Healthcare. If there is any topic besides politics that raises your blood pressure, it’s just the thought of getting sick and having mountains of medical bills. Illness is followed by the fear of not paying your medical bills and eventually filling medical bankruptcy.
In the world’s greatest democracy, health care for millions is a constant struggle with decisions to buy medications, have surgery, see the doctor, or eat tonight? One political party believes that primary healthcare is a right. Another political party sees healthcare as a privilege for those who can afford the cost of care. Providers and vendors in healthcare across all its channels and components in the healthcare medical-industrial complex see it as an opportunity to make billions of dollars.
Make no mistake, folks; there is no healthcare reform. The politicians are just tinkering around the edges and calling it reform while hospitals, pharmaceutical companies, insurance companies, medical device manufacturers, and others lobby against meaningful change. You can’t fix it by tinkering with what is broken.
We all know healthcare is expensive. In 2019 healthcare expenditures totaled $3.8 trillion or $11,582 per person per year, accounted for 17.7 percent of GDP (source CMS). For all that money spent on the most expensive healthcare globally, the United States ranks 37th in the world for health outcomes (source World Population Review).
Now that being said, while others debate the pro and cons of whether healthcare is a fundamental right for all or a privilege for those who can afford it, I have put together some tips to use to lower your healthcare costs.
How do I know how to do this?
Because I have been working in healthcare in senior management positions in providers and vendors since 1983, I know how the sausage is made to coin a phrase. With a Master of Health Administration and a published book on healthcare quality, you can use these tips for better and cost affordable healthcare.
Ten Steps to lower your healthcare costs.
- It would help if you had a primary care doctor. We don’t have a health care system; we have a sick care system built around the hospital, the most expensive setting for medical care. You need a primary care physician to stay on top of your medical needs and help you navigate a complex healthcare system.
- Compare prices. It’s not as hard as you may think. On January 1, 2021, hospitals were required to post in a searchable database on their website the prices for 200 standard medical procedures; it takes a little work on your part, but you go off to have that test done, do a little price searching. All hospitals are the same. All the procedures are the same. It’s just a question of what anyone hospital is charging.
- Stay out of the hospital emergency room unless it’s a life-threatening medical condition. Look, you only need a hospital for a few things, emergency care, complex acute medical conditions, and intensive care. If you have children or are planning for a baby, then a NICU (Neonatal Intensive Care Unit) and PICU (Pediatric Intensive Care Unit) would be on your hospital list. Use a walk-in clinic where available, for example of a Walgreens or CVS.
- Have doctors order for a lab test, diagnostic x-ray, rehabilitation, etc., do not use the hospital or a hospital-based free-standing facility. There is any number of alternate site diagnostic testing facilities in any number of specialties. Your primary care doctor can recommend a location, or you can do a Google search for the testing location that is most convenient and accessible to you. A little bit of searching, calling ahead, and asking what the price for the test can get you the best deal.
- Prescriptions are a significant driver in the rising cost of healthcare. If you do not have health insurance, then use these free programs, which can help significantly reduce the cost of your drugs. You need to sign up, but it’s worth the effort: RxAssist, GoodRx, NeedyMeds, and SimpleFill. Also, many state governments have prescription assistance programs. You need to do the work to apply and see if you are eligible. Ignore the drug advertisements and go generic.
- It’s a fact that the healthcare system revolves around health insurance. That is where the Health Exchanges come into play under the Affordable Care Act, and many states have expanded eligibility for Medicaid. You have to apply. Even if the cost of insurance is high, subsidies and discounts are available to pay for the insurance. But you must make an effort to try and apply in the insurance exchange or your state Medicaid program.
- Did you know what many surgical procedures today can be performed in a free-standing Ambulatory Surgical Care Center (ACS)? ASCs can be far more cost-effective, convenient, and affordable than hospital-based surgery. In most cases, ACSs provide higher quality and patient experience as well. Not all surgical procedures are suitable for an ASC, but if you’re having surgery, talk with your primary care physician or surgeon to see if a free-standing ASC is a better alternative to the hospital hospital-based surgical center.
- Here comes the health and wellness lecture. Part of reducing your medical spending is trying the best you can to maintain a healthy weight, not smoke, exercise regularly, eating a nutritious meal, etc. It’s hard, and I get that. But a lot of healthcare is more under your control than not. There is personal accountability and responsibility to try and be healthy. That doesn’t mean you’re not going to get sick and require medical treatment, but you can lower the odds of needing lifesaving medical care through healthy living. It’s a cost-avoidance strategy, but it’s proven to work.
- Wait, and it may go away. Prompt treatment of a heart attack or stroke can save your life or prevent devastating disability. But we frequently get tests and treatments for aches, pains, and other discomforts that might have gone away on their own because the illness-producing stress of work or school lets up, for example, or the immune system fights off the infection. If you feel sick, by all means, get evaluated, but if your doctor suggests the test of time, take the test.
- Read your bills. According to the Medical Billing Advocates of America, about 80 percent of medical bills contain errors. And doctors’ offices and labs aren’t exempt from making mistakes. Don’t be afraid to call your doctor or the hospital billing department to clarify a charge, and make sure you’re persistent.
Absent any real effort on the part of elected leaders to truly address the high cost of healthcare in the United States; you have the power to lower your healthcare costs. All it takes is a little effort on your part.
These ten steps are a small personal price to pay to avoid significantly high medical expenses.