How often do you go to the doctor? If you are like me you don’t go often because it is inconvenient and expensive. Health issues tend to pile up. When something comes along for which I really need immediate treatment, I make an appointment and I go. Now, the national average cost for a visit to the doctor’s office is about $65. That, however, does not tell the whole story. If I go in for a sore throat and I am seeking an antibiotic, I also do a “health care dump”. “Doc I have a sore throat, but there is more. My elbow hurts, I have a mole on my arm I would like you to look at, allergy season is coming and I need a new antihistamine, and I am about out of my asthma medication.” My doctor listens intently and taps away on this little electronic note pad. He then diagnoses and prescribes something for each of my illnesses. Each malady is an International Classification of Disease (ICD). Each prescription is a Common Procedural Terminology (CPT). For every CPT, the doctor is reimbursed. So, when I go in for my sore throat which should cost me $65, I walk out of there with a bill for $300! This leads me to my second observation. Insurance co-pays are going away in all but the most “cadillac” of insurance plans. The co-pay will be replaced by higher deductibles. For most people the significance of this is lost, but when you combine the “health care dump” to the end of co-pays, you get a very significant monetary event. Before, I paid $15 to $25 for my co-pay and I could tell the doctor everything that was bothering me. I would do so because it was convenient and because I was making the best use of my co-pay. The insurance company paid the remaining $285 for the CPTs. Now, if I have failed to exceed my deductible, I have to pay the entire $300. It shifts the cost burden away from the insurance company and on to the consumer. In some ways, this is a good thing. It forces the consumer of medical services to shop for a better deal in health care. However, it could mean that I opt not to have the doctor help me with my elbow or take a look at the mole. Maybe I do without the asthma treatment, which, during an asthma attack, can put tremendous strain on my heart. No, the best solution is not to eliminate care, but to find a more cost effective delivery system. Many telemedicine offerings will do the entire “health care dump” for a flat fee. Viva la consumer!!!!
Posts Tagged ‘benefits’
How Many Things are Wrong with You??
Wednesday, February 24th, 2010Creative Solutions
Wednesday, January 20th, 2010If companies like Aetna, Humana, United Healthcare, Blue Cross/Blue Shield, Cisco and many more have already stepped up and pledged millions of dollars to advance creative IT healthcare solutions, I would think it is time we listened. With the aging population, fragmented care, a looming primary care physician shortage and a healthcare debate that may never be settled, it will be up to the marketplace to demand change. The most effective solution (a biased opinion no doubt) is to embrace telemedicine in all its forms at all levels. The technology is here and technology is the key. The infrastructure is growing exponentially and the advantages FAR out way any outdated notions about its ability to drive change. We will go kicking and screaming no doubt but we WILL go. The sooner we get on board the better. If you own a company, work in HR or have any say so in the benefits your employees or customers have access to then do your homework. Keep an open mind and realize that we are on the cusp of a changing and far more enlightened and advanced world than we have ever seen. Earth changes, global-warming, global economy… (more…)