$958 for a blood test? Something’s wrong
I originally wrote this column for my former paper, the Cincinnati Enquirer. I had not planned to run it in the PI because this didn’t happen in Garfield County and I didn’t want to imply that a health system here was responsible.
The reaction after this was published in Cincinnati last week, though, was such that I decided to share it with readers here. The broad issues are health-care costs and the lack of transparency in pricing, which are nationwide questions. As many of us move to high-deductible insurance plans, we are asked to be better consumers of our health-care “purchases.”
The system and our culture are not set up that way, so getting answers is both difficult and extremely time-consuming — and that effort may not work. Buying health care is like buying a coat or a car — but finding out the price only by getting a bill in the mail. That’s screwed up. We might all be able to press, over time, with the backing of our employers if we have group coverage, for more transparency in pricing, but often the providers don’t have any idea of the price tag.
Here’s the column as it appeared in the Enquirer, with minor edits:
Imagine going for an oil change and, at the end, being told you owe $400. The bill shows that you got essentially the same service as six months before, when you paid $45.
That’s how I feel about the $1,000 I’ve been billed for routine blood labs I had last spring at a Cincinnati health system.
In 2013, my total cholesterol was above 200 and I had a health insurance plan like what I’d had most of my working life. I had a co-pay and occasional other costs for my doctor visit and any tests.
I had my blood lipids checked a couple times in 2013. As always, it seemed routine.
By fall, the doctor wanted to put me on Lipitor, and I acceded. I hated the side effects and, after discussing it with my doctor, stopped, switching to massive doses of fish oil and psyllium – though I didn’t significantly change my diet.
In March, it was time to recheck my lipids. Everything about the lab visit was ordinary. The only thing that had changed was my insurance, which, like so many other workers’ plans in America, had been switched by my employer to a high-deductible policy.
I had to meet a $1,500 deductible before the plan paid for anything but preventive care.
Early in the year, I asked my doctor what an office visit cost.
No one in the office knew the price. “We just have to file the insurance. We’ll bill you.”
If my part in bringing down health care costs is being a better consumer, I need to be able to see the prices without spending hours on the phone.
When I had my blood drawn in March, the phlebotomist took several vials. It didn’t occur to me to, three vials in, to ask how much each was costing and what it was for. The routine for blood tests is to fast, get to the lab early and eat something before work. I’m really not shopping at that point.
I also assumed this was a preventive, covered procedure meant to help lower my risk of heart disease. I hadn’t had a physical in 2014, so I couldn’t imagine I was blowing $1,000.
Just as I wouldn’t pay $400 for an oil change, given the choice, I wouldn’t buy a $1,000 routine blood test. We aren’t given an a la carte menu on these. The doc orders them and we trust that they are needed.
The bill I got in June, after I’d moved to Colorado, was for $958. The insurance company had paid $79. So apparently some of the blood drawn – not much – was part of a preventive procedure.
The bill also showed an insurance adjustment that lowered my cost by $1. One. Dollar.
I called the health system and was told the bill was a mistake, don’t worry about it, we’re talking to the insurance company.
I got the same bill again last month. I called again and was told the same thing.
The issue here, though, isn’t what the health system might be able to extract from the insurer. It’s the clearly ridiculous cost, the complete lack of transparency in medical prices and the lack of any real consumer choice.
Meanwhile, I met a doctor here, Greg Feinsinger of Glenwood Medical Associates, who is studying the effects of a vegan diet. I tried it and my lipids showed significant, fast improvement.
As part of the program, I had my blood drawn twice. I paid a total of $60.
Blood panels don’t cost $1,000. We’re getting gouged. I’ll pass on the air filter.
Randy Essex is editor of the Post Independent.
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