We take care of our car. The oil, lights, brakes and steering are checked and in good shape, so we don’t expect anything mechanical to go wrong. Routine care costs are cheap and easy – besides, if the car is in bad shape the insurance company won’t cover it and it needs to pass a mechanical inspection each year.
Unexpectedly, a family member had a minor automobile accident which was his/her fault (I am being careful not to identify the party due to privacy concerns). Repairs were needed, or more significant concerns would develop down the road. We considered taking the car to the dealer for repair but decided that would be too expensive. For convenience we used a local shop – and because damages were minor we chose to pay for the bill out-of-pocket to avoid our insurance premium going up the next year. The repair shop took care of all the other blemishes and detailed the car inside and out. A week later, the car looks perfect. We knew it was going to cost $2,600 and that’s what the bill said.
Now healthcare… Even though a checkup is free, you haven’t had one in several years. You develop a symptom and ignore it until it becomes severe because 1) you don’t want to know, or 2) you hope it will just go away. It doesn’t, and you end up in an emergency room. The $200 copay is manageable, but the doctor suggests that there might be something more serious going on. Without even considering costs you start asking around to find the top specialist for this issue and make an appointment. The specialist wants to rule out everything and orders blood work, radiology and scans. And you go wherever she tells you without even considering cost or quality of the service provider. Bills start flooding your mailbox – you paid your doctor a copay, but then the lab sent you a bill for $1,000. You were concerned, and ultimately learned the lab is in-network and the insurance company paid the $97 discounted cost (you think: odd – the lab billed $1,000 but was paid $97. How can that be? But whatever, it’s not your money).
The x-rays are another story – your plan has a deductible and coinsurance and your cost comes out to $700. You are surprised, but in view of the health issues you aren’t going to deal with the bill now. A few sleepless nights and a couple doctor visits later and you find the issue was something benign. You have no idea what these additional visits are going to cost, but breathe a sigh of relief (and you still haven’t dealt with your skin condition/migraine/aching shoulder…pick one). After a few loud calls to the insurance carrier and the radiologist you realize the x-ray bill is not going away, so you pay it. Between this cost, the ER and doctors’ copays and the pharmacy, this little problem was expensive and you are angry. After all – why do you have insurance? At your next open enrollment you are outraged because your deductible went up $250 and your share of premiums are increasing by 11%.
By the way, the auto repair shop encourages me to go through my insurance company and told me if I did, they would take whatever the insurance company gave them and would not charge me a deductible. He thought (like healthcare) that if I wasn’t paying I wouldn’t care what he charged and he could get away with sending a much bigger bill.