24 June 2013
We were not surprised with the recent release of data from the federal Centers for Medicare and Medicaid.
The numbers allow consumers to compare provider costs of significant hospital procedures. The figures show that, no matter where in our region this care is provided, all of these procedures cost much more than the average person can bear alone.
Perhaps a few of us could do it, but what average working person has the available funds to pay $35,000 for a knee replacement, more than $37,000 to have a pacemaker implanted or nearly $40,000 to have a drug-coated stent inserted into a vein?
These are roughly the charges if you go to Heartland Regional Medical Center for these procedures. And by the way, these are among the lowest charges found for these procedures among all Kansas City area hospitals.
That’s good, in relative terms, for Heartland patients, but you still don’t want to be caught paying the full tab. This listing of prices does not account for how much insurance might pay — a critical part of the equation for anyone who is smart about accessing health care.
Advocates for consumers make these recommendations:
■ By all means, find a way to insure you and your family. If you work in a position that does not offer access to group health insurance, you still need to take care of securing major medical coverage.
This is part of the health care reform debate that veers off the tracks for many people. Some people simply can’t afford insurance; others make irresponsible choices, end up not being able to pay their bills and add to the costs for everyone else.
And don’t expect the national move to “universal health insurance” to suddenly cover your costs. In one example reported recently, someone in a low-wage job — say $21,000 annually — legally could be offered insurance at a cost equal to 9.5 percent of that income, according to the new health care law. That could mean an annual premium as high as $1,995.
There is no time to waste in making provisions in your family budget for adequate health insurance coverage. The so-called national Affordable Care Act doesn’t change that.
■ Get to know your insurance and your carrier. Health care has changed, and it’s past time for many people to pull out their policies, ask basic questions about things like deductibles and higher costs for visits to the emergency room, and manage their health care expenses accordingly.
If you have options, look for a policy and premium that make the best sense for your situation.