With all the current rhetoric and national debate over government-sponsored health insurance, “Obama-Care,” and what all this could mean to individuals and small businesses, it can be overwhelming to think about health care, much less understand it.
What this whole health care debacle does do, however, is provide the perfect opportunity for people to “take control” of their health care.
Melinda Ciesielczyk, partner and independent insurance agent with CH Benefits of Holland, Ohio, who has spent many years in the health insurance industry, sums it up this way, “The first and biggest step is to get educated,” she said.
“Secondly, consumers need to understand that health care and health insurance are not one in the same. These are two distinctly different entities and should be addressed separately,” Ciesielczyk said.
“Emergency health care in the United States of America is something we are all entitled to. Non-emergency health care however, has a cost,” she said. “Where and how do you want to spend your money? The minute your first dollar is spent at a provider (i.e. doctor’s office, physical therapy clinic, pharmacy) you have ‘purchased’ health care.”
Let’s look at a few examples of a consumer-driven approach to health care.
Let’s say you are a parent with a child who needs a tonsillectomy. In years past, patients were told to go to the hospital for pre-admission blood work and then they would be admitted for surgery with the possibility of staying a day or two in the hospital. Today, these procedures can be performed at a free-standing surgery center as well as a hospital. What are the cost differences, if any, in having this procedure at a hospital versus an outpatient surgery center? If blood work is needed, could there be cost differences in obtaining this at a hospital versus a free-standing laboratory? What is the surgeon’s fee and is there room to comparative-shop?
Another example of cost-conscious spending on health care is prescription medications. I have a soft spot in my heart for the elderly who, many times, must decide between buying their blood pressure or heart medications or eating or paying the heat bill. The cost of prescription drugs in this country is mind boggling. Some drug companies are trying to help. They have created qualifying programs that can help defray or even eliminate the cost of some medications for those in need.
Major stores such as Meijer, Kroger and Wal-Mart, as well as others, are offering discounted pricing for common generic drugs, and many are offering free antibiotics. If you have to pay full price for your medications, have you compared the cost of your prescription at all of your area pharmacies including the outpatient pharmacy at your local hospital? You may be surprised at the price differences among pharmacies.
Yet another example of cost-minded health care is physical therapy. Most of the time, if someone is in need of physical therapy and/or rehabilitation, a prescription is written for a certain number of visits to the therapist. Most people are unaware of the number of visits their insurance plan covers per year and rarely question when the therapy can be stopped.
Now, let me make a disclaimer here. This information isn’t intended to make you go out and shop for the cheapest doctor or health care practitioner, because so many other things come into play here. What it is meant to do is stimulate a consumer-driven mindset to consciously make your health care dollar go as far as possible; to become educated and proactive before you spend money for your health care. Ask your practitioner if tests being ordered are really necessary. Ask if there is a less expensive alternative for a given test (X-ray vs. MRI), treatment or medication. In future articles, we’ll touch on health care and insurance related topics such as benefits, coverage and how critical it is to understand your insurance. We’ll approach it from both sides of the examination table.
The bottom line it this – sooner or later, health care is going to cost you something. If it is going to cost you, then take the time to get educated, investigate and shop.
After all, it’s your health care. Own it.