Overheard tonight in the local Emergency Room - from a nurse to a patient, "I checked with your attending, he said it was okay for you to take your Aleve from home. We don't usually let that happen, but this way you can save at least $100 by not taking one of ours."
I smirked at my husband because not 10 minutes earlier I had said,"I should go home and get your meds so they don't charge us $100 a pill." He didn't believe me.
ERs and hospitals and doctors offices of all kinds are funny places when it comes to that money thing. Its crazy. What so many people don't know is, but some do, and many more have suppositions...it's all about the insurance agencies. They have screwed Americans in so many directions people can't even follow it anymore.
I can say this from experience after not having had health insurance for a while. If you are healthy, and only need preventative care...or even if you need some additional procedures, other than catastrophic care, NOT having insurance is surprisingly affordable. When you present yourself as a cash customer, usually in a bizarre, reactionary whisper - as if there is some shame in not having insurance - the prices for anything and everything drop dramatically. Sometimes by more than half.
When I carried insurance (and I'm in that holding pattern with the Affordable Health Care marketplace waiting on my new cards to come through - almost reluctantly) a regular check up cost me, whatever my co-pay was at the time - sometimes it was $50, sometimes as much as $100, in addition to the monthly fees to maintain the insurance.
Without it, I walked in and out for usually somewhere in the ballpark of $65 depending on whether or not I needed any bloodwork done or some other lab test. A standard CBC runs somewhere around $15 - $25 depending on the lab you choose. And done.
Vaccinations? No more than $10 - $15 a shot. Xrays? about $25 - 40 depending on how many are needed.
Meds are where it got tricky - but so many are now available in generic, and some stores even run $4 a pop on the most popular medications - typically those used for folks who are fighting a common illness.
Even when I had to have a larger procedure done - I asked what it would cost before telling them I was a (in a whisper) cash customer. It was a barium contrast test (oral - thank you), that the nurse originally said would be about $1600. When my news came, she said, "oh...then it will be about $600. It was elective, for sure, so there was no guarantee that any insurance would have covered it anyway - but then I would have been on the hook for the insurance price rather than the cash price. Go figure!
Granted - catastrophic care is generally beyond anyone's reach, other than those 1 percenters (a class to which we very much do not belong) - however, I think there's even some play in there. My husband recently had to undergo an emergency heart catheterization and have two stents inserted with four days in the hospital (a VERY for-profit institution, no less). I was sure the final costs would round up close to the $100,000 range - after hearing what many of my friends and family had been through, and based on other times we have experienced hospital stays. I reminded billing multiple times that we were cash paying customers. The entire bill, even with all the separate billing for lab work, the ER physicians, the tests...came to no more than $22,000.
When we were insured we had a bout in the hospital from a car accident that cost us almost half that for just the ER visit alone. Same hospital.
So is it any wonder why it's a problem getting young, healthy people to sign up for insurance? I almost don't blame them. Health insurance companies have made a mockery of the medical profession, inflating costs and holding medical providers hostage to their antics.
We need to direct our angst and shake our fists at them...the insurance companies...and remind them what game they really are in - supposedly taking care of people medically - rather than taking care of those at the top rung of the organziations financially. Or dismantle them completely, making the health care industry competitive with their pricing, just like every other business in America. I'd like to think this ACA thing will work...but knowing how selfish our culture has become, I doubt it. We'll all pick and choose the things we like about it - like no denial of coverage due to pre-existing conditions, or keeping our older children covered - but overall it won't work if everyone doesn't play.
Overhead at the tonight at the local Emergency Room: Patient to nurse, "Thank you so much for your help." Nurse to patient, "That's what I'm here for. That's what we're all here for...to help." Maybe they should tell that to the insurance companies.
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