Agraphia Medical Tragicomedy

17Mar/06Off

Healthcare Costs

Why does health insurance cost so much?

I had a nasty sore throat a month ago, and went to campus health. The doc took one look and then sat on his rolly chair (editor's note: I can't wait to be the one who sits in the rolly chair). He was, in his words, "85% certain" I had strep. Now, there were several things I could do.

1) I could go on the assumption that I had strep and just take the antibiotics.
2) I could get a rapid strep culture that has a 13% false negative rate.
- If the rapid strep was positive, I would take the antibiotics.
- If the rapid strep was negative, we would assume I was the 13%. Then I'd take the antibiotics.
3) I could get the regular strep test and wait 2 days for the results, taking antibiotics in the meantime.

Now, the one hitch in all of this is that it didn't smell like strep (believe it or not, smell is an important diagnostic tool. Several of the ER docs I worked for last summer could walk into a room and tell if the patient was sick simply from smell). So, like anybody, I would have loved to have known, for sure, if I had strep. Note that in all 3 cases, I would be taking the antibiotics regardless.

Lets introduce money into the situation. The doc's visit cost $10. The antibiotics were going to cost $12. The rapid strep was $20, and the regular strep was $30. None of these were covered by insurance.

I walked out having paid $22 (choice #1). I think most people would have. If I still had a problem in a few days, I could go back for some testing. But, if insurance paid for it, you'd better believe that I would have had a rapid strep test. I mean, it's free, right? I think you see where I'm going with this. That would have doubled the cost of the visit... and insurance would be the one to pay for it.

...except that in the end, of course insurance isn't the one who pays. They pass the costs on in the form of higher premiums.

That's exactly the problem with healthcare. People don't see what things actually cost, and this is compounded by two things. First, they have already paid thousands of dollars per year for insurance, so they want to recoup the costs. Second, since they don't have to pay the thousands of dollars for an MRI, or a CT, they want the diagnostic testing done. I mean, hey, if I can know what I've got for sure, and I can do it for free...

Of course, there are many other problems as well. The state of Pennsylvania spends $3 billion a year on prescription drugs for the elderly. 2.5% of that is spent on Nexium ALONE. Nexium is used for acid reflux. Only thing is, Prilosec OTC (OTC stands for Over The Counter) is infinitely cheaper, and in many cases, works just as well. Or, Tums cost $2. Or, god forbid, stop drinking a case a day, eating 40 spicy wings at dinner, and polishing it off with a 5th of vodka.

Filed under: Best Of, Medicine Comments Off
Comments (3) Trackbacks (0)
  1. I too love the Zacarius! So what is all this blogging leading too? What are you suggesting? Are you saying we should do away with private insurance companies? Thats absurd, who would ever want to do that…they do so much for society (not!!) and “take care” of so many people (that can pay for it).

  2. i love you achary

    peas

  3. zac is the new freakonomics slash black.


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