Health Insurance and Me

I've ranted about this before: I have no love for the health insurance I currently have. There are many things to complain about but the one that is troubling me most lately is the plan's attempt to portray its bugs and difficulties as features; I'm talking about consumer-driven health-care. The theory behind these plans place the health insurance policy-holders in the role as consumer and thus place the responsibility of controlling health-care costs in said policy-holders hands. By placing the burden on the policy-holders to make the financial choices on how the health-care dollars are spent, a more direct relationship between those paying for the care and those receiving the care is formed. Financial self-interest becomes a factor in making health-care choices and the policy-holders/patients don't freely spend money when they think of it as theirs rather than the insurance companies.

I like the theory but the way my insurance is set up now it utterly defeats any attempt to make this work in practice. I found this out again when I tried to price out the total cost I will have to pay for a minor procedure I have soon. Due to specialization, fragmentation, multiple providers and a complicated billing system, it is practically impossible to determine the cost for this procedure before I actually get a bill in the mail. I can get a price for the doctor performing the procedure and I can get a price for procedure (if its at the only in-network hospital here in town but it could be at any other number of smaller clinics who charge their own prices). I can't, though, get a price for the anesthesiologist who will be helping during the procedure because nobody, not the doctor, not the hospital, knows who that will be anytime closer than a day or two before the procedure. Getting the incomplete prices I did took me three or four hours of phone calls.

To state it plainly, my health insurance company forces me to go shopping for the my health care providers and when I do, I find out that nothing has price tags. It is virtually impossible to try to manage my health care costs the way my insurance company says I should. The health insurance company wants to make it seem that by shopping around I can control my health care costs but I know this isn't true and it is hard to imagine that health insurance executives don't know this as well. Besides, would you choose a surgeon, radiologist, or oncologist you had never met to perform a one-time medical procedure because he or she was the most affordable? I can't think of anybody who would unless they had no choice. And don't even get me started on in- and out-of network, deductibles, co-insurance, co-pays, and the cyclical billing routine between medical service provider, insurance company and patient.

I've made this challenge before and I'll make it again: I double-dog dare you to try to find out the price you will actually have to pay for any given medical procedure a priori. Unless it is not much more than a simple visit to your everyday doctor where no testing is done (and what doctor do you know that doesn't want to "run a few tests" while you're there) you will not be able to get a price of any value before you actually go in.

At least I can't. Not one accurate enough to be useful, that is.