When you’re a consumer, “How much does this cost?” should be a simple question with a simple answer.
Inside Big Box Medicine, however, it rarely is.
Why? Come on. They don’t want you to see those prices.
And, who cares, right? Your health insurance will take care of it! Ha…
I’m showing a bill from a recent pre-operative physical with my excellent family medicine physician who is employed by a regional iteration of Big Box Medicine.
Of course, the first time I saw any of these numbers was weeks after the appointment and well after I had already signed the form agreeing to be financially responsible for all of the charges, but as a loyal customer of Big Box Medicine, I’ve come to expect this peculiar way of doing business.
Let’s look at the lab testing component.
“Complete CBC” (translation: complete blood count, sometimes called a hemogram, measured things like white and red blood cells and platelets) = $91
“Metabolic Panel, Basic” (translation: measures important stuff in your blood like sodium, potassium, glucose, urea, and creatinine) = $138
And it cost $35 for the phlebotomist to draw my blood. That part actually seems reasonable.
Total for the two lab tests and cost of drawing the blood = $264
In my upcoming direct care practice, if I ordered these same tests for you, the kit would be mailed to your home, you would take it to your preferred local phlebotomist (choice! a helpful map of local phlebotomists would be included for your convenience), and the kit would be sent off for processing.
$15 for shipping
$3 for CBC
$2 for BMP
$1.40 third party service fee
$35 for local phlebotomist (same as above, for simplicity)
Total direct care cost: $56.40
Even if I chose to add something like $10 to compensate myself for ordering, managing, interpreting, and acting on the labs, that would bring it up to a grand total of only $66.40.
And that’s without health insurance.
Compare that to $264 through Big Box Medicine.
And, you would know this price before agreeing to be responsible for paying for it (weird, I know).
To be fair, I called Patient Financial Services (my practice won’t need an entire department with that name) to ask if these prices would have been lower if I had been paying in cash without insurance.
Their answer: “Our costs are what they are.”
Still wonder why docs are leaving (or being dismissed from) Big Box Medicine in droves?
It’s OK, Big Box Medicine loves to hire cheaper labor anyway. It helps the bottom line regardless of potential long term impact on patient care and safety.
Health insurance is a critically important tool. I want it to remain viable and be more affordable. My family will pay more than $35,000 for our health insurance premiums this year, in addition to an ever increasing deductible, co-pays, and co-insurance.
It should NOT be used for things like pre-operative physicals and basic lab tests. When used for these purposes, this is where we end up.
If you value transparency and aren’t satisfied with what you’ve been getting from Big Box Medicine (quality, access, cost), it’s time to consider an alternative for some of your healthcare needs.
