By Kris McFalls
More and more, the healthcare industry is adopting the approach of the airlines by piling on fees to make up for decreasing profit margins. Everyone, it seems, wants more for less, leaving some patients no choice but to pay up or simply give up. And while insurance companies are frequent targets of consumer rage, they are not the only ones trying to find creative ways to stay afloat in a floundering economy.
Here is a sampling of a few things I have found:
- At a recent doctors’ visit, I noticed an engraved sign that warned if patients cancel within 24 hours of appointment time, they will be charged. The $25 amount was crossed out and changed to $70. Maybe if they actually collect on that, they can afford a new sign.
- Urgent care clinics and stand-alone emergency rooms seem to be popping up all over the place. Providers claim it is so they can meet the growing needs of the community. What they don’t tell you is that these types of facilities simply bring in more income than primary care clinics. Insurance companies figured out the game, and guess what? There’s an extra fee for that.
- Hospitals and outpatient facilities often post signs that convey the message that they may be “in-network”, but the labs and doctors employed in their facilities may not be. Furthermore, labs in particular could be outsourced to an out-of-network facility. So what is a patient supposed to do, have blood taken at multiple sites to ensure each test is done at an in-network facility? Surely that will curb costs. Nope!
- In addition to an annual deductible, consumers face additional deductibles within the insurance plan, some of which are not subject to the consumer’s out-of-pocket maximum. For instance, several major plans now have an annual overall deductible and a separate annual prescription deductible that must be met, after which the patient is also charged a co-pay or co-insurance. Of course, like coupons, deductibles cannot be combined.
- Politicians think we need better incentives to use primary care providers. They often suggest charging higher fees for expensive specialists to curb the overuse of unnecessary services. What politicians don’t understand is that patients with rare chronic diseases would love to see a primary care provider who understands their needs. Do they happen to know where one can be found? I guess their ignorance is understandable; they do, after all, have the best healthcare in the country that our tax dollars can provide.
- Insurers have created new specialty tiers, which apply to some medications, with 25 percent to 50 percent co-insurance. As the name suggests, these medications are special and, in fact, life-changing for many. However, they are so named not because of their miraculous effects on patients’ lives; they fall into the specialty tier because they generally cost more than $600 a month. Keep in mind that under many plans, those costs do not go toward the yearly out-of-pocket maximum. Great, let’s take the most vulnerable patients and price them out of their medications; surely that will bring the cost of healthcare down. Not!
No doubt about it, healthcare rates are skyrocketing at an alarming speed, and we must all do our part to keep costs down. Patients with a chronic disease are often well-schooled in budgetary restraints and the high costs of medicine, so they are mindful of healthcare expenses and take a proactive role in curbing these costs. Yet, despite this, the recent escalation in costs puts them in the unsustainable position of having to choose between basic essentials and life-saving medications. It’s not right!
Have you noticed extra fees being added to your healthcare services? Leave a comment so we can talk about your concerns.