Post # 1
So in January my husband and I both caught the flu, and it was bad enough we went to the doctor for it (we couldn’t really move, had 102 degree fevers, and had coughing fits so bad we couldn’t keep food down. We had Influenza A). We have a high deductible insurance plan and HSA, so a lot of general stuff gets covered through the HSA (which has tax benefits, but it’s still our money going into that account).
We went through a General Practitioner, not urgent care. The doctor saw both of us at the same time. We had to get tested for which flu strain we had. We spent only a few minutes with our doctor – probably about 10-15 minutes. We recently got the bill, and it was $986. Insurance covered some of it, so we have to pay $654. By the way, this does not cover our Tamiflu prescription, which we picked up elsewhere for another $50.
I get laboratory testing’s expensive, but we’re paying $350 just for the visit! There’s no reason why a basic doctor’s visit should cost this much!
Post # 3
- Wedding: March 2012 - Pelican Grand Beach Resort
I completely agree. This is why the ACA fails, in my opinion… it does nothing to control the costs of healthcare, which are outrageous and not actually in keeping with the costs of service.
Post # 5
Is that normal? I don’t think I have ever paid for any doctor visit or medical tests.
Post # 6
@mrsSonthebeach: That’s my beef with it, too, and it’s the underlying problem with healthcare in this country. Our costs are just too high (and this becomes pretty clear when you compare costs to Canada, for example).
Post # 7
This is why for-profit health care is generally a bad idea. The consumer can’t usually shop around like they could if they were buying a car or some new socks. The vendor has all the power in the relationship. And they can (and do) charge more than if it were a highly regulated, not-for-profit industry.
Post # 8
@MrsN14: it depends on the sort of insurance you have. Low-deductible insurance, usually not.
My husband’s employer changed insurance to high-deductible PPO and HSA. HSA’s are sort of like a tax-deferred savings account that both you and your employer put money in, and if you have one, you usually have a high-deductible account. With a high-deductible account, there’s a higher cap on what expenses you cover until your insurance kicks in.
Post # 9
- Wedding: March 2012 - Pelican Grand Beach Resort
@MrsN14: Even with normal insurance, you usually have to pay a co-pay for visits and co-insurance on tests. Usually these co-pays and co-insurance payments do not count towards your yearly deductible. Because of the ACA, a yearly well-visit must be covered fully by the insurer.
Post # 10
Just an FYI before we start bashing here. The healthcare insurance companies do not set the prices. Many factors are in place to the prices, between age, gender and location of where you live. Also what the actual clinic/doctors charge.
I work in the healthcare insurance industry for the past 9 years.. there is more than meets the eye on what the average joe sees.
Post # 11
@Horseradish: YUP. There are also a lot of intentional economic inefficiencies to keep costs up as well.
Post # 12
The consumer also needs to call their doctor on some of the things they do and tests they order. In this case there is no need to send off specimen to test for the strain of flu. The choice of prescription, Tamiflu, is the same no matter what the strain of flu, so that is just money down the drain.
We need to ask our doctors “Will this test make a difference to your treatment plan?”
Post # 13
First off, sorry you and your husband were so sick. That is never fun 🙁
Medical costs have really gotten out of control in this country. There are a lot of composite reasons, but a large part of it is the trickle-down effect from 2 sources: high costs of medical education training and poor reimbursement from state-funded insurances for medical costs.
Doctors, nurses, etc. spend a ton of money training to get their degrees. The sheer cost of going to school is outrageous and many schools keep upping their fees. The salaries for health care professional reflect this, and unfortunately part of the cost must be passed to the patient in terms of increased office fees.
Secondly, many government funded health insurances (medicaid, medicare, CHIP, etc) give crap for reimbursement, but these people make up such a huge chunk of the patient population that doctors can’t just say “no”. Many office do limit the number of gov’t funded insured patients they will have just because how much they get paid is fixed and really low. Again, passing on costs to other patients.
The same is happening at the pharmacy – govt reimbursement for drugs is absolutely terrible, so the cost gets shunted to increased prices for everybody else. Margins on drugs are just not what they used to be, and cost of school for pharmacists is increasing just like doctors’ training.
Overall, it just stinks. You’re stuck paying out of pocket for a huge expense if you choose a high deductible health plan, or you could be paying premiums out the wazoo if you go for comprehensive coverage. Even getting a flu shot may or may not have prevented your illnesses, as the A strain is particularly virulent this year and some vaccinated people are still becoming ill (albeit not as badly as those unvaccinated).
Post # 14
I think you did a great job of explaining why we are over simplifying the issues at hand.
Post # 15
@julies1949: THIS. THIS EXACTLY.
Im a trainee doctor in England UK, and we *ONLY* do a test if the result will make a difference to our management plan. A few of my friends are originally from the USA and Canada, and they comment a lot on the sheer cost of tests over there, and how they are often done for the sake of it, rather than necessity.
Its a sad situation that it should be the patients responsibility to question whether the test is necessary, but in the same respect i have had patients from the USA seriously berate me and my seniors because we are reluctant to spend NHS resources and send them for CT scans and MRIs for something as simple as a first occurance of a migraine, responsive to treatment. Sometimes i think patients have unrealistic expectations of what care they should be getting, and this could be contributing to the vicious cycle of doctors over-investigating/diagnosing.
Bottom line though, this doctor should have known better than to be ordering those tests.
Additionally, im a bit perplexed as to why you were given tamiflu. In the UK tamiflu is highly controlled and is only given to those are high risk (eg diabetics who become very unwell), and those who are in hospital with it, in order to reduce drug resistance… Im so sorry your bill is so high! Im not sure what the answer is with regards to health care. You guys have it bad with the lack of cover and cost, and in England the NHS is falling apart because we cant afford it. I often wonder how Canada and Italy are making it work…
Post # 16
@pharmy: we both had our flu shots – our symptoms were really bad for about 4 days, which from what I understand is the lower end of things. my mom was really sick for 2 weeks with the same thing, and did not have her shot . And thanks for the explanation, that all makes a lot of sense. I think the bottom line is that we need serious health care reform in this country.
@julies1949: lesson learned.
@Rachael1287: interesting to hear from someone in the UK – that was informative!