I’ve had a lipoma on my right shoulder blade for the past 5 years. I didn’t do anything about it right away because the doctor told me they aren’t harmful and don’t need to be removed. In the past few years I’ve kinda wanted to get it removed, but it has been excluded by our health insurance because we have an underwritten individual/family policy. Also, we’ve always had higher deductible plans that wouldn’t have covered it unless we’d met the deductible anyway, even if it wasn’t excluded.
Lately though, I’ve been reading about how people have been having their lipoma’s removed by a dermatologist in their office instead of having a much more expensive outpatient surgery done in a hospital. In Colorado, the prices can be ~$500-$600 for a dermatologist compared to ~$2,000+ for an outpatient surgery. I pulled up a list of Broomfield area dermatologists close to me using Humana’s provider finder and started calling around. I told them it was a baseball sized lipoma on my right shoulder blade.
One doctor told me it would be between $200 and $300. Another one told me it would be between $300 and $500. And another one told me it would be around $600. The rest told me I’d have to schedule a consultation before they knew what needed to be done. Anyway… I’m talking to some doctors and I’m going to have them give me an estimate on the cost and whether they’ll be able to remove it in their office.
But the point is, most people who are covered under an expensive group health insurance plan through their employer might not have needed to worry about the cost. So they don’t have any reason to shop around like I did and the doctor has no reason to keep the price down either.
This is a perfect example of the point consumer driven health care (CDHC) advocates are trying to make. Here is an exerpt of a post called “HSAs Explained“, from the “Father of Health Savings Accounts”, The John Goodman Health Blog:
Suppose we passed a law tomorrow prohibiting all insurance companies (including Medicare and Medicaid) from paying any medical bills less than $5,000. What would happen?
The medical marketplace would transform almost overnight. Within a couple of months, there would be no such thing as a primary care physician (PCP) who did not post prices – at least for routine procedure PCPs would offer telephone and email consultations. They would keep patient records electronically (just like lawyers and accountants). Overall, there would develop a teeming, bustling, entrepreneurial marketplace for primary care, diagnostic tests and most prescription drugs.
Specialty markets would develop for the chronically ill, as doctors competed for their business instead of trying to avoid them. Patient education would become an emerging field, with providers offering to teach diabetics, asthmatics, etc. how to manage their own care. Internet drug sales would double, triple and quadruple, as brand drugs faced increasing competition from generic, therapeutic and over-the-counter substitutes. At the same time, overall health care spending would plummet.
Add in the fact that consumer driven plans don’t keep people from seeking needed medical care, and consumer driven plans like HSAs present a very good alternative to the traditional system.