Managing the cost of healthcare

Doug Horn

Of all the costs we incur in our lifetime, the cost of healthcare is one that is difficult to control. Often there is little time to shop for required healthcare. My wife recently needed to have her gallbladder removed, and she would not let me shop the cost of the removal on the Internet. I asked, “How else we can control the costs, if I cannot do a price comparison?” I shop prices for my hunting equipment, so why not a gallbladder surgery?!

While you may have chuckled at my request, the fact is most healthcare services provided are not negotiated by the patient. If insurance is involved, it is likely the healthcare provider has agreed to certain prices or standard billings, but getting two for one or ten percent off is not something that generally happens with healthcare. Special pricing for services may be accepted by some medical offices, while others may not consider it. If insurance is not involved or there is a high deductible on the coverage, some practitioners may be willing to offer a lower price for office visits. They may require full payment when services are provided and require the payment is made with cash or check rather than credit card; thus, this saves them the credit card fee. To see if this is possible, it should be discussed with the office manager or physician prior to the first appointment.

Another area where costs may seem out-of-hand is services provided to Medicare patients. I am sure we have all heard the stories where the one aspirin pill was billed to Medicare for fifty dollars or more. While the costs of these services may not come directly out of your back pocket, we all contribute to the cost of this care through our tax dollars. Medicare fraud can be reported at www.medicare.gov. Since Medicare services are paid by the government but they are not the recipient of the care, they do not know whether the services were actually provided or not. The patient is often the key factor in discovering the fraud that occurs.

If there are procedures listed on the billing you do not recall, the government asks that you first check with the physician or provider to confirm the items. Doing so enables simple mistakes to be corrected by the provider. But, if fraud is still suspected, then you should document the concern with the provider’s name and any identifying number; the item in question; the date the service was provided; the amount approved and paid by Medicare; the name of the Medicare patient and their Medicare number; why the claim should not have been paid; and other key information to support the concern. Doing this may help lower taxes we pay.

Another area for concern is the cost of dental care. It seems today there are more gadgets in and surrounding some dental chairs than an airplane cockpit. For some, today’s dental care is no longer the simple teeth cleaning and the occasional filling of a cavity. It involves the byte wing x-ray, the panoramic x-ray, whitening, taking pictures of the tooth’s surface, cancer screens, building up a tooth or grinding it down… Like all professions, there are thousands of talented and caring dental professionals and then there are a few bad apples. It seems the few bad apples are now looking for ways to create additional revenue from the dental chair. I have been told some dental offices track the quality and selling skills of each hygienist by the number of additional procedures they sell. Since when did meeting sales quotas define a quality dental hygienist? It is unfortunate this is occurring in such a reputable profession. For many patients, they will respond to these recommendations (really sales pitches) with “when do I need to get this done?” This most likely is due to the trust they have, never realizing some of these recommendations may not be necessary.

So, before agreeing to extra laser applications or other services which may be unfamiliar, ask questions and become informed. Determine whether the treatment is medically necessary and why it is needed now. Ask if there are steps that could be taken personally to resolve the issue without treatment. A second opinion may also be prudent. Today when budgets are still tight for many, it is inappropriate to spend funds on treatments which may not be absolutely required.

This is similar to the services and products provided by many financial professionals. It is sad, but consumers should remember not all professionals, regardless of the profession, deserve their unquestioning trust.

For assistance with portfolio allocations, insurance, estate planning, or investment management contact me at Quality Financial Concepts or one of the other Certified Financial Planners in our area. To continue a personal quest for education, you can also view our learning center on our website, www.goqfc.com. There you will find articles on a variety of topics, on-line seminars, calculators, as well as a host of other free tools.

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