By Dr. Tim Bartholow, WEA Trust Chief Medical Officer
For the last 30 years, health care costs for families have risen two to three times faster than their wages. For much of this time, we've said the cost of health care will break the system. In the last 5 years, employers have been unable to absorb those rising costs, forcing patients to take the increase. With average family deductibles at $4,000 and as high as $10,000, people are forced to make difficult choices between health care and other needs.
Of course, we should all be thinking about smart health care decisions, like knowing when you should visit urgent care versus the more expensive emergency room. But mothers shouldn't have to wonder if they should take their next dose of $100 migraine medication or schedule a $400 lab test. They shouldn't have to worry about affording an office visit for their child's ear infection because of the cost.
Many simply don't spend the money on health care because they can't, or they don't have it. In America today, we have too many people deciding between health care costs and putting food on the table. When families do not seek care, or take their medications because of cost, make no mistake, the cost of care is now a measure of its quality.
Is it complicated or simple?
Some will say health care is complicated and yes, navigating the system has to be made simpler. However, we should not excuse health care's clunkiness or rising cost by labeling it as "complicated." When it comes down to it, we do know what we want. We want an expert, who is acting in our best interest, who we can afford. It's as simple as that.
How do I know if I'm paying more than I should?
There are a few resources online that help you determine if you are paying a fair price. Click here for one example. If you go to the doctor, you can see on your explanation of benefits what your insurer paid and compare it to the website.
If you're paying bills many times more than what is a fair price, you may want to ask questions. Areas where I am most concerned about costs include radiology, medications and lab tests. These types of services are commodities, and commodities, like a gallon of milk for example, generally should be about the same price wherever you go.
I'm frustrated, what should I do?
We need our hospital systems to be focused on constraining their budgets while also being able to hire enough primary care physicians, behavioral health specialists, nurses and pharmacists.
Your health system needs to work with your insurer to help with the question, "Do I really need this?" Your health system needs to understand the pressures you face and that your wages simply can't keep up with these rapidly increasing health care costs. When you seek care, do you need to be seen in a fancy, glamorous hospital, or do you need care that you can afford? Tell your provider what tradeoffs you are making to afford your care and tell them what you truly need.
To further send this message, use health care services that are less expensive, like telehealth for example, for quick visits and opinions. Options like Smart Choice MRI for imaging services are $600, while other options across the state are over $2,000. In addition, there will be new solutions coming in the next couple years that will continue to disrupt the system as it is-pay attention to these options.
Why should I care about health care costs?
We want you to be able to afford health care-to not have it break your family budget. Making smart health care choices sends a message to health systems that you expect care that fits what you can afford, otherwise you will choose another option that does. This is the best way to make your point.
As the richest nation in the world, shouldn't we have a system that allows adequate care that families can afford?
It doesn't matter which insurer or health care system you have, at the end of the day, we all want an expert, acting in our best interest, that we can afford.
See? It's not all that complicated. Cost is now a measure of quality care and you deserve care that fits within your budget.