Last week, my car broke down. There was absolutely no ignition noise when I turned the key. After calling a local auto shop and describing my car problem, the mechanic told me to bring it in for further examination. I immediately became tense; all I could think about was the out-of-pocket cost. I asked if he could refrain from doing any work on the car until he gave me a cost quote and was shocked at his reply: “We are not permitted to work on the car until we tell you how much it will cost.”
Unfortunately, I didn’t receive this type of response from my healthcare provider. Last year my doctor referred me to a specialist for an MRI on my knee and I was surprised to receive a $700 bill. I thought I had taken all the right steps to avoid this kind of bill. I asked my insurance company ahead of time about any costs; I made sure the referral came from my primary care provider; and, I even asked the MRI provider if the procedure was covered by my insurance. In the end I was charged because of a stipulation in my insurance plan. The fact that I had gone to extra effort to determine the cost of the procedure and still was not able to get the correct information from either my medical or insurance provider highlights the conundrum placed on many healthcare consumers: we are offered medical services, but are not fully informed about the exact cost of care until it is too late.
While the Affordable Care Act is making strides to promote cost transparency and consumer understanding of health benefits, I feel there is a crucial missing element to reform: the need for medical and insurance providers to communicate up-front costs that consumers may incur for receiving health services. Currently, the onus is on the consumer to check with the medical providers and insurance companies to get answers that are difficult to get. I think that medical and insurance providers, similar to my mechanic, should be obligated to provide clear cost quotes before providing non-emergency services.