The Problem with Affordable Healthcare

So, I went to the doctor the other day for a little bit of minor surgery. It wasn’t really a big deal. Just a local anesthetic around the surgical area, about 15 minutes of chopping into my head and suturing me up, and I was out of the exam room door. That’s when the issues started.

The Affordable Care Act was supposed to make healthcare “affordable” for everybody in this country. Healthcare costs were supposed to come down. Insurance was supposed to become cheaper. Access to healthcare was supposed to increase for everybody. Yeah…about that.

Unless you are a total partisan, and by any objective measure, the plan has been a gigantic mess. The government spent far too much on the website, and the initial roll-out was a major disaster. The cost of healthcare continues to rise, there are more people on Medicaid than ever before (which some would actually point to as a success, I guess), and – in many areas – insurance premiums have more than doubled for many users.

That’s not to say that there haven’t been some good things that have come out of the new law. Insurers are no longer able to refuse coverage for ridiculous preexisting conditions clauses. Some people in lower income brackets now have access to coverage that they were not able to get before. However, this all comes at a price. Ironically, since the law was sold in part as a way to decrease job lock, that price falls disproportionately on Americans who are self-employed small business owners.

What’s the Solution?

For opponents of the new law, a consumer-driven system seems to be the cure to all the healthcare world’s ills. In this consumer-friendly utopian system, consumers would be able to shop around for the best prices on doctors and procedures. If you don’t like what one doctor is charging you, simply go out and get a price quote from another doctor. Ideally, this would force healthcare prices to go down due to competition, creating affordable healthcare.

Of course, there are a few problems with that. In many instances, when it comes to your health, you may not be able to shop around for the best price. First, you may be heading to the doctor because you have a health emergency. In the middle of a heart attack, I don’t think you’re going to stop and ask for a price list so that you can compare with the hospital down the street.

Even if you have the time to compare prices, chances are you’ll never be able to do so. Most offices are not able to tell you how much their procedures cost. Trust me. I’ve tried this time and time again. The answer is almost always the same: “Well, I’m not sure what the price is. We just punch the coding in.” So, let me get this straight, you can’t tell me the price because of coding? You can’t punch the code in right now and tell me? “Nope. Sorry.”

That is where I was again the other day with my minor surgery. I wanted to pay the bill, but nobody could tell me what the coding was exactly. And because it could be coded one of two ways, nobody could tell me the price. “It will be between $300 and $500…I think.” OK, well, send me a bill I guess.

Is Transparency the Key?

Our current healthcare system sucks. All we’ve done is replaced one pile of crap with another. Even if a consumer wanted to shop around, the medical establishment in this country has made it far too difficult for them to do so. When you can’t get a price quote directly from the office who is doing the procedure because the billing system is too complex, something is wrong. Honestly, I’m beginning to feel like the medical profession wants it this way. No other industry is allowed to operate like this. Why is the medical industry? (Money, obviously.)

How do we fix this problem and make affordable healthcare a reality? One side would argue that the government should control all the healthcare, amounting to a sort of blank check. The other would say that government should stay completely out of it, let consumers shop around, and let the market dictate pricing. Neither of these solutions are good, nor are they feasible. However, we could start by requiring the medical industry to be transparent in its pricing. At least that would give those of us left out in the cold by Obamacare a chance to make a real choice.