Skip to main content

The Parable of the High-Deductible Health Plan and the Careful Shopper

I carry - and pay for - my own health insurance now that I'm self-employed and don't have some rich health system footing the bill.  Though generally healthy, I do take meds for cholesterol and seasonal allergies, wear contact lenses and faithfully keep up with the routine screenings recommended for an old fart. 

My plan is a Blue Cross high-deductible plan where I carry the first $2,500 of financial responsibility.  Man, overnight that turned me into a different kind of patient and health care shopper.

No more Zocor for $90 a month.  Now it's WalMart's generic statin for $5.  (I've always hated WalMart and don't know which is worse; the price of setting aside that hate or the fact that the price is so low.)

No more going where my doctor tells me for lab tests and EKGs.  His in-house phlebotomist is convenient but pricey.  The hospital up the street is service-constipated, their billing is aggressive and nasty and their prices are worse - when they know what the prices ARE.

Suddenly I've got other labs and testing facilities falling all over me to extend discounts.  Two percent for cash?  Not good enough?  How about a 50% discount on all fees - facility and professional - and 60 days to pay?  Sold!

Maybe an expanded business opportunity for the "buyers agents" out there- expert negotiators who assist people like me in finding the best self-pay deals.  And a new opportunity for growth-focused health care strategists.   There's lots of would-be customers looking for a price.  Customers just like me.  Well, better looking perhaps, but you know what I mean.

Comments

Popular posts from this blog

Michael Porter On Health Care Reform

Michael Porter, writing in the New England Journal of Medicine, proposes "A Strategy For Health Care Reform - Toward A Value-Based System." His proposals are fundamental, lucid and right-on, meaning they're sure to be opposed by some parties to the debate, the so-called "Yes, but..." crowd. Most important, in my opinion, is this: "... electronic medical records will enable value improvement, but only if they support integrated care and outcome measurement. Simply automating current delivery practices will be a hugely expensive exercise in futility. Among our highest near-term priorities is to finalize and then continuously update health information technology (HIT) standards that include precise data definitions (for diagnoses and treatments, for example), an architecture for aggregating data for each patient over time and across providers, and protocols for seamless communication among systems. "Finally, consumers must become much mor

Being Disrupted Ain't Fun. Deal With It.

Articles about disrupting healthcare, particularly those analogizing, say, Tesla's example with healthcare's current state, are frequently met with a chorus of (paraphrasing here) "Irrelevant! Cars are easy, healthcare is hard." You know, patients and doctors as examples of "information asymmetry" and all that. Well, let me ask you this: assuming you drive a car with a traditional internal combustion engine, how much do you know about the metallurgy in your car's engine block? I'll bet the answer is: virtually nothing. In fact it's probably less than you know about your own body's GI tract. Yet somehow, every day, us (allegedly) ignorant people buy and drive cars without help from a cadre of experts. Most of us do so and live happily ever after (at least until the warranty expires. Warranties...another thing healthcare could learn from Tesla.) Now, us free range dummies - impatient with information asymmetry - are storming healthcare

My Take On Anthem-Cigna, Big Dumb Companies and the Executives Who Run Them

After last Friday's Appeals Court decision, Anthem's hostile takeover of, er, merger with Cigna has but a faint pulse. Good. Unplug the respirator. Cigna's figured it out but Anthem is like that late-late horror show where the corpse refuses to die. Meanwhile, 150 McKinsey consultants are on standby for post-merger "integration" support. I guess "no deal, no paycheck..." is powerfully motivating to keep the patient alive a while longer. In court, Anthem argued that assembling a $54 billion behemoth is a necessary precondition to sparking all manner of wondrous innovations and delivering $2.4 billion in efficiencies. The basic argument appears to be "We need to double in size to grow a brain. And just imagine all those savings translating directly into lower premiums for employers and consumers."  Stop. Read that paragraph again. Ignore the dubious "lower premiums" argument and focus on the deal's savings. $2.4 billion saved