This is one of those things that just makes me scratch my head…
Recently, my husband and I made the switch from a traditional PPO health plan to a high deductible plan with a Healthcare Savings Account. We like this because we pay over $300 less per month and can put this $300 into a tax free HSA that we can use anytime (this year, next, in 10 years) to pay for health care costs. With the higher PPO premiums, once you pay the money, it is gone and can never be used later.
Having a higher deductible account means that we pay for all the routine stuff up-front. As a result, we are much more in tune with what things cost. Take this recent example:
We get a regular monthly prescription.
- Under the PPO plan, we paid a $15 co-pay and Rite-Aid billed our insurance company for XX dollars.
- The first month we were paying the whole cost, we stayed with Rite-Aid. The same prescription cost $60. This was using no insurance card.
- This month we went to Costco. Again we are paying the whole cost. The cost for the SAME medicine was $13.75. Less than the co-pay we had under the PPO plan and a fraction of the total cost charged at Rite-Aid.
When stuff like this happens, you just have to scratch your head, right? The health care system is messed up and I know we all know it. If Costco can buy this medicine and make a profit off it by charging $13.75, then what’s going on? Logic would say that Rite-Aid buys more pharmacy goods than Costco and should be able to get a better (or at least similar) rate. Logic says that a PPO company should be able to negotiate a better rate.
We are obviously not dealing with logic here.
Mucky muck, mucky muck, mucky muck. This system is all mucked up and I am afraid that the people in a position to fix this (politicians, government) are systemically challenged too. How do we have a prayer to fix this?
For our own situation, I feel a bit more in charge about my routine healthcare now, but if either one of us were to require major treatment (knock on wood) the same crazy system would pick up again.
As an OD person, I feel pained by this. As an American, I feel pained by this. And I feel a bit helpless, too. I bet there are people out there on fixed budgets paying $60 or more for this medication every month! That’s terrible!
As you read in my post about my trip to Thailand, I hurt my back two hours after I landed in Bangkok. This was not just a little backache, I was in major pain and I had limited movement. AND I had a full schedule of speeches and workshops for the next three days. Anyway, long story short.
- I talked to a doctor at 2am.
- The doctor arranged for a nurse to come to my hotel room at 8am to give me a shot and three prescriptions. And she gave me a shot and enough of the three medications to last 10 days.
- The cost? $30 US. The quality of the care – excellent.
I have told people that I felt bad because if the same thing happened in the US, the service would not have been as convenient and we would have charged them MUCH more. Several hundred dollars, probably.