Friday, June 28, 2013

'How Much Would You Pay To 'Look Good and Feel Mah-velous' Versus Just Being Healthy?

'It is better to look good than feel good'
$20.

That is all it takes to get a person to do something different when it comes to health care cost containment.

We found out yesterday from a veteran of medical billing services that everyone 'says' they want their own doctor, their own prescriptions from their local pharmacy, their own local hospital....until they can find the same level of service somewhere else for $20 less.

So much for 'loyalty' in the medical field, huh?

You hear it said so often that it has become almost a mantra in the healthcare debate: 'People want the freedom to choose their own doctor.'

That being said, how do most people go about 'choosing their own doctor' in the first place?

Many people use the same doctor their family has used for decades if they live in the same locale much of their lives. When the older doctor retires, the people keep going to the same doctor's office where over time, a young family member has taken over the practice or other doctors have come on-board and 'assumed the mantle of physician/patient confidentiality' from the senior physician in the practice.

Hardly anyone actually 'chooses' their own doctor based on things like 'price' or 'quality' as they do in the local grocery store, do they?

'I'd like to see your cost sheet first before I come to see you for my annual check-up, Doc. Can you give me a list of all the adverse outcomes your patients have had over the past decade please? How many of your patients have left your practice versus how many new patients have started coming to see you for services because you are so great?'

You wouldn't buy a kumquat from your local Harris-Teeter if they were all spoiled and cost $25/each, would you?

Then why don't we do more 'shopping' in the medical field before 'purchasing' their services?

That is what is needed in American medicine today. 'Managed care' has come of age in ways that HMOs (health maintenance organizations) tried to do and failed in the 1990's to contain and control health care costs.

Nowadays, managed care groups focus more on helping people get healthy and stay healthy and therefore stay out of the emergency rooms or hospitals altogether. They act more as 'negotiators', 'advocates' or 'concierges' for the patient and less like green eye-shade accountants in the back room denying services right and left without any regard for the patient's health or well-being.

The rise of 'third-party payors' such as your insurance company, Medicare and Medicaid have done a lot to discourage responsible health care consumption in America over the past 40 years.

'If someone else is paying for it, what the heck? I'll go check myself in for a bloody hangnail if I want to!' has been an example of the prevailing attitude or our collective sense of entitlement when it comes to 'perfect' health care delivery, not just competent delivery of services.

Now consider this:

A company comes along and signs you up as a plan participant. They go over your current health care status with a fine-tooth comb and find out what you are doing right to take care of your body and what you are not doing well to take care of yourself (smoking, boozing it up, drug abuse, lack of exercise, diet of a box of Twinkies everyday now that they are coming back on the market)

When it comes to buying your monthly medicine for high blood pressure, whathaveyou, they suggest you consider a generic drug for your prescription.

'I want my name-brand medicine!' you protest. 'I feel great when I take XYZ every day!'

'It will save you $20/month. That is $240 year you can spend on something else you like to do' they inform you.

'I'll take it. Where do I pick it up?' you will say almost every single time according to this expert we spoke with yesterday.

How about a larger procedure?

'Your biopsy will cost $250 if we do it here in the office. Your co-pay will be $50. If we do it down the road at our other out-patient clinic, we can do it for $200 and your co-pay will be $30. Which will you choose?'

'If it means me saving $20, I'll go down the street, Doc, if you don't mind, of course!'

The problem is that none of us does that 'shopping' comparison now when it comes to health care because A) It is so confusing to begin with; B) We don't know what we are doing; and C) We are a tad bit 'lazy' when it comes to shopping for medical services, aren't we?

We will walk out of a grocery store if the shrimp is $22/lb. 'Heck, I can drive to Morehead City and back and pick up a couple of pounds of shrimp the next time I am down there and freeze it for later!' is the rationale we use to avoid such high-priced shrimp.

We will walk out of a car dealership if the $200 add-on feature in the new Nissan is not given to you 'free' as part of the final deal.

But when it comes to paying for medical services, as long as you have a pretty decent plan or the taxpayers pay for your medical care through Medicaid (100%) or Medicare (85%+):

'Whatever you say, Doctor! Sign me up! You know, it it better for me to look good than feel good and look mah-velous!' as Billy Crystal's 'Fernando' used to intone on SNL.



Managed care where people can help us all take better care of ourselves and save money in the process is one major way to do it. It is coming in the wake of Obamacare at every level of medical delivery as almost an inevitability.

When you see where you can save $20 on any medical procedure, you'll do it. Try it and see.

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