Hidden health care costs ramp up patient aggravation

More and more employed people who have health insurance are facing large deductibles so they are actually paying "out of pocket" for tests, X-rays and doctor visits. Health care policy-makers talk about involving the consumer in the cost of care as a way to force competition and hold down prices. But finding out how much something costs can be a herculean effort and take hours of time phoning around. Despite a law in California that dates back to 2006 that requires hospitals to post common test prices, it is nearly impossible for a patient to find out ahead what something costs.

I gave my patient an order for a hip X-ray to evaluate pain that would not go away. Because she has a $5,000 deductible with Anthem Blue Cross insurance, she knew that she would be paying for it. She spent hours calling local hospitals to compare prices and became more frustrated and confused as time went on. She was told they couldn't look it up without a code. She was asked what hospital campus she would use for the X-ray (implying there are different prices at the same hospital if you used a different X-ray machine). She was placed on hold and cut off when transferred. She was quoted a price of $745 at one hospital and $886 at another and this did not include the radiologist fee for reading the X-ray.

I have advised her to call her insurance company, but I have doubts they will tell her their contracted price (which becomes her cost) in advance.

This is the reality of health care in the United States. Even patients who have insurance struggle with decisions about cost and benefit of tests and spend hours trying to get information to make health decisions. It is time for patients and employers who buy health insurance to stand up and demand transparency of costs.

This post originally appeared at Everything Health. Toni Brayer, MD, FACP, is an ACP Internist editorial board member who blogs at EverythingHealth, designed to address the rapid changes in science, medicine, health and healing in the 21st Century.