The Real Problem with Health Care

The best way to heal the nation’s sick health-care industry is to put patients in the middle of the process

Over the past months, a debate about how to manage health care has raged throughout the country. Although Republicans and Democrats each have their own plans, it seems that politicians from both parties and most Americans can at least agree on the problem: The cost of health care is rising too fast. At its current rate of increase, reasonable health care may soon be unattainable for many Americans.

In my opinion, this is a real and serious problem indeed. However, I must confess that aside from paying passing attention to headlines in newspapers and sound bites on radio and television, I haven’t been able to make this a personal issue—something that mattered to me in my daily life.

That changed last week when I went to visit a family doctor—what’s now called a “primary health provider.” This was my first visit to a doctor in years. I am 28 years old, healthy, and thus have had no need to see a physician.

I checked in with the doc because I had had a serious bout with food poisoning. It had lingered a tad longer than it should, so I wanted to be certain it wasn’t something more serious. The doctor did a quick exam. Then he took blood to send to a lab, and suggested a few other tests I could take to determine if my problem was more than food poisoning.

I noticed that as he was suggesting various forms of treatment, there were no price tags attached to any of it. It just didn’t matter to him because he assumed, rightly, that it wouldn’t matter to me. I’m thinking, hey! I’m insured, I’m young, I never use any of that expensive coverage, so sure—give me every test known to man. My health insurance is picking up the tab.

As I walked out of the doc’s office I had a sudden insight as to why our health care system is so screwed up and expensive.

When you visit a doctor, prices of treatment are never revealed. We as consumers don’t know the real cost of the care we insist on getting for ourselves. And if we don’t know how much things cost, what kinds of decisions are we making? Do you really need that CT scan? Do you need it so much you’d pay $4,500 for it? If you were footing the bill yourself, you’d probably want a second opinion before opting to have a CT scan that takes minutes but costs as much as a good second-hand Toyota.

It’s human nature. Imagine you are at the fanciest steak house in your hometown. When you get the menu, there are no prices listed. If lunch is on you, the 8-ounce filet will do fine. If lunch is on me, you might be thinking the surf-and-turf is the way to go.

But the truth is that you do pay for your health care costs, albeit in indirect, hidden ways. For example, most employees are paid via direct deposit into their checking account. Therefore most employees don’t see the Medicare taxes taken out, or the Social Security taxes taken out, or their contribution to their health insurance premium taken out. In the same way, when that same employee goes to the doctor, he or she never sees the true cost of their care.

But as soon as a dollar figure is attached to health care, it gets much more interesting and a lot more personal. Give an employee his $2,000 bi-weekly check, then ask him for $800 back for all of his taxes, and see how long it takes before he elects to have a health savings account (HSA) and begins to make smarter health choices.

Years ago, a study was conducted on the care given to rental cars by those who rent them. Researchers discovered that in the entire history of the rental car business, not once did a renter ever have a car washed before returning it. Why? Because we don’t fully value what we don’t own.

So let’s put the patient in the middle of the process. When we’re sick, give us the power of information and the wisdom to make our own choices. When transparency is brought to health care and patients know the real cost of the treatment they elect to receive, we will begin to make substantial progress in fixing the health care crisis.

Until that happens, it’s all free Band-Aids and chewing gum—business as usual for a critically sick health care system.