments were from consumers who had tried to get pricing information before they had a medical service and were told that information is confidential. That's ridiculous. We should all ask and keep asking until hospitals, doctors' offices, labs, imaging centers and all the other parts of the system get the message that they need to evolve with the times just like consumers, whether we like it or not. It's ludicrous to think that consumers have to take the brunt of paying for more of their care without giving them the information and skills to do so. That's what we'll try to remedy, in some small way, on this blog.
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