In the ongoing healthcare debate a frequent complaint is, “It’s so expensive!” But to me, the real problem isn’t the cost; it’s the fact that I never know the cost. You walk into a doctor’s office and you have no idea if that visit is going to cost you $20 or $2,000. What if other industries were run by insurance?
Restaurant:
Customer: “I’m trying to decide between the grilled chicken salad and the blackened salmon. They both sound good. How much does each cost?”
Waiter: “The blackened salmon is probably more but that all depends on the negotiated rates with your insurance company.”
“Oh, so can I see a menu with those rates?”
“No, we don’t have that.”
“Why not?”
“You just order, eat your food and then we’ll bill your insurance company.”
“And if they don’t pay for it all, then I’ll get a bill?”
“That’s right.”
“And how much will that be?”
“I have no idea. You’ll have to wait and see when your bill comes. I’m just the waiter.”
The Gap:
Customer: “I’d like to buy these jeans. How much do they cost?”
Store clerk: “Have you met your deductible?”
“I’m not sure. I’ve definitely bought a lot of clothes this year.”
“You have to spend at least $500 and then your insurance will cover 80% of your clothes.”
“Well let’s see. I bought some clothes here a few months ago and then I bought some jeans for my husband last week.”
“Your husband’s jeans don’t count. He has to spend $500 too.”
“What about clothes for my baby? I’ve definitely bought a lot of clothes for him.”
“No, your baby has to spend $500 as well.”
“So if I haven’t met my deductible, how much are these jeans?”
“That all depends.”
“Um, I’m not sure I want these jeans anymore. It’s just too complicated.”
“Well, you’ll have to pay for trying them on and for my services counseling you on the subject.”
Grocery store:
Customer: “So how much are all these groceries?”
Cashier: “Well, your insurance company will bill you but it looks like right now you have a co-pay for $50.”
“But I thought my co-pay was only $20!”
“Yes, but these groceries were out of network.”
“Out of network? But I bought them all right here in your store!”
“These zucchinis here, they’re from Florida. That’s out of network. And this bread? It’s made in California. That’s way-outta-network. Your insurance company ain’t gonna cover that at all.”
“So my insurance company is going to send me a bill on top of the co-pay I’m already paying?”
“That’s right! And you can bet there’s gonna be an extra charge for me. I usually work at the store down the street so I’m outta network too!” (Laughs maniacally)
Isn’t it all ridiculously confusing? I mean, I’m college educated; I should be able to understand my health insurance. But there’s nothing to understand because there’s no rhyme or reason to any of the prices or what they’ll cover. So what's the best solution? I don't know but I hope it involves a menu.
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