Clueless about cost Blog added by Kathryn Mayer on January 23, 2014
Kathryn Mayer

Kathryn Mayer

Joined: August 16, 2012

Happens every time.

Some great new research tells us something great about health care. But then there’s a “but” attached.

(And when I say this happens with “research about health care,” I really mean this happens with everything in life: “Yes, the steak dinner is on special tonight. But it’s à la carte sides.” NO!!!)

Anyhow, the latest survey from the Altarum Institute asked consumers a whole host of questions about their care. To sum up the good news: Consumers are more active than ever in their health care decisions.

Yay! Patients are more vocal about treatment options, medications and health care providers.

For example, docs aren’t the ones calling the shots anymore, as nine out of 10 people want to have a say in important decisions regarding their health care. One-third would like to make a shared decision with their doctor, 43 percent want to make the final decision with some professional input, and 16 percent prefer to be completely in charge of their medical decisions. Just 1 percent said they want their doctor to make the final call.

That’s the good news. The bad news is despite this consumer activism, we’re still not being proactive enough — if at all — about health care costs. Besides the fact that we’re not thinking about future health care costs in retirement — a measly 5 percent of people are certain they’ll have the recommended amount of savings needed to cover health care expenses after they retire — we’re just not talking about cost in general.

Though most consumers surveyed claimed to be comfortable talking about costs with doctors or other providers, less than half say they’ve asked about treatment costs. They also expressed little confidence in their ability to shop for cheaper health care. Only 6 percent felt very confident and 29 percent were somewhat confident that they could take steps to find less expensive care.

And therein lies the (big) problem. We can’t be active consumers without addressing costs.

It’s like buying a house, a car, or a TV and discussing what we want with salespeople, but not even mentioning the cost.

How did this happen? We’ve gotten into a trend that we obviously can’t seem to break. Obviously price transparency is a huge issue. Want a great — aka a terrible — example of that? New research finds that hospital charges for delivering a baby varies so widely from one California medical center to another that some facilities charge women eight to 11 times more than others. Yikes.
But it comes down to us, too. And though it sounds basic, there are a number of simple things we can all do as consumers: Kick unhealthy behaviors and adopt good ones. Save for unexpected health care costs — and buy a policy or two that will help you pay the bills if something happens (critical illness, disability, etc.). Shop around for coverage and treatments. And, of course, talk about cost with your doctor.

(If it’s any indication of a problem, consumers who accepted no responsibility for the cost of care also were more likely to report the unhealthy behaviors that contribute to high costs. That is, 20 percent of individuals who strongly agreed with the statement “There is nothing I can do to affect the cost of health care” also reported they are overweight, use tobacco, or don’t exercise.)

Enrollment in consumer-driven health plans also seems to help.

I’d like to point out what Wendy Lynch, who authored the Altarum Institute's study, said: “Consumers still believe that problems in health care are the fault of insurance companies or government and underestimate what they can do themselves.”

Let’s hope she’s on to something — and that the rest of us catch on. Because being consumer driven without a clue about cost isn’t really being a good consumer.

Originally published on
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