My not-YM approved move

[Ava]

Today, I did something YM would not approve; I purchased a service without knowing the price.
I'm sure everyone here would comment how impulsive and irresponsible I am.
Until I explain.
I've got a weird rush in my chest area for a few days. It itches like crazy. It has now spread to my arms and ankles. So I got scared. I went to the walk-in clinic as soon as I left work.
The lady that sits at the front desk did the paperwork. She made me sign several forms.
Then she proceeded to inform me that they would take the co-pay, but they could not tell me how much the visit cost would be, how much my insurance would cover, and how much I would have to pay out of pocket.
I was dumbfounded. You cannot tell me how much this visit will be? No, she said, there's no way of knowing.
I was so scared and desperate that I signed on the dotted line anyway.
It turned out to be a common infection. I still don't know how much this will cost me.
Does that make sense to you? You are buying a service without knowing the full price.
Say whatever you want about Obamacare, but the current system has to go.

[Deleted]

I think we all buy medical services without really knowing what they will cost us.

DH had cataract surgery.  We got the DOB (determination of benefits) for his new glasses.  They are covered but applied toward his deductible.  Medicare gets a second shot at paying.  If they don't, we pay.

We didn't know they were only $295 until the got the DOB.  It's not a big deal.  We both pay about $600 for new glasses regularly. 

The point is he ordered them without knowing what they will cost us.

[resolution]

I think that is pretty much standard, and I agree the system has to change so they at least give a price estimate. We took DH in a few months ago with chest pains and he got a CT scan. We had no idea what it would cost or if the insurance would cover it, but they recommended we do it immediately to rule out a blood clot. We found out later it would have been $1000 but the insurance covered it so we paid $40. 

[Ava]

resolution; that's great. But imagine if the insurance hadn't covered the procedure. That would be a completely different scenario. They don't even know how much insurance will cover. Don't they have charts, or schedules, of routine procedures? I mean, we are talking about pretty standard medical care.
I think it's so complicated because they (the medical institutions) want it that way.
They shouldn't be able to get away with it.

[justme]

If you went to an urgent care (in network if you have that type of plan) and they collected a copayment that should be it - unless than ran tests that weren't covered or you have a plan that charges you for any tests run during a Drs appointment. When I was on a copayment plan it was $25 Dr, $60 urgent care, and $100 ER. Beyond that copay everything else they did was covered (as long as it was something the plan covered) with no extra cost.

Urgent care is like the ER and it's hard for them to give you an estimate before you've been seen. They have no idea if you need tests or just a simple physical exam or any meds. If you're that concerned, after the Dr has filled out what they did they should be able to at least tell you what they bill for what was done (but to get that answer you may have to wait a bit after you're done with the Dr) - though your insurance will discount that.

[resolution]

I agree the system is broken. Unfortunately I don't think the Obamacare will fix that kind of problem, although it will establish out of pocket maximums that will afford some protection to people. CMS recently released hospital charges for the most common procedures and some hospitals charge three times as much as others, with no way to predict in advance.  www.bloomberg.com/news/2013-05-08/hospital-charges-vary-across-u-s-for-same-procedures.html

My view of it is that if he had a potentially deadly blood clot I would pay whatever I had to fix it. If it ended up more than we have, then we could bankrupt but he would still be alive.

[Ava]

You shouldn't have to go bankrupt for medical care.
I realize Obamacare is not the solution, but I think it's a step in the right direction. Something has to be done.
It's true that for Dr. office appointments you have a co-pay and that's it. But when it comes to emergencies, accidents, hospitalizations, you are at their mercy.
I'm not worried about my bill for today, even though I don't know how much it will be. I know I'll be able to afford my portion of it.
I'm just pointing out how unfair the system is. Some costs have been published, and there's no rhyme or reason to what different hospitals charge for the same procedure. Why is that? Who determines the prices, and what's the criteria?
Would you buy a car if you didn't know the total price? But you have to buy surgery and hospitalization without knowing the full price.

[resolution]

I would buy the car with no price if a family member might die without the car. That's the dilemma with health care.

[justme]

I don't know about other people's experiences, but if it's a planned surgery/procedure I've known the costs ahead of time. They have always told me the billed amount, what my insurance covers, and given how much I've paid of my deductible how much they estimate my portion to be. So the only unknown is when it's an emergency. Maybe they could have a list of what every procedure is billed at to show you - but that's not what your insurance allows which differs with each insurance. Would you rather them say "Well, we think you need a CT scan, but the biller is having problems with the computer so we can't get your estimate yet. Let's hope it's nothing bad while we wait!" or just do what's needed to be done when you go to the ER? I know when I went to the ER for a migraine the meds I have didn't work I would have told them to fuck off if they waited to give me meds/treatment until I was shown an estimate.

[haapai]

Realistically speaking, you knew walking into the urgent care center that there was a defacto limit on what it could cost you.   If they can't even set a broken bone, there isn't much chance that they'll diagnose you with lupus. 

In some ways, they did you a huge favor by telling you that they had no idea what the appointment and/or script would cost you out of pocket. 

The ER probably would not have been as up front, plus they would have lied about the waiting time.