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Competition, cost sharing and healthcare woes

I’ve got a suggestion for our lawmakers up in DC who can’t seem to get a grip on America’s healthcare situation: competition, the thing that makes our capitalistic economy thrive. I believe a little more of it could turn things around, and I have a story to prove it. First though, I’ll go back and share a bit of my medical history — the premium-paying part of it.

My husband is a state employee with a benefits package, but 13 years ago we opted out of the family health plan. Premiums were consuming nearly a third of his take-home pay, and deductibles were high. After some research, we jumped off the traditional insurance band wagon and onto a Christian cost-sharing medical plan called Samaritan Ministries. It was one of the best decisions we ever made.

Cost-sharing plans are exactly what their name implies. Members share the costs of appointments, procedures, surgeries, tests — the whole shebang. That means participants have an incentive to keep costs down. It’s amazing how the introduction of that simple component into the conversation — incentive — changes your thinking on all things medical.

Before, I depended on Big Daddy Blue Cross Blue Shield to pick up the slack. Why should I wonder if all those tests the doctor ordered were really necessary? Why should I question that odd charge or the one that’s listed twice? Now it’s different. When someone in our family incurs a medical cost, fellow members of Samaritan send us their monthly share and a note saying things like “praying for your complete recovery.” You better believe I’m going line by line through each itemized bill.   

Here’s what I’ve noticed, though: Not everybody in the medical field likes people who go line by line through their itemized bills. I think they prefer consumers who throw receipts into an abyss and leave an insurance company (or a government bureaucracy) to figure it out. But guess what? It pays to be a little inquisitive. 

Last year Daughter No. 2 had a nagging problem with her knee following cross country season. The doctor eventually ordered an MRI after trying some other fixes. I made the necessary appointment, and an accounts payable staff member called with the estimate: Around $2,400 for the MRI, $1,800 if paid in full in advance. (Yes, cash talks. In this case, it talked to the tune of a 25 percent savings.)    

Overall, I felt pretty good about the estimated charge. By paying in full, I’d be doing my part to keep costs down. I mean, $1,800 is a lot of money, but obviously it could be worse, right? Then I remembered something I’d read on the Samaritans Ministries website about a company called MediBid. They connect patients with doctors and medical facilities that offer transparent, competitive pricing on non-emergent health care. Our family decided to give it a try. We plugged in our information and determined we’d be willing to travel within 75 miles for a significant savings. 

The next week Daughter No. 2 had an MRI at a quality facility less than an hour away from our home — for $875.

Surmise what you will from that account, but I’m not the only one thinking a little competition might be good for what ails the American health care system. U.S. Sen. Rand Paul, a physician, speaks of it as well: “The reason capitalism doesn’t work in health care is the consumer is disconnected from the product. When you connect with the consumer, and the consumer cares about the price, guess what? The consumer will shop. And when the consumer shops, competition works.”

The average family of four probably doesn’t have much time to shop medical costs. If the profile information on eHealth is any indication, they’re too busy paying $14,300 a year for premiums and $8,322 for deductibles (which means they shuck out more than $22,600 before insurance kicks in). Bless their hearts. I can’t help but think, “There go I, if not for a cost-sharing plan.” Our monthly medical coverage expenses plummeted 75 percent when we made the switch.

But apart from all the dollar signs involved, there’s another big reason Christians are jumping off the traditional insurance bandwagon, and I’d be remiss if I didn’t mention it: They want to provide for their family’s health care needs in a way that doesn’t force support for abortion, abortifacient drugs, and other practices that are contrary to Biblical faith. These days, that takes some effort.

Kim Henderson is a freelance writer. Contact her at kimhenderson319@gmail.com.