The REAL Costs of Healthcare -- Now Transparent -- and YOU Can Help, Too

The real costs of healthcare, in particular doctor visits, have been a mystery for a long time to us patients.

First there is what the doctor charges, then there is a co-pay which, if we are insured, is our little corner of what that doctor charges. Then there is the balance-due -- the amount we have to pay to a doctor who might help us work with our insurance, but doesn't really accept our insurance. Then there is the additional co-pay, which is the 80/20 or 60/40 amount (whatever your policy calls for) which gets billed to us after we visit, but which is still manipulated through some mirror, using some smoke, before it arrives in the mail.

We get explanations of benefits -- but I sometimes wonder just who the insurance company is explaining them to. I understand some of it, but not all of it. And I consider myself to have more than half a brain. What happens for people who just don't get numbers?

The only people who have a real idea of how much a doctor charges is a doctor. And what a doctor really charges, and what she gets paid are often two different things, too. How many professions do you know of where the charge for a service is rarely even related to what gets paid? Like this: you go to your hairdresser and when he's all finished making you beautiful, he tells you his charge is $85. But -- you don't pay him $85. Instead, at the beginning of the year, you and your hairdresser negotiated a different fee, so that instead of charging you the entire $85 fee, you only get charged $52. Sounds good, right?

I can give you all kinds of reasons why it may not be in our best interests for that to happen, and I can give you even more reasons why the payment systems should be changed, but the bottom line is -- it's still all confusing to us patients.

Oh -- and did I mention what happens for people who have no insurance at all? They get charged the entire fee, but they can negotiate it with the doctor. And today's blog purpose might just help those with no insurance, or those who are underinsured the most.

But everyone should be interested and everyone will want to take notice....

You can now find out what tens of thousands of doctors charge for their services, across the country. You can also find out what the averages are, and what insurance companies have negotiated with many of them. A company called change: healthcare is now online with more numbers, satisfying more curiosity, and setting the stage for better decisions making.

And you can participate, too. You can upload information about your own costs of care, anonymously, right at change:healthcare, which will help other people in your area know more information about the real costs of care.

This is a brave, new, transparency world. There are a lot of places pricing can go. The concept of patients having this information is so new, that it's tough to tell what can happen to it from here.

Care to share some ideas? How will YOU use this information? What information do you wish you could still access? I've set up a section in the Patient Empowerment Forum to discuss it, and I've asked the people responsible for change: healthcare to answer your questions...

How can we use this kind of information to upset the payment balance to make it fairer for us all?
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