Skip The Cost Now, Pay More Later!

In the new Bloomberg article by Pat Wechsler titled, Survey: Americans More Likely to Skip Health Care for Cost, we read that Americans are likely to skip going to the doctor, fill prescriptions, and delay or avoid treatments and procedures that are recommended due to high out of pocket costs. As I read the article I am keenly aware that this "news" article simply scratches the surface regarding trends in health care and the amazing amount of influence one's perspective has in this area. Continuing to read the story we find that there are some comparisons between Western European statistics regarding total costs per citizen and patient habits regarding their prescription filling history.

What is interesting to me is that despite the difference in systems, we still find that Germans too are likely to defer their treatments during these times. Why would 25% of German's be defering treatment? I wish the article would have drilled down on this.

The tone of the article is simply this. American system bad, Western European system much better. I am sick of this! Of course it is better in Western Europe, it doesn't cost the patient as much upfront to receive medical services! These are state controlled enterprises. We do not have that system. When you begin having this discussion the first thing you have to ask anyone is whether or not you think the government should run the entire medical system in a country. If the answer is yes, you don't need to go any further.

Has anyone been paying attention to the implosion of the Western European financial system? A reason (not the only reason) that their citizens have access to low cost health care is that the system is unsustainable and not based on pricing in reality! We will soon see how effective these systems will be at providing health care with no cost or little out of pocket cost when government budgets, pensions, and entitlements are cut. I am not hammering Europe with the mindset that the US system is perfect, not at all! I am hammering Europe with the idea that the European budget collapse and fiscal experience is our future if major changes are not made to our health care system including Medicare and Social Security! More entitlement programs and unfunded benefits are not the answer.

I maintain that one of the greatest inhibitors of efficient care in the US system is the lack of transparency of pricing for all services. Specifically, if a person has insurance and pays a $25 copay, he has no idea what the true cost of that office visit really cost. Where is the menu of prices on the doctor's wall stating what the charges will be? Oh yes, I know the receipt he is handed is printed up, but then again there are contracted rates for each specific network and even a cash price if a patient doesn't have insurance or the means to pay. Finally, add Medicare and Medicaid into the mix and the only resulting thing you have from this recipe is a disaster. What a confusing system built to defraud consumers at every turn.

Because there is no transparency amoung providers, there is no competition. How can I make a rational decision about a procedure if I cannot determine the cost. How can I make a good judgement about quality of care and weigh that against the additional price I would pay for choosing a specific practice or specialist? It is quite impossible as the US system is structured. I know of a couple of websites that have attempted to rationalize costs and make them available, but they are very location specific and are not user friendly. If any readers have found great resources, please email me or post a comment, I'd love to review it!

Is it any wonder that Americans would defer costs in the teeth of a recession? Of course not! When more than 15% of Americans are unemployed, under-employed, or have simply given up looking for jobs why wouldn't smart shoppers attempt to find anything that can be cut to ensure they can continue meeting their obligations? I think the real concern here is that when Americans defer costs in key areas of treatment such as preventative care and wellness we ultimately see more serious and more expensive consequences down the road. I have seen this all too often as families choose the high deductible health plans that didn't offer preventative care without meeting the high deductible. Fortunately (and one of the good enhancements of the PPA) the new health care law required all individual plans here in Texas to provide preventative care at no cost to the patient. This hopefully will remove the hesitancy of clients to visit the doctor for annual check ups.
Please let me know your thoughts, I've enjoyed hearing from you!

Jason W Bohmann
Texas Health Design
www.texashealthdesign.com
713-422-2935