Patients Blind When Health Care Comparison Shopping

“The patient really has no way to act as an informed consumer,” Dr. Smith said. “You can’t call up a facility and say, ‘By the way, is my doctor any good?’ or, ‘Tell me who the best one is.’ “—A doctor responding to a study that found some doctors were 10 times better than other doctors at discovering precancerous lesions through colonoscopy. [NYT]

Comments

Edit Your Comment

  1. sophistiKate says:

    “10 times as better as”? Really?

  2. Bladefist says:

    YES. This is the health care reform we need in America. Allowing capitalism in Health Care Industry. Allowing informed consumers to make choices. Allowing the best Drs to make the most money and the terrible Drs don’t make it.

    This is the reform we need, not a 20 trillion dollar Liberal universal healthcare that will drain this economy even more, and turn hospitals into the DMV.

  3. Sudonum says:

    As I get older I see this as part of the problem with health care. The consumer of the product is not directly involved in paying for the product, therefor they have no incentive to shop for the best price or otherwise keep costs down. You don’t pay for the Dr’s visit, your insurance company does, if you’ve got insurance, that is. And while there are those who will rightly say that you should spare no expense when it comes to your health, there should still be market forces to keep costs competitive.

  4. samurailynn says:

    Seriously, our health care is messed up. I wanted to shop around at different pharmacies to see which would be cheapest to get my husband’s prescription at. I was told that they cannot tell us how much it will cost until they fill it, but that we don’t have to buy it after they fill it. It would probably take us more time to go around filling and not purchasing prescriptions at different drug stores than it could ever possibly be worth.

  5. itsallme says:

    @samurailynn: Try pillbot for pricing. [www.pillbot.com]

  6. caranguejo says:

    I work in healthcare, and at our facility we are not allowed to comment on the efficacy of our providers when asked by patients. We always get asked, and the response is always that we’re unable to make those kinds of comments. We also get asked about doctors sex, race, religion, and other things we’re not allowed to comment on either. All the patient gets is a name in the mail for their appointment reminder letter.

    The way to get around this is to just ask the secretery to make the best decision for you as the patient. That way, the secretery isn’t actually commenting on the providers abilities and violating ethics/policies, but they will set you up with someone appropriate and probably the best provider there.

    The only other tip that I can really provide is to just be polite but also to know exactly what you want when you’re calling. Nine out of ten patients do not know what they need in terms of their care, and they’re also incredibly rude and make demeaning comments on the phone when asked questions. Patient knowing exactly what they need = patient getting the best doctor to get the job done, and less time spent on the phone trying to figure out how to book your appointment.

    Hope this helps anyone that’s concerned.

  7. averyml says:

    @Sudonum: Our healthplan does, supposedly, encourage us to “comparison shop.” But, unfortunately, the industry isn’t really set up that way. Try calling three different hospitals and asking them how much it costs to get an MRI.

  8. gorckat says:

    @Bladefist:

    Allowing the best Drs to make the most money and the terrible Drs don’t make it.

    Somehow I’d expect poor people to continue to get bent over and shafted with paying the “cheap” doctors (whom I expect would have rates similar to what they are now, while the good ones charge more) for subpar care.

    Or is that the purpose of your proposal, judging by your avvie (I kid…on the level :P)

  9. DevPts says:

    @Bladefist: Absolutely ! More often than not informed consumers will seek the lest expensive of the available options therefore driving costs down.

    There are those, of course, whom are willing to pay a premium (read: larger cost) in the, oft-time, mistaken belief they are receiving something better than the other guy.

    Either way; truly informed consumers tend to educate each other of the real value of a product (regardless of the product).

    If you never see the bill do you really care what the cost is ?
    If you can’t compare services with any certainty how are decisions being made, by lack of choice leading to defacto selection ?

    Perhaps the Democrats got it right… let the government pay for it so the cost can never really be regulated by Mr. Market.

  10. MaytagRepairman says:

    I had a similar problem when diagnosed with sleep apnea and needed a cpap machine. None of the local “in the insurance network” medical suppliers had any prices on their web site. When I approached a company their representative couldn’t even tell me how much the machine I was prescribed cost. “That is negotiated with the insurance company at the corporate level.” They couldn’t tell me the cost of the machine but they could tell me the cost of the accessories — $49 for the plastic tube connecting the mask to the machine which could be found online for $10. Too bad the online company couldn’t bill my insurance.

  11. camille_javal says:

    @samurailynn: I was told that they cannot tell us how much it will cost until they fill it, but that we don’t have to buy it after they fill it.

    Who said this? Your insurance company? The pharmacies? The pharmacies should be able to give you the basic, out-of-pocket price without filling it; if they claim otherwise, ask why (because they might be lying). If it’s your insurance, find out the details of your policy, and you should be able to figure it out combining that information and the prices from calling the pharmacies. (E.g., my current policy has a three-tier pricing plan, so they can tell me which drugs are in which tiers; my old policy was coverage up to $60 a month, so shopping around was important – Costco has always had the best prices, by the way, to lift from another thread – you used to not have to be a member to use their mail-order prescription system.)

    If a pharmacy ever claims they cannot tell you the price over the phone, and tries to claim some state regulation preventing them, there’s a 1979 (? or 1980) Supreme Court case that says otherwise.

  12. alice_bunnie says:

    @DevPts:
    If you never see the bill do you really care what the cost is ?

    On the other hand, when you call the hospital to dispute the bill and the billing person says “Don’t worry about it, insurance will pay for it.” and you feel like beating them through the phone. Who do they think pays for the insurance?

    Perhaps the Democrats got it right… let the government pay for it so the cost can never really be regulated by Mr. Market.

    And, I feel like beating people like that through the computer? Who do they think pays? Because, in the end it isn’t “the government” that’s paying?

  13. Bladefist says:

    @gorckat: Yes and No. Just like with any product, cheaper doesn’t always mean worse. I always buy the store brand cereal because it tastes the same but is a $1 cheaper.

    On the other end of that, sure, people who are poor could get sub-par health services. And I know it seems mean, but thats America. No where in the constition does it say the government should provide healthcare, or that we should all receive the same level of health care services. This is not a socialism, we are not all financially equals, and your only right is to pursue happiness, not actually be happy.

    So will bill gates probably have better health services then Jim Bob the gas station attendant? Absolutely. Is that cruel? No. I’m a constitutionalist, which by that regard makes me a conservative, and if you want everyone to be the same, move to China.

    Here, you have to pursue happiness, and there are winners and losers and that is what makes this country so great, is because we have motivation every morning to get up and do our best. So we can provide for our families better.

  14. rhombopteryx says:

    “Comparison Shopping”

    Really?
    The average american barely has health insurance, with that insurance limiting them to the few doctors who’ve agreed to cut enough corners to get their prices down to the insurer’s level.

    This is like saying the average starving Ethiopian doesn’t know how to pick the most healthy desserts.

    I feel really bad for that poor, poor medical consumer who has a choice of which health care they’ll receive, and then blows it because they aren’t better informed…

  15. DevPts says:

    @alice_bunnie: You evidently failed to see the dripping sarcasm of my remark.

    The government needs to stay away from my health care. Insurers need to go pack sand right up their arses. And un-informed remarks like yours make me want to write a letter to the legislature eliciting more funds for education !

  16. samurailynn says:

    @itsallme: Thanks for the suggestion, but the prescription wouldn’t come up under brand name or generic name.

    @camille_javal: It was the pharmacy saying that. It could have to do with the fact that I wanted to know the price using the Oregon Prescription Drug Program. We pay for an individual plan for my husband and I wanted to see if it is worth it to keep paying for the prescription portion of that plan. The OPDP is basically a discount program but I used it for an antibiotic and the price went from $32 to $5. I just wanted to compare the cost of paying for a prescription insurance plan with using the OPDP, but they were saying I’d have to fill the prescription before they can tell me how much I would have to pay.

  17. johnva says:

    @Bladefist: So your assumption is that people who are too poor to afford healthcare got that way because they were too lazy to work hard enough to get ahead?

    I’ve got news for you: a lot of the things that influence our healthcare costs and ability to pay them have NOTHING to do with hard work. Should people who get injured on the job and lose their ability to work in their profession just get thrown to the wolves? Because that’s what happens to a lot of people in low-income industries. What about children of poor people? They should get poor healthcare simply because their parents were poor for whatever reason? What about people with genetic diseases or predispositions? Is that just their tough luck that they were born that way, and you’re A-OK with the insurers charging them 25x more or denying them coverage altogether?

    We don’t live in a libertarian utopia. The free market promotes efficiency in a lot of areas, but its unregulated application to healthcare ends up promoting vast inequitability.

  18. Bladefist says:

    @johnva: Thank you for illustrating my point. Liberals are all cry-baby. Waaaaaaaaaaaaa it’s not fair!!!

    Move to China where it’s fair.

    I am not rich, I have been lower class my whole life until recently I am middle class now. I’ve gone without health insurance, I’ve paid 400$ for health insurance. It pisses me off. But it’s not the governments job to watch over me.

    Also I didn’t call anyone lazy. I searched the page for ‘Lazy’ and the only time it came up was from you. Some of the hardest working people make the least money. That’s because they are doing unskilled work. Anyone can mow a yard. The rich people have gambled w/ their livelyhood on investments. Thats working hard as well.

  19. gorckat says:

    @Bladefist:

    I always buy the store brand cereal because it tastes the same but is a $1 cheaper.

    Good point- I often buy the cheap cereal, too :P

    I disagree that just because the constitution doesn’t say everyone should have universal health care means we shouldn’t look for a way to make it possible.

  20. Bladefist says:

    @gorckat: Regardless of all the arguing going over, I truly believe this country will never have universal healthcare.

    We cant afford it. We would have to give up tons of other programs, or significantly raise taxes. If taxes went up enough to pay for it, there would be protests in the streets.

  21. ThomasD3 says:

    look at Europe: yes taxes are high, but healthcare is significantly better. Look at Canada as well.

    Everyone bashes universal healthcare as if it was communism. What healthy society preys on their own? Even Iran has universal healthcare.

    We have lots of great things here, but healtcare and education are pathetic and universal healthcare seems to work for other countries, some more free, some less free than us. We know now that unregulated capitalism can not provide healthcare and this site is the living proof we can not trust businesses to regulate themselves; universal healthcare has worked for decades for many countries, it can work here too; we just need to start to accept that maybe we can also take lessons from others instead of pretending we’re always right.

  22. lakuma says:

    Watch “Sicko” !! I’m tried of paying $700 a month so that my family can have a sub-par HMO through my work, and I work for my county!! Bring on Universal Health Care!!

  23. mikelotus says:

    We can afford health care if we can afford Iraq. We spend more now than any country on earth for less results. Get it? Twice as much as France, the next most expensive health care for less results than France or any other western nation. Less results, get? More money, get it? If you ever believe that health care can ever be an efficient market, prove it right now or go away with your anti government rants.

  24. Bladefist says:

    @ThomasD3: Your points are great points assuming Europe and Canada are a success in the area of U-HealthCare. The only place I’ve head its successful is from left-win Michael Moore. Any friends I’ve had from there or people I’ve have talked to on forums from there, have only had negative things to say.

  25. Bladefist says:

    @mikelotus: If we aren’t safe, then healthcare wont matter because we’ll be dead. I’m not trying to Fear Monger, but the fact is there are people who want to kill us, and ignoring that doesn’t make it go away.

  26. ThomasD3 says:

    Bladefist:

    I lived in the Canada for 3.5 years, Germany for 2 years, and split the rest (I’m 35) between the USA and France.

    The other countries do have issues, and yes, there are many people unhappy about health-care problems. It’s only when you see what happens here that you realize the health-care complaints abroad are nothing as serious.

    You could compare that to them saying they have cars with bad mileage while our own is on fire and we don’t even admit we need a new one.

    Taxes are way higher in Europe, in Germany I lost 45% of my income to taxes vs 35% here. But I could pay 10 euro to see *any* doctor, my medications were between 3 and 10 euros each and none of the roads had potholes :)

    I just finished a hospital stay: the hospital charges 45 times (yes, 45) the cost of medication (if you buy it from the outside). The doctor charges $200 for 4 minutes of talking + 2-3 minutes of writing.

    I started a post at : http://www.sibylleandthomas.info about my story and I’m going to post a scan of the entiere bill in the next few days; it’s is completely insane and the ‘human side’ of care is really bad too in comparison.

    So, yes, u-health care has issue and is costly, but it does work. we pay more than other people and get less and even there we manage to screw it up by helping out unevenly… this is why something has to change.

  27. mikelotus says:

    @Bladefist: @Bladefist:
    right, iraquis are trying to kill us here. at least that will soon be coming to an end. and they spend less on health care in europe and they live longer and have lower infant mortality. as i said, show me a free market based system that works. i can show you one that does not — ours.

  28. DrNick says:

    Hey everybody!