How to whip The Cost Beast and The Quality of Life Serpent
What we’d most want our friends and loved ones to know
As of 2016, the average cost of healthcare for a typical American family of four covered by an average employer sponsored PPO plan is $25,826.
Years ago we were shielded from the costs of our healthcare related products and services since our insurance (usually via employers) paid for almost all of it. As The Cost Beast‘s influence grew stronger and the costs of healthcare skyrocketed, these costs are increasingly being shifted to us in the form of higher insurance premiums, higher deductibles, more excluded benefits and a higher incidence of the use of out of network providers. These problems are made worse by the Quality of Life Serpent who encouraged the assumption that all care impacts everyone the same and in a positive manner (it doesn’t); more care is always better than less care (not necessarily); and that more expensive care is of higher quality (it’s not).
Finally, there is a strong institutional bias amongst providers to provide procedures, to do tests, and to prescribe medications. And there is an expectation on the part of patients that they receive all of the above. When in fact, this has often lead to over-diagnosis and over-treatment, resulting in harm rather than help as well as over payment. Our current environment is defined by paternalistic medical decision making where providers are not accustomed to offering patients treatment options that include information on anticipated efficacy, side effects, or costs. And the pharma and medical device manufacturers are applying extreme pressure and influence to keep it that way to maximize the use of their products, even when they’re to the detriment of the patient.
The result? Too often, we receive and pay for products and services that are of no help to us. Or that we did not ask for. Or that can even be predicted to harm us. Or we pay way, way more than reasonable and customary fees for what we do need. Untold retirement, vacation, education and other family savings funds have been unnecessarily depleted as a result. 60% of all bankruptcies include major medical debt. We don’t want you to be counted among this group.
Our goal as consumers should be to behave the same way we do as when we buy any other product or service. We should seek pricing transparency and information on anticipated quality, and we should actively seek what we consider to be high value. And we need to be prepared to just say no to tests, procedures, medications, and other services and products that have little to no anticipated value, or that can be predicted to harm us.
Nanny Cam photo suspected to be of a frustrated Cost Beast surprising young Winston Callahan the night of Oct 14th, 2014, while Winston’s parents were discussing the merits (few) and risks (high) of lower back surgery for Winston’s father.
How we might help
Provide the help we all need to spend wisely, recognize and seek value, and avoid unnecessary risk and even bankruptcy. At the end of this chapter, you will have a personal plan and a series of checklists to protect yourself and family from unnecessary costs and financial risks.
Some areas we’ll cover
How do I know about how much my anticipated healthcare services are going to cost? And how do I know I was charged a reasonable amount afterwards? (Includes downloadable checklists for outpatient and inpatient experiences)
Next: We win the game by paying a fair price for high value care. But the Cost Beast claims victory when he can lure you into avoidable overpayment.
The next areas we’ll cover soon
Thanks to all of those who have provided input so far. Based on what we’ve heard, these appear to be the next highest topics of interest that we plan on covering next:
If I need a procedure or to go into the hospital, they’re all pretty much the same in quality and cost. Right?
I’m sure others have the same condition I do, but there is no way that their experiences can help me. Or mine, theirs.
My employer provides my health insurance, so it doesn’t matter that I don’t understand it. I don’t have any alternatives, anyway.
My doctors and my hospital all have electronic medical records, so they must talk to each other and know what each other has done for and to me.
When I’m about to die, my doctors or my family will decide what’s reasonable to try to save my life. Or if I write a Living Will, it’s all taken care of and my desires will be followed to the letter.
All this wellness and value based consumerism stuff sounds great, but I’m too young (or too old) for all that. It can’t impact me at this stage in life.
This is America, and we’re the best at everything including healthcare. Right?