Healthcare Hullabaloo: Bizarro #4 – How much is That Darvon in the Window?

We are a consumer driven society. Now that we’re faced with tough economic times, almost everyone is price conscious. Rumor has it that even Donald Trump is clipping coupons from the Sunday circular (He does, after all, come from a long line of coupon clippers).

Drive by almost any retail store, and you can see their latest sales and promotions emblazoned across their front windows, in letters so tall that they make the New York Post jealous.

I have long been a comparison shopper: Before making a purchase, I want to be reasonably assured that I am getting a fair price. I want to know that the price that I am paying is not significantly higher than I could pay for the same item elsewhere. On the rare occasion when I do overpay for an item, I tend to feel foolish and cheated after learning that I could have paid significantly less for the same item at another retailer.

With the advent of UPC technology, it’s now even easier to be a price conscious shopper. If an item’s price is not clearly marked, for whatever reason, it is now quite simple for any store employee to look up the price of that item. Many retailers, like Wal Mart, now allow you to look up a price yourself with bar code scanning kiosks placed around the store.

So imagine, if you will, a store that did not have any prices posted, and who made it difficult for you to find out how much something costs until after you purchased it. In fact, what would you think if that store made you pay for your purchase by credit card, and you couldn’t find out how much it cost until you received your statement in the mail, 4 to 6 weeks later? Would you shop at that store? Me neither.

Yet, this is exactly the type of behavior that we accept from the health care industry.

When we see a physician, how often are we aware of what their services cost until after we receive treatment? I am not talking co-pays here – I mean the total cost of the services, including what they are collecting from our insurance carriers (ALWAYS remember Star Trek Economics -

http://healthcarehullabalo.blogspot.com/2010/02/star-trek-economics.html

). Very often, we don’t discover this information until we receive our EOB from our insurance carrier weeks after the services have been rendered.

The problem that this creates is that we’re totally insulated from the true costs of health care. As consumers, we have no knowledge, and therefore no say, in what our health care truly costs. We can’t comparison shop between different providers. This has allowed the prices we pay for our care to spiral upwards, out of control.

I always laugh when I see health care insurance carriers extolling the fact that they are doing their part in ‘keeping health care affordable’. First of all, that’s my job – not yours. I never asked you to do that for me. Secondly, you’re doing a pretty shitty job of keeping things affordable. I would love to tell them, as the Donald is so fond of saying, “You’re Fired!”. Unfortunately, the system is stacked against me and I can’t afford to fire them (See Bizarro #2). So, like an underperforming relative that we hired to keep peace in the family, we can’t fire our health insurance company.

The situation is just as bad in the pharmacy. Here, the dichotomy between the real world and the Bizarro world is even more pronounced.

The front half of the drugstore exists in the real world. Prices are clearly marked, and they are often quite competitive with other retailers. The back of the store, however, exists in the Bizarro world. In the pharmacy department, where prescriptions are filled, no prices are posted. Ask the price of a prescription before you have it filled and you are almost guaranteed to be met by a slightly annoyed blank stare. Sometimes they’ll answer this question by saying “your Co-Pay is….” But that is not an answer to the question I asked.

Many people don’t realize that retail prices for prescription drugs do vary significantly from pharmacy to pharmacy. If you want to be a smart shopper, and you live in New Jersey, there is a web site that will allow you to price shop a drug from the various retailers in your area. Maintained by the State’s Attorney General’s Office, it’s a great resource for the comparison shopper. Even if you have insurance, please remember that, regardless of your fixed co-pay, you will eventually pay the full price in the end. Beam me up, Scotty.

The web site is : https://www6.state.nj.us/LPSCA_DRUG/search.jsp

Remarkably, prescription drug prices can vary between drugstores by as much as 25%. Just as surprising, the major chains don’t always have the best pricing. It just goes to show you how the ‘hidden price policy’ works in their favor. Drugstore chains will fight for your business by advertising that their AA batteries are 50 cents cheaper than their competitors, but it takes some sleuthing to discover that they are charging you $50 more for your bottle of Nexium.

In fact, it seems that that ubiquitous glass wall that separates the pharmacy department from the rest of the store is some kind of inter-dimensional barrier that keeps the two worlds apart. Perhaps if that wall wasn’t there, there would be some kind of matter/anti-matter explosion that would destroy all life on earth….

In the front of the store, they’re printing photos. In the back of the store, they’re printing money.

Even the workers are separated. The white coats in the pharmacy dress differently from the front-store workers in their cheery red or blue vests and aprons. I bet that they even have separate toilets – after all, the two worlds can never be allowed to collide.

So, here we azre, a nation of consumers who are acutely aware of what almost everything costs, except if our spending is health care related. In that arena, we remain placidly and mutely ignorant.

Bizarre.

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Who are you? Do you agree with me, disagree with me, or have another perspective to share?

PLEASE put your 2 cents in by leaving a comment or email me at HealthcareBlog@SystematixOnline.com