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“The sheer opacity and complexity of health care prices wastes patients’ time and, at times, undermines the legitimacy of the health system itself.” ~ Journal of Ethics | American Medical Association
** Note: You can also read Dr. Mara’s blog on Medium.
I write quite a bit about how the healthcare system, driven by profit-motive and influenced by ageist perspectives, often does not give our elders the care they would benefit from without constant advocacy by loved ones. However, we must also be aware that the profit-driven healthcare system requires vigilance for our own healthcare.
Recently, I experienced a common scam when I scheduled an imaging appointment for a simple follow-up ultrasound. I found this particular imaging center on Google, and it had all good reviews. I didn’t realize that it was attached to a hospital, nor did I understand what that would mean for me. I discovered one day before the appointment that this would mean quite a bit for me and my wallet.
I called the day before my appointment and asked them to run my insurance, so that I would know what I owed. I was told an amount that seemed extremely high, even with my excellent insurance. They would charge my insurance company nearly $1,000, leaving me to owe $675. Luckily, I remembered that I had this same scan a year ago in another location, and with terrible insurance, I might add, and I paid only a fraction of that cost. Ultrasounds usually are not very expensive. I had to push the billing representative on the phone to find out why the cost was so high. She finally told me that it was billed as an “outpatient hospital procedure,” since the imaging center is attached to a hospital. The “remedy” to this outrageous fee was to “offer” me a payment plan. I didn’t find that to be satisfactory. I cancelled instead, and let her know I’d look for another more reasonable facility to have the scan.
Later, a radiologist friend told me that, at hospital-affiliated centers, a very profitable “hospital fee” is added, even if you never set foot into the hospital. Plus, there is a separate fee for the radiologist to read the scan. Meanwhile, stand-alone imaging centers only charge one fee for the ultrasound, period. I also found out that NBC News recently did an exposé on this very scam!
Following my last-minute cancellation of that expensive appointment, I called a stand-alone imaging center, one that my chiropractor recommended. The price was $275, which is less than one-third of the first place, and that’s before factoring in what my insurance would cover.
After I discovered this shady billing practice, I called the person at the facility where I had scheduled that first appointment. “Why don’t you tell patients up front about the extra costs?” (Silly question, I know!). She answered, “There’s a sign on the wall in the office.” (I looked that up. It’s a Federal law to hang a sign.) In other words, after a patient arrives for their appointment, having done whatever they’ve needed to do to prepare for whatever scan they’re having, they may or may not see the sign. They might not even realize they need to read the wall signs! And, if they understand that they are being overcharged (that’s a big “if”), then they have to decide if they’re going to walk out right before the scan that they’ve gone through the trouble to prepare for — and find someplace else for the procedure.
I honestly would not have known I was being overcharged had I not had the same scan a year ago in a different facility. Now, there are times when it might be advised to go to a hospital-affiliated imaging center, such as when having a complicated scan or, perhaps, if you’ve just been in the hospital and your doctor is affiliated with the hospital. But, if you call for a simple scan, it’s not likely that the person scheduling your scan will tell you up-front about all of those extra, unnecessary fees.
This story is not unique to imaging. My particular experience was with an imaging center. But, in reality, healthcare has become so profit-driven that the patient’s well-being is often the lowest priority.
We, as healthcare consumers, really need to be active advocates for our own medical care. Profit motive healthcare affects all of us, no matter our age. We really need to do our research. Shop around the way you would when looking for a new car. Don’t just assume that any medical facility is looking out for your best interests. Sometimes they are… and sometimes they aren’t. Unfortunately, for some facilities, profit is the first priority. More and more Americans are facing steep medical debt, and some are even dealing with medical bankruptcy. Many are having to choose between putting food on their table or getting medical care.
The bottom line is that we need to be vigilant with regard to getting the medical care we need without being overcharged and going into debt for that care. And, we often don’t know we’re being fleeced until we know…and, hopefully, at that point, it’s not too late.
Google reviews aren’t always reliable, as healthcare facilities often remove negative ones. Ask people whom you trust in your community for referrals, based on their own experiences. Also, call the various medical clinics and ask for the prices.
We all deserve the best medical care without going into debt. And we all must be our own healthcare advocate.
You can read similar blogs by Dr. Mara at her website, where you can also listen to her internet radio show, now also on Apple Podcasts. Check out Dr. Mara’s internationally best-selling book, The Passionate Life: Creating Vitality & Joy at Any Age, now available on Audible in addition to digital and paperback. And get the link to the new Caregiver’s Advocate Vol 2 book, when it’s available, starting August 19, as well as information about Dr. Mara’s caregiving/advocacy coaching — launching soon! And be sure to follow her on Facebook for all the latest news!
