Smart shoppers can save on health-care spending

February 23, 1992|By Ed Lopez | Ed Lopez,Knight-Ridder News Service

While politicians wrangle over how best to solve the nation's health-care crisis, consumers can help themselves now by becoming better shoppers for health services.

Taking a more active role in health-care decisions is especially important because employers continue to ask workers to pay a greater share of health costs.

Perhaps the biggest barrier consumers face initially is their attitude. Traditionally, consumers play a passive role in the health-care system, going along with whatever doctors and hospitals recommend without asking questions.

This passivity is so deeply ingrained that it may feel awkward, perhaps even a bit impertinent, to interact with a doctor as one does with one's auto mechanic.

However, medical care can cost dearly. And normal prudence need not be abandoned simply because the expense involves health care.

Don't be intimidated by medical lingo or tolerate an attitude that your concerns are unwelcome. Try to set aside the common myth that the more you pay, the better the care must be.

Be candid with your physician about your cost concerns. Physicians know there is a major push to lower health costs, so they shouldn't be surprised if you raise the issue.

Perhaps the biggest mistake consumers make is waiting until they get sick to compare hospital and physician charges.

"Being sick is not something you choose to do, so when you're not feeling well, you're not up to doing health-care shopping," said Linda Quick, executive director of the Health Council of South Florida, a research and planning agency.

If your doctor thinks hospital admission is necessary, ask if he has privileges at more than one hospital. Discuss the selection of a hospital if there is a significant difference in costs. However, your doctor may have reasons for recommending one hospital over another independent of cost. It doesn't hurt to discuss it.

To sidestep costly surprises, talk to your insurance company about what coverage is available under your policy. Get a clear idea of what your out-of-pocket costs will be.

If surgery is recommended, it is your right and may be in your best interest to get a second opinion. Ask that your test results be forwarded to a second physician to avoid added time and cost. If surgery is necessary, ask if it can be done on an outpatient basis.

Here are some recommended questions to ask your doctor:

* What is your usual charge for this type of visit, procedure, operation or treatment? What does it include?

* Based on my diagnosis, what other charges may there be and from what source?

* What are my options for treatment? For example, inpatient vs. outpatient surgery, drug therapy vs. surgery.

* Should I expect to receive bills from other doctors? If so, for what

services? Bills may also come from an anesthesiologist, pathologist, surgical assistant, etc.

* What payment terms can I arrange for any money due after my health benefits are exhausted?

* Is it possible to use generic drugs instead of brand-name medications?

Not long after a hospital stay, the bills will come rolling in. It behooves consumers to be especially vigilant. Billing mistakes can happen.

Hospital bills should be checked for repeat billings for identical services performed on the same day. Check to see if you were billed for an entire day's stay even if you were discharged in the morning.

Are you being charged for drugs or services that you never received? Were all the lab tests that were performed ordered by your physician?

If the bill has charges that you don't understand or agree with, call your doctor or hospital billing office for an explanation.

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