Why can’t I find the prices for health care?

With rising health insurance deductibles it’s important to know the prices of the health care that you’re buying. So why is it so hard to find out how much an appendectomy costs? Or even an aspirin?

It’s because of the way that health care is priced in the first place – through health insurance:

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And, remember…

It’s not the COSTS of health care that are outrageous…it’s the CHARGES.

Physician. Health Insurance Agent. Author. Health care humorist. Medical satirist. Disruptor. At your service. My name is Kevin Wacasey, and I’ve been practicing medicine since 1994. When I graduated from medical school, I took an oath to do no harm to my patients. To me, that includes financial harm. But since health insurance took over health care over 40 years ago, health care prices have skyrocketed. And despite what we’re told by the media every day, it isn’t the costs of health care that are outrageous; it’s the charges. So if you’ve ever wondered why we spend so much on health insurance and health care, then come along and join me as I explore the crazy world of Healthcareonomics. Health care doesn’t have to be expensive. Let me show you how. For speaking opportunities and to pass along your questions/comments, please email me at drw@healthcareonomics.com.

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  1. Roland




  2. Andrea Kerivan

    Dear Dr Wacasey,

    I just finished your book The Guide to buying health insurance. My husband who is 58 is about to retire and I’m 55. We have been on a high deductible PPO plan from United Healthcare with an HSA
    The one question that I have is if we find a good bronze plan that is an HMO are all the plans Silver gold and platinum equal in terms of network of doctors hospitals and care? Is it only the cost structure that differentiates the medals or is it also that the network and level of care is different.
    Having been on a high deductible plan we understand exactly what you are saying but we just want to make sure that once the out of pocket is reached that at that point we would have excellent care.
    Your book is great Thank You. I have also looked ito Direct care physicians here in Boston

    • Thank you for the compliment, and thank you for reading the book!

      As to your question, it really depends. No two health insurance plans are the same, and the devilish details as they say, are in the pages and pages of fine print. In other words, in some cases the cost structure may be the only difference between metal “levels,” but in other cases the network will be affected as well (keep in mind than an HMO is much more restrictive in general than your PPO plan).

      I’m not sure how far his practice is from you, but Dr. Jeff Gold is a DPC physician in the Boston area: http://golddirectcare.com/.

      So do your homework by carefully comparing not only the cost of each plan, but the details as well. Best of luck!

      • Andrea Kerivan

        Dear Dr Wacasey,

        I really appreciate you getting back to me. I have picked out 4 Insurance companies and will use your equation to compare all of their plans and then look carefully at the details of each. We are able to stay on my husbands plan after 18 months of cobra. Its been a good plan but we just want to make sure that spending 24,000 a year is the right choice.
        I have seen Dr Gold and will contact him. He is fairly close to us. We have been paying eveything out of pocket and letting our HSA accumulate all these years. We are already used to that.
        Its been very helpful to have someone help with this very confusing issue. I will recommend your book to other friends.
        Andrea Kerivan

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