How To Mitigate Your Health Care Costs With no fix to our health care system on the horizon, health care costs continue to rise. If health care inflation continues to outpace regular inflation, eventually health care will consume all of our resources. This is unsustainable and something will have to give. Until that time, what can you do to help mitigate the cost of your health care? What is driving health care charges? The mantra from those who believe in total self-responsibility is that you have to learn to “shop” for better care and better prices. The current administration takes this approach and wants to create a free market system. To make a free market for health care work, the information has to be readily available so you can compare prices, you must be given options on the types of care available, and you must be well enough to ask for it. The current environment is not set up for you to shop effectively for health care. Since the providers of health care currently get paid more to do more for patients, they have few incentives to minimize cost. Although many doctors care about their patients, with the purchase of many practices by hospital systems, the health care administrators are the boss. They give the providers incentives to run up your costs and penalize the doctors if they are not pulling their weight in “maximizing revenue.” Additionally, they insulate the doctors from the billing – doctors document a code for how much they do and never see how much that translates into charges for you. And who cares? In the past, patients didn’t have to pay the bill, the insurance company paid the bill. We know the fallacy of that line of thinking. In the old days of low deductibles, people didn’t care about the costs even though this attitude is what caused premiums to skyrocket. Now that patients have to share the pain with huge deductibles, we all are acutely aware of the cost and many don’t have the few thousand dollars socked away to meet those deductibles year after year. Since the system is not set up for you to “shop” and incentives are not in place for the health care system to control your cost, you must do what you can to hold the health care system accountable. What can you do as a patient to bring accountability to health care costs? The only weapon you have right now is to be an empowered patient. What does this entail? Asking lots of questions and challenging the system. Here are some tips: Document everything and everyone you talked to in regards to billing. When making an appointment, be sure to ask “Is this in my network?” not “Do you take my insurance?” Most doctors will take any insurance, but that doesn’t mean they are in your network. Out of network care is EXPENSIVE so try to avoid it. If you are in the hospital or emergency department, on all the paperwork they make you sign, write “Do not utilize any out of network care” and get a copy. Before they take it away, use your phone to take a picture of your paperwork as a backup. If testing is ordered, ask the doctor what they want to learn from the test and specifically how it will change approach to treatment. If the doctor cannot provide a clear answer, ask if the test is really necessary. Ask if tests being done are in network and if the doctors evaluating those tests are in network. Also ask which test provider has lower charges. Document, document, document. Do not allow tests to be ordered before you see the doctor if you have never seen the doctor. Too much testing is ordered by rote in the guise of saving time. Testing has risks and should only be ordered if there is a specific need. False positives are common which sends the doctor down rabbit holes ordering more tests. This increases your anxiety and costs. If being referred for therapy or other consults, ask which provider has lower charges. Hospital owned therapy centers charge significantly more than privately owned facilities. If medication is ordered, understand the risk, benefits, and how long you will be on the medication. Ask if it is the most cost-effective medication for your condition. Ask what you can do to improve the situation. It is less time consuming for the doctor to prescribe a pill when diet and exercise may be a better route. Ask for home therapy techniques. If the doctor won’t take the time to educate you, ask for resources so you can get the education you need to take better care of yourself. What we really need is to fix the medical system. There are many ways to do this if we can get the politicians to do their jobs. Until then, patients need to rattle the cage of the health care system. The squeaky wheel gets the grease. If we all stand up to the health care behemoth, maybe change will occur. Code: https://www.forbes.com/sites/braintree/2018/05/03/how-braintree-extend-takes-the-headache-out-of-contextual-commerce/#2d942c5262ad