Unhealthy Discontent

Last weekend I got sick. I had chills and a fever with no cold symptoms, and developed searing pain, swelling, and redness in the lower calf of my left leg. It was weird, and I was worried. Thankfully I found a walk-in medical clinic open on Sunday, where I was duly diagnosed with cellulitus [warning: yucky photos, not of me].

Within 48 hours of being placed on high-powered antibiotics, all of my symptoms disappeared, and I’m still doing great today. Everyone involved, from the reception staff to the Nurse Practitioner that helped cure me, was fantastic. I am extremely grateful that such excellent care was available on short notice, during a weekend. Without it, I would have probably gone through the ordeal (and cost) of an emergency room visit.

Now that the whole thing is over, I’ve discovered something completely unexpected:  nobody can tell me how much my visit cost, and I won’t know for weeks. This is a problem because I’m one of the growing number of Americans with a High Deductible Health Plan, and I have to pay the first $2,500 of each year’s medical expenses out of my pocket. I actually love the plan because it puts me in control of my healthcare spending, lets me build an extra cushion for retirement, and provides an excellent safety net if anything truly catastrophic should happen.

It makes me think long and hard before I make a weekend visit to the doctor, too. I naturally asked how much it would cost as I phoned to set up my initial visit, and was told that it depended on what was needed to diagnose the problem. Fair enough. I still decided to go. I felt as though my problem was important enough to treat immediately, and that this was the best alternative to an emergency room I could find.

After my visit was over, I was again told that there was no way of knowing how much I’d need to pay until it went through the billing office during the work week. “No sweat,” I thought. “I’m just lucky they were open on Sunday.” Last Friday, however, I called the billing department, and for the third time, nobody could tell me how much my visit cost. What about the follow-up visit I was asked to make? How much would that cost? There’s no way to know that, either. I was floored. Am I that naïve to expect an answer? Evidently so.

I spoke to helpful, knowledgeable, and understanding people. I didn’t get the sense that they were intentionally giving me a hard time, and I tried to be as respectful as possible when we spoke. They genuinely don’t have access to enough information to tell me how much a doctor’s visit will cost, even if they wanted to. The majority of patients have a copay that doesn’t vary, and insurance covers the rest after the required paperwork is submitted, so it’s usually not a problem. Each plan and company simply has different levels of coverage, making it impossible to determine prices until the full process is complete.

As a result, I am literally at their mercy. I’ve obligated myself to pay for something and have no idea how much it will be. I can’t think of any other business transaction that works this way. Where else do you agree to use a service before knowing its price structure, and don’t find out what you got yourself into until weeks later?

In the end I’d make the same decision again, without hesitation. The care I received was excellent and necessary. I’ve just received a first-hand glimpse at one small part of how broken our healthcare system is, and I’m flabbergasted. Now, I have to figure out what to do about the follow-up visit…

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