Conventional wisdom holds that it is impossible to compare prices for medical care as consumers do in other markets. But it’s not only possible, it’s easier than most of the naysayers realize.
For the critics, the argument comes down to one thing: There’s a lot of information out there, and it can be confusing for laypeople to sort out what kind of care is appropriate and how they can get the best deal on it.
But shopping for care and lowering costs don’t necessarily mean poring over websites to compare the benefits of medications and treatments, and then hunting for the best price that’s available for them. With just a small effort, anybody has the chance to drastically lower their health-care costs—without committing to undertake a daunting amount of research.
Here’s a look at some of the steps anyone can take, to show how easy the process of lowering costs can be.
Start with your doctor’s office. Physicians are very willing to discuss lower-cost treatment options with patients. Often, merely asking doctors questions about cost and financial concerns is enough to prompt the doctors to recommend less-expensive care or simply monitoring a condition to see if it gets better on its own.
Being smarter about prescription drugs represents another simple technique that can have a big impact on patients’ costs. And, again, it’s not a matter of comparing the efficacy of different treatments yourself—simply tell your doctor that the cost of medicine is a consideration.
The free drug samples doctors often hand out are for brand drugs, which typically come with high prices once you need a refill. Patients can start by asking their doctor if he or she can prescribe a less-expensive generic drug instead.
It’s also possible to compare prices for diagnostic services and lab work. Consider my wife’s experience in scheduling a CT scan. When she called a local hospital outpatient clinic, she was taken aback when told her share of the cost would be $2,700. I’m a former hospital accountant; hospitals charge higher prices than anywhere else. Avoid them if you can.
I used Google to check for CT scans using the billing code my wife’s doctor had ordered. In less than 10 minutes, I found a cash price for $403 that included the radiologist fee. Always ask about cash prices; they are often cheaper than your insurer’s negotiated price. (But remember: Paying cash for these kinds of procedures may not count toward your deductible.)
Critics argue that the public doesn’t seem to want to shop for health care. People want to get quality care and be confident about their choices, so they would rather make a choice based on personal recommendation, not price.
What’s more, these naysayers argue, patients lack a sufficient incentive to shop for care, because how much they save depends on how their benefit plans and deductibles are set up.
It’s certainly true that Americans want to know they are getting good care, and they are unlikely to switch doctors to save small amounts of money. If there were no consequences, of course they would choose convenience and peace of mind like they do in any other market.
But people are losing that luxury. The average employee deductible for self-coverage is soaring—to the point that many families are essentially paying all of their medical bills out of pocket. That means that people won’t be able to avoid the incentive to shop around for care.
As for the argument that many Americans can’t do simple shopping because they don’t have access to a lot of providers, they can still ask their doctor about less-expensive treatments for their condition. And they can still pay the cash price for their service out-of-pocket, which is often less than their health plan’s negotiated price. An hour’s drive to a neighboring town for an MRI or CT scan could save hundreds, maybe a thousand dollars or two.
Acting like a prudent health-care consumer is not that hard. And consumerism spurs providers to act more like competitors.