Medical costs are everyone's responsibility (including mine)


It's an all too common scenario--patient sees doctor, doctor recommends test, patient undergoes test, patient receives expensive bill for test.

And this time it happened to me.

I visited my doctor several weeks ago and he recommended that I have some bloodwork done for preventive testing. My doctor is covered under my insurance plan, so I didn't think twice about the healthcare costs. I didn't question my financial obligation in the matter when I spoke with the doctor and his nurses. And I didn't even consider the price of the medical service when I visited the separate clinic that performed the blood draw.

Then a few days ago, I received my explanation of benefits and read that I now owe $1,300 for the service.

Wait, what?

How did it come to be that I unwittingly underwent a medical service without even considering its cost? I'm an informed consumer and healthcare writer; I should know better. Perhaps the system is designed in such a flawed and fragmented way that even someone knowledgeable and savvy about its workings can fall into this situation.

I'm not trying to excuse myself from accountability. I willingly admit that I should have addressed the cost of the bloodwork with someone. I could have easily, for example, picked up the phone and called my insurer to learn whether it was a covered service and, if not, discover my portion of the costs before the blood was drawn.

But that's also the point--why didn't I check into the pricing? And if I didn't inquire about costs, why would other consumers? The overall lack of financial awareness that's widespread across the healthcare industry is shooting all players in their collective feet.

Very few people actually know how much healthcare actually costs. And the prices themselves of each procedure or service varies from provider to provider based on insurance contracts. Until we can better educate consumers, and the other industry players, about how healthcare is priced and what the costs are, we will make minimal headway toward addressing the crisis of ever-rising costs throughout the industry.

Would I have still undergone the blood draw had I known I'd be paying $1,300 for it? I honestly don't know. It might have been worth it to have the results--information is often priceless when it comes to healthcare. But I don't make a practice of ponying up $1,300--or $13 for that matter--willy nilly.

So where does the responsibility lie? Does it lie with the doctor? He could have at least broached the topic of cost when he suggested the test. Even if he didn't know the specifics of my coverage, he could have given me a friendly heads up: "Hey, this blood draw that I'm recommending might cost you a couple thousand bucks!"

Does it lie with the clinic? The receptionist at the sign-in desk could have asked whether or how I was paying for the service. Or she could have provided me with some typical or average prices of common procedures performed at the clinic. At a minimum, that could have pulled me out of the cloud of cluelessness I was somehow operating under. "Oh, right, medical services cost money. And I might be liable for a portion of that price!"

Does it lie with the phlebotomist who drew my blood? She verified my insurance information and perhaps could have probed me for information about my own financial obligation before drawing my blood.

I would argue that responsibility lies with all of us. We all hope to achieve the same goal--a healthful population at lower costs.

What I would have liked was to provide myself with the opportunity to make an informed decision in the matter. I don't take medical utilization lightly, so I try to be as conscious and purposeful in my health-related decisions. Maybe I would have opted out of the test. Maybe I would have asked my doctor more detailed questions about the value and importance of the information the bloodwork could have uncovered and then made a decision.

If any of the healthcare industry players had even mentioned the word "cost" to me, I might have made a different decision about the service. Regardless of the step I would have chosen, I would have done it with solid research and knowledge in my back pocket. And that's always the best way to make decisions that impact yourself and your health.  -Dina (@HealthPayer)