Luann J was feeling more tired than normal and was having trouble getting motivated to do her daily exercise. So she scheduled an appointment with her doctor and had some basic blood work performed. When the results came back Luann’s liver enzymes were elevated. Her doctor ordered more blood work, a series, to check to make sure that Luann did not have Hepatitis. When these all came back as negative, the next step, Luann was told, was to go for an ultrasound exam.
Now because as we know by now, medicine is not an exact science, there may be times in your life where you need more than one type of medical testing. If you have good health insurance, this may not be an issue for you. However, because more than 50 million Americans are uninsured, paying for multiple medical tests can seriously stretch the family budget. And what happens to your friends and neighbors who are without basic health care coverage really does affect how much you have left in your pocketbook at the end of the day, whether you are aware of it or not.
In 2008, Expenditures for Health Care in the United States totaled more than $2.3 trillion dollars. This figure is more than 16.2% of the nation’s Gross Domestic Product (GDP) and is the highest of any industrialized country in the world. Note: A first place honor you don’t want for your country!
You might assume that having the most spending of any industrialized nation in the world may put the US at the top in terms of health related outcomes, yet that assumption couldn’t be any further from the truth. The consequences of having more than 50 million Americans uninsured are quite dire.
Although the US spends more than any other industrialized nation per capita on health care, the United States ranks consistently at the lower end of scoring for measures compared to other industrialized nations in the areas of life expectancy, infant mortality, and the percentage of its’ citizens with health insurance coverage. In these other industrialized nations, almost every single citizen has health care coverage, yet more than 16% of our US population is without any health care coverage.
There’s much talk in Washington these days about controlling health care costs, and health care reform undoubtedly has already had an impact on pricing with regards to rising health care premiums even though most of the reforms won’t take effect until 2014. If health care reform is repealed, are the insurance companies that have already raised their rates in anticipation of the increased costs going into effect in 2014 going to give consumers paying for health care insurance now a refund?
And what will you pay today, in January of 2011, if you’re a medical consumer, like Luann J, who needs an ultrasound test and you don’t have any health insurance.
Think that if you pay cash and are uninsured, that you’ll get the best discount? Guess again.
Let’s check it out and see what options Luann has as a consumer in Austin Texas getting an ultrasound.
Luann checked with several radiology providers in Austin, and because she had read our previous article about the significant differences with CAT scan pricing, she went with the lowest provider from our last case study, River Ranch Radiology in Austin, TX.
River Ranch Radiology: Full Abdominal Ultrasound $255.00 without insurance/cash payment day of exam
With Insurance Humana $125.62
With Insurance United Healthcare $120.23
So even though Luann would be paying CASH at the time of her ultrasound scan, and the business office does not have to submit her bill, wait for payment, and wait for possible denial of coverage or other red tape that sometimes happens with an insurance provider, Luann, as a cash paying patient will pay $255.00 for her ultrasound exam at River Ranch Radiology.
The least expensive Full Abdominal Ultrasound in Austin, Texas that Luann was able to find was actually at Austin Radiological Association (ARA) in Austin, Texas. Although in our last report ARA was significantly higher in price for an abdominal CAT scan, when Luann checked prices in January of 2011 for a full Abdominal Ultrasound she was told that with a cash payment at the time of the ultrasound exam the price for the full abdominal ultrasound in Austin would be $208.20
So today, Luann will get her ultrasound at ARA in Austin. But what’s wrong with this picture?
Well for starters, if uninsured Americans like Luann restrict access to healthcare because they are charged the upper limits on pricing for procedures instead of the better ‘negotiated’ rates, guess what happens? Healthcare gets much more expensive when prevention is ignored and disease progresses. Preventative services are much more cost effective than treating a disease which has spiraled out of control. Since more than 16% of the US Population is uninsured, shouldn’t they get a discounted ‘group rate’? When we charge the uninsured the highest rates of all shouldn’t we all look at the financial implications that this brings with it? Just because you have health insurance today does not mean that you will have it tomorrow. And if you find yourself in the unfortunate situation of not having health care coverage, expect to pay top dollar for any medical procedures you may need done.
HospitalSoup.com has more information available on Texas Hospitals or Hospitals in the Texas Area that provide medical services and healthcare testing.
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