Friday, December 3, 2010

RANT: Healthcare

This is such a controversial topic that I really don't want to get into it too deep. 

We lost our Health Insurance when my husband was laid off in 2008.  We took the gamble that as healthy young(ish) adults we would not need health insurance.  We opted to pay out of pocket for any services we may need.  (Don't even get me started on how much cheaper it is to use a midwife and a birthcenter instead of a doctor and a hospital.)  And today, I needed to go to the doctor... for the first time in 3+ years (other than maternity stuff). 

How do you decide where to go when you don't have a list of doctors set forth by your insurance?  Personally, I went to the doctor I went to before bcause they have a cash discount.  I got a 33% discount because I paid cash (or they take credit) on the day of service.  Yes, I even use coupons at the doctor's office.

Now, I have a prescription in my hot little hand.  Because I'm the one paying, I searched Wal-Mart's $4 generic list.  Nope.  I searched Target's $4 generic list.  Nope.  I searched Walgreen's $10 generic list.  Nope.  I searched RiteAid's $9 generic list.  Voila.  I already love RiteAid and the rockin' deals I got today so this is not so difficult.  I'll probably go ahead and get 90 days for $16... yep, another $11 coupon without clipping a thing.  I just wish they had one of their $25 new prescription coupons right now.  Shucks.

When I had insurance, I didn't think twice about it brand name meds were $15, generics were $10.  I think I was part of the healthcare problem.   
  • Do you think about how your healthcare dollars are spent? 
  • Would it benefit your family to pocket your employer's contribution and purchase a higher deductible plan on your own and just pay cash for simple office visits (out of FSA funds, even)?
  • Would the cost of healthcare decrease if there was competition?  (Dr A gives a 33% discount, Dr B doesn't, etc...)
Once the dust settles and our elected officials come up with a better plan... one that wouldn't fine my family $2400 for two uninsured adults, we'll buy catastrophic insurance with a high deductible for the whole crew.  One that covers annual checkups and well-child schtuff with little or no out of pocket cost to us.


  1. RiteAid's coupons (the ones in the circulars, anyway) are for transferred prescriptions only, so don't knock yourself out over that one. :)

    And even with insurance, the Rx stuff is crazy. I get prescription prenatals and they are $4 at Target (and QFC/Safeway/Fred Meyer who price match) but $10+ at other places. Often, my co-pay isn't even met, so i'm sorta in the same boat as you, shopping around for the best deal.

    As for competition, i assume you mean for non-emergency services? The problem is that it's very difficult to get that information. e.g. I tried to price what a c-section would cost without insurance coverage (long story) when i was pregnant with Reese and caused the billing manager a great deal of confusion (and i never did get a definitive answer). I am but a sample size of one, yes, and all i really have is anecdotal evidence (supplied by friends/family) to support it but i'm not the only one stymied when trying to find the cost of a procedure.

    I like the *idea* of high-deductible/HSA programs but my friends who have them say there are a lot of kinks that need to be worked out first. One friend (another sample size of one) told me she spends a ridiculous amount of time fighting for reimbursements - for very simple things as co-pays. Another friend (n=2!) kept getting billed at the uninsured rate because her providers didn't understand why she was paying out-of-pocket if she had insurance.

    The amount of time these two spend on the phone with CSRs (i.e. the amount of time CSRs spend on the phone with them) doesn't seem to be doing much for reducing health care costs which kind of flies in the face of the whole cost-saving point of HD plans and HSAs.

    But do i have an answer? No. Not a simple one, anyway. I just know that the current system is broken and a lot of things have to change.

  2. MultiCare gives you a 40% self-pay discount, too. Just an FYI. You have to call to get it, but they are always friendly and adjust the bill for me right away.

  3. Great post. As the parents of eight children who have lived without insurance most of our adult lives, I am appalled by the health insurance industry. First of all, health insurance doesn't equal HEALTH. The politicians who try to pull our heart strings by making us think that low income families will go without CARE and HEALTH are blowing smoke.

    Our children get excellent preventative care from their parents. We pay out of pocket for needed services. My husband has done electrical work to pay for our baby doctor. We have used excellent home birth midwives (and yes, the care was wonderful). We have bargained with the hospital financial people for reduced rates if we pay cash.

    In other words, there are options out there. We always get an itemized bill because health insurance has caused every little thing to cost more (years ago our bill included 8.00 for 7 iron pills!).

    The health insurance industry will only continue if people are encouraged to be fearful.

    Yes, I think that catastrophic insurance is very wise but it is also wise to take good care of ourselves, educate ourselves about nutrition and health and find a doctor, midwife or nurse practitioner who will work with you as a family doctor. In states such as Washington, be very aware that the state makes money for each CPS call for neglect and they can call anything they want "neglect"...thus, it helps to have a "professional" that is on your side. Know your rights

    More than you wanted to know. Thanks for letting me rant!