Quote of the Week (Maybe the Month)

Posted on September 9, 2009. Filed under: Affordable Health Care, Current Events, Health Care Costs, Health Care Reform | Tags: , , , , |

“It’s like debating the difference between
aspirin and Tylenol for a cancer patient.”

— Dr. David Himmelstein, when asked about the health care reform bills in Congress

Dr. Himmelstein is an associate professor of medicine at Harvard Medical School who  he helped write major studies finding that medical bills were a leading contributor to personal bankruptcies in the United States.

Read the whole article in the New York Times here.

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Bargains in Health Care

Posted on October 22, 2008. Filed under: Affordable Health Care, Preventive Care | Tags: , , , , , , |

Many of my patients are as concerned with costs as with the state of their health. Because of that, I work with them to make sure health care is both affordable and comprehensive. By far, the cheapest form of health care is prevention. So in my practice, I focus on  intercepting disease or health issues as early as possible or preventing them altogether. It does not take much to be a little creative. Here are some cost-saving ideas patients can take to their doctors.

Physicals do not have be administered exactly every 12 months.  There is nothing wrong with getting checkups every 15 to 18 months — a process I call “straddling.” For instance, last year many of my patients came for physicals in October, November or December, and if they were healthy, we will not schedule their next physical until early 2009. Yet only 13 to 16 months have transpired between physicals, allowing the patient to “straddle” two calendar years — 2007 and 2008 — with only one deductible payout (in 2007).

Lab tests can run in the hundreds of dollars. Again, with some thought and research, there are ways to save. For instance, for patients who are covering costs for bloodwork, we use the services of HealthCheckUSA, a nationwide company that offers discounted lab services at a savings of sometimes more than 50 percent. A complete health profile blood test valued at $530 only costs $200 at HealthCheck.

Another way to save on bloodwork is to have all basic tests run before the physical. That way, your doctor will have the test results in hand for the appointment, saving both of you the time and expense of a follow-up visit to review test results.

Your doctor can also shop around for lower costs. For tests like chest x-rays, which I always recommend for physicals, I refer patients to outpatient radiology facilities in San Antonio like South Texas Radiology, O’Neill and Associates and M&S Imaging San Antonio, where x-rays and a radiologist’s interpretation of them can be as low as $60. That’s considerably cheaper than at a hospital, where x-rays alone can run $125, and the radiologist’s interpretation could be $25 to $35 more.

These facilities are often cheaper for other tests as well. For patients who can pay with cash at the time of the test, many facilities will discount their fees. Ask your doctor for recommendations.

For women 40 and up, I recommend pelvic sonograms, which are noninvasive, safe and are cost effective. I ask the radiologist to examine the pelvis and provide additional views of the kidneys, which can give us valuable information about other organs. This type of sonogram has led to the early diagnosis of liver and kidney cancers as well as ovarian cancer well before the cancers could manifest. Insurance usually covers pelvic sonograms, especially if a woman has symptoms in the pelvic region.

I recommend colon cancer screening with a 60-inch scope for patients in their 40s.  However, most insurance covers only flexible sigmoidoscopies (24-inch scope) before age 50; that test is cheaper than a full colonscopy because it is performed without sedation in the specialist’s office rather than a surgical center. I get around this by asking the colon specialist to use the longer scope in the under-50 patients.  With the longer scope, he can perform a more thorough exam. The cost of around $150 is much less than $800 for the full colonoscopy.

If costs are a concern, don’t hesitate to have a frank talk with your doctor. Remember, your doctor is your advocate. He can shop around for cost savings and refer you to labs he uses regularly for discounts. Many doctors will often lower their own fees to their patients to help make healthcare affordable. After all, his goal is the same as yours: to ensure your health.

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