Writer Gilbert Chesterton declared that “The object of a New Year is not that we should have a new year. It is that we should have a new soul and a new nose; new feet, a new backbone, new ears, and new eyes….Unless a man starts afresh about things, he will certainly do nothing effective.”
But for those of us with high deductible medical insurance, new feet and backbones may have to wait. The January 1 re-set means costs are entirely out of pocket until that limit is reached. But don’t let cost woes force you to postpone needed care, a simpler cash option may save money in the long run.
A recent Forbes report describes that “about half of all people with employer-provided coverage have a deductible of at least $1,000…the average deductible for silver plans in the (Obamacare) exchanges this year is almost $4,000.” Their studies even found that for some lower-income fast food employees, coverage requires “a $7,150 deductible for an individual and double that for a family.”
This means care in January and February requires a little extra thought and a lot of post-holiday budgeting. Unfortunately, many people opt to skip it altogether. One study shows that “Twenty-nine percent of US patients delayed healthcare in 2018 because of high patient financial responsibility…What’s more, patients are putting off care for symptoms that reportedly deserve medical attention.”
At outpatient surgery facilities like Longview’s Pacific Surgical Center, doctors provide state-of-the-art treatment with minimal recovery time and low cost. Their billing staff works with a variety of insurance plans, including Medicare, but clearly posted prices are often cheaper than your overall out of pocket portion. It may seem counter-intuitive, but sometimes skipping insurance altogether is the cheaper option.
The medical industry’s Healthcare Bluebook documents pricing to aid overall transparency. Their recent Executive Summary noted that “A review of commercial medical-claims data found that U.S. healthcare costs are reduced by more than $38 billion per year due to the availability of ambulatory surgery centers (ASCs) as an appropriate setting for outpatient procedures. More than $5 billion of the cost reduction accrues to the patient through lower deductible and coinsurance payments.”
They also found that “as much as $55 billion could be saved annually” by moving some procedures from hospitals to ASCs. For example, researchers cited how in North Carolina a standard knee arthroscopy cost $12,500 in the hospital setting but only $6,100 in an ASC. At PSC, all prices are available online and include facility fee, surgeon’s fee, and anesthesiologist’s fee.
Postponing treatment can sometimes result in additional injury or increased recovery time. For joint issues in the ankles, knees, shoulders, and wrists, one doctor warned that waiting too long leads to worsening of joint deformity, stiffness, loss of strength, and compensatory issues. He described this as when “People with severe hip arthritis often experience back pain, and people with knee arthritis often complain of pain in their opposite knee.”
This can sometimes be complicated by age. “Your surgeon can usually overcome the technical difficulty of performing joint replacement on someone who has delayed her surgery, but there can be patients who develop medical problems as a result of aging and decreased physical activity. Weight gain, decreased endurance, cardiac and pulmonary conditions are all concerns for people who put off joint replacement for too long.”
At PSC, all procedures are done on an outpatient basis with imaging, labs, and follow-up available on-site. Their minimally invasive techniques require very little missed work and downtime so you’re quickly back on your feet with family, friends, and co-workers.
High deductibles mean lower monthly premiums but if you need surgery, fear of medical debt is a very real worry. A 2018 study found that “Though Americans certainly aren’t strangers to debt, the impact of owing money extends not just to their financial decisions, but health-related ones…And it makes sense. After all, racking up costly medical bills might only exacerbate an existing problem. But what many patients may not realize is that putting off treatment in an effort to save money could end up costing them more money, thus perpetuating the cycle they’re hoping to avoid in the first place. Talk about painful.”
If in doubt, call PSC at 360-772-7900 and let their counselors walk you through the options. They’ll partner with your primary care physician to determine the best course of treatment. Make an appointment online or request a specialist before your visit. Don’t let money woes keep you down and start the New Year feeling 100%.