This segment reviews steps that viewers can take locally as well as civic actions that can support healthcare restraint and reform at a national level.
In the last Segment we looked at what I call the Big Fix. It is based on the idea of setting limits fairly. I highlighted the Oregon Health Plan that was successfully implemented from 1994 to 2002.
In this final Segment, I hope to motivate you to action: Think National, and Act Local.
Here are some ideas for acting locally.
Healthcare is a big topic to talk about. Tell friends about the need to set limits. Send out links to this You Tube on your social media. Also ask questions of your doctors to let them know that cost is an issue for you, such as those suggested by Elisabeth Rosenthal on NPR News Hour.
- How much will this test/surgery/ exam cost?
An “I don’t know” or “It depends on your insurance” from the doctor is not an answer. The doctor should give you a ballpark range or the cash price at the center where he or she refers.
- How will this test/surgery/exam change my treatment?
If the answer is “It won’t, but it might be good to know,” take a pass.
- Which blood test are you ordering? What X-ray? Why?
When doctors order blood work, they are frequently just ticking off boxes on a long electronic checklist, with no awareness of how much any might cost. Your questions alone will make them more discriminating.
- Are there cheaper alternatives that are equally good, or nearly so?
If you go to a pharmacy or a lab and encounter a high price, call your doctor’s office and tell him or her about it. Force your doctor to learn. He or she likely didn’t know.
- Where will this test/surgery/exam be performed — at the hospital, at a surgery center or in the office — and how does the place impact the price?
Doctors often practice and do procedures in different places on different days of the week. If you go on a Thursday and that happens to be your doctor’s day at the hospital, it could double the price of your biopsy or colonoscopy. If he or she refers you to an ambulatory surgery center, ask, “Are you an owner?” A little shaming might encourage better behavior.
- Who else will be involved in my treatment? Will I be getting a separate bill from another provider? Can you recommend someone in my insurance network?
Avoid a lot of unexpected charges up front by making sure that whoever is involved in your care — doctor, physician assistant, pathologist, anesthesiologist — is in your insurer’s network.
Here are some ideas for thinking national. Write your congressmen. Join small groups — or form them — to meet with congressmen. Write letters to the newspaper editor.
The key talking point is: Ask them to support fair limits on Essential Benefits using the combination of cost-benefit research and public input, modeled after the Oregon Health Plan of 1994. It may surprise you that this research is already authorized in the Affordable Care Act at Section 6301. Tell Congress to retain or expand this provision.
Thank you for your interest in reforming the US healthcare system for ourselves and for future generations.
Stay involved. A lot is riding on it.