Friday, May 30, 2014
The following true story could be written by anyone who recently has visited a doctor, spent time in an ER, or worse, been admitted to the hospital.
The moral of the story is rudimentary...
If you don’t take control of your own health care you are at the mercy of the system. Today, that is not necessarily a happy place.
At 46, Frances Lee (name changed for healthcare privacy) was diagnosed with diabetes only to learn five years later she also had cardio-vascular disease. In the same year, she endured surgery for skin cancer.
Single and employed in a demanding, high-stress job, Lee faced an uncertain future.
And, she was at the mercy of the dysfunctional system, forced into it as mounting doctor bills, expensive prescription drugs, and a stagnant economy continued an assault on her health.
Now, ten years later, the spirited 61-year-old has become an extraordinary advocate for herself and her health who no longer leaves her care in the hands of someone else.
For a few weeks this spring, Lee was experiencing recurring angina. She was anxious to have her annual stress test and discussion with her cardiologist.
Instead, she faced the worst of our new healthcare reality when her doctor of ten years made a significant change in his practice with only a vague explanation to his patients. He ordered a standard stress test from a local hospital.
Determined to understand these changes, Lee called the billing department to be sure her insurance would be accepted, expecting to pay her standard co-payment.
What she learned was confusing and upsetting.
Between the test itself, the hospital charges, the technicians, the specialist who reads reports, and pharmacy charges, it could have costs her hundreds, perhaps thousands.
Well beyond her ability to pay upfront.
The test her doctor ordered wasn’t the nuclear stress test she was accustomed to having right there in his office. “The hospital even required a $900 deductible in addition to 20 percent of the allowable by my insurance company,” she said indignantly.
In prior years, Lee’s out-of-pocket expense for the test was $100 or less.
According to the Federal Reserve, more than half of all debt collections that appear on Americans’ credit reports are from medical bills. Moreover, people who owe medical debts are over-penalized when it comes to their credit scores, according to a new study from the U.S. Consumer Financial Protection Bureau.
In the weeks since, Lee is thankful that she took the time to uncover the reasons for the significant changes in her care, conceivably saving herself hundreds of dollars.
All because the doctor is now partnered with the hospital.
“Thank God I was not in an emergency situation,” and added, “I can’t begin to imagine the bills I would have faced.
Jonathan Bush, co-founder and CEO of athenahealth, writes in his stirring book, “Where Does It Hurt”, about the deep dysfunction of the $2.7 trillion medical industry.
He calls for a “revolution in health care to give customers more choices, more freedom, more power and more information,” according to the Amazon book description.
Accepting more responsibility, a central focus to his message, requires us to take back control of our own healthcare.
Make informed choices about the care you receive, realizing your doctor’s orders may not be in your best interest.
Like Frances Lee. You may save thousands.
This column submitted by Cindy McLaughlin, a healthcare consultant. She can be reached at 843-457-8545.