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Oct 14, 201309:40 AMOpen Mic

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Can we apply good consumer habits to health care? Heck yes

(page 1 of 2)

Ponder this: Your roof suddenly starts leaking after a bad storm. First thing in the morning you call your insurance adjuster, check out potential contractors with friends, and then get a couple of bids for the job. After picking the best — but not necessarily the cheapest — bid, you’re confident your roof will be fixed right. That’s being a smart consumer, right?

Now consider this scenario: Your foot suddenly starts hurting after a vigorous weekend workout. You call your insurance company to get your coverage, get recommendations from friends, and get a couple of competitive bids to find out who can fix you up. Right? Not so much.

Unfortunately, it seems that even the smartest consumers tend to lose their intelligence when it comes to health care. We immediately rush to the clinic when our children cough, sneeze, or develop fevers rather than make a call and have a nurse triage the situation over the phone. And just like we do when we rush into a bad home improvement job, we pay the price for our bad consumerism. Our personal health care costs are out of control, and considering our behavior, we might be partially to blame.

For the most part, we can’t control when we get sick or hurt — although some would argue that we could do a better job of taking care of ourselves and taking more safety precautions to prevent illness and injury. We could quit smoking, wear our seatbelts, and eat healthier diets — just like we prevent damage to our roofs by getting the extra snow off the eaves and making sure there are no low-hanging dead branches near our house.

Okay, so let’s say we take perfect care of ourselves but we still get sick or injured. Then what? That’s when we need to be extra careful with our decisions. Whether it’s a $25,000 roof or a $25,000 foot surgery, it’s still a consumer decision, and it requires the best information. For years, the Better Business Bureau has been saying, “Check before you buy.” Once you’ve signed on the dotted line and committed to a purchase, your options quickly diminish. The best way to have a great purchase experience is to do your homework before you buy.

(Continued)

Old to new | New to old
Oct 15, 2013 12:19 pm
 Posted by  Ben S.

While Ms. Hazen is correct that we should become better health care consumers, she is very naive about how the U.S. health care system actually works. Health care may be the most opaque marketplace in the country, and in fact it fights against the kind of apples-to-apples comparison we can more easily make for many products and professional services.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/05/08/one-hospital-charges-8000-another-38000/

Oct 15, 2013 12:29 pm
 Posted by  Anonymous

Just because it is an opaque market and it is difficult to make apples-to-apples comparisons, is no reason to not TRY to make calls and get the information required to be control your buying decisions.

In the post article, if you could find the information and save $30,000 or whatever your co-pay share of that $30,000, shouldn't you try to call? Also, an MRI (per Ms. Hazen's example) is something that you can get a quote on.

If you find her example to be naive, I find your example to be lazy.

Nice article Ms. Hazen!

Oct 16, 2013 06:12 am
 Posted by  Darla D.

Great post! Consumers need to take an active role in health care decisions, but they may need help. It can often be difficult for consumers to “shop around” to compare quality and cost. If you have insurance through your employer, ask the HR department if there are tools designed to help you make better decisions. Employers who provide health benefits through The Alliance have access to QualityCounts reports that compare the cost of selected outpatient procedures and offer information about the quality of inpatient procedures at different facilities. That’s just one example of the information that may be available from your employer to help you make better decisions about health care quality and cost.

Oct 16, 2013 06:55 am
 Posted by  Anonymous

With HMOs you have few choices of who to see - if your employer offers one plan, you have one clinic and one set of fees. Yes, it's better to go to the clinic than the emergency room, and people need to be taught that. HOWEVER, one problem with the excessive cough/cold/fever do-I-really-need-to-see-a-doctor situation, is that so many employers don't trust their employees and REQUIRE a doctor's excuse for sick days for even the simplest virus! So they have to make an appointment even though it won't really do them any good, just to get the piece of paper that says it's okay to use one of their precious few sick days. Consumers aren't entirely to blame for the overuse of the system.

Oct 17, 2013 12:28 pm
 Posted by  Ben S.

Consumers have little incentive to compare costs when their insurance companies restrict them to a specific network, and make complex, private payment agreements with providers. Comparing costs is more useful for consumers with high-deductible plans. But even here, billing departments are often unable to provide clear information on cost.

This is one reason medical tourism is so attractive. You need a hip replacement? Here's exactly what it will cost and who will treat you.

Jan 7, 2014 07:42 am
 Posted by  Ben S.

This was published in the Journal of the American Medical Association. It's easier to get information on parking at some hospitals than procedures.

http://archinte.jamanetwork.com/article.aspx?articleid=1783043

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