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The Cost Differential We’re All Paying for, One Way or the Other

09 Mar

A couple weeks ago, my doc scheduled a routine CT scan to check out my lungs – only because I once was a heavy smoker, way back in the day. The results were fine, but I learned something important I'd like to pass along.

A couple days before I was to show up at the hospital radiology department, my insurance company called to ask if I knew that the scan at the hospital would cost somewhere between $1200-$1600, and I could have the same scan done at a free-standing radiation clinic for $275. What?

Like many people, I don't pay for these things out of my own pocket, so it had never occurred to me to ask about cost. Between my primary insurance coverage and Medicare, this stuff just gets paid.

I asked why there was such a huge cost differential. Was there a difference in the quality of the equipment? In the skill of the radiologists interpreting the pictures? In access to the report?

She said she didn't think so, but she could call the centers closest to where I lived to ask these questions.

In the meantime, she thought maybe that with the hospital, there could be overhead costs that got thrown into the cost of the scan – so I'd be paying, not just for the scan, but for the O.R., the E.R., the P.R., a huge staff, a lot of liability insurance – the works. With the stand-alone, I would mostly be paying for the cost of the scan. (And, technically, it was not I doing the paying, of course, but my insurance.)

She kept me on the line while she called a couple of centers. The first one did not in fact have equipment as good or as high resolution as my hospital's. But the second one did. I then called my doc's office to ask about the difference. A savvy nurse I trust there acknowledged that there was no real difference in quality – just price.

I had the work done at the stand-alone center.

It proved to be a terrific place. I'd go back in a heartbeat. It was classy, new, spotless and spiffy. It had a great staff and I got courteous, efficient service, leaving a half hour later with my own personal disk in hand. The report landed in my doc's laptop a couple days later.

I wondered how this insane pricing system affected the cost of everyone's premiums, when we all blindly sign up for these scans at the hospital. Most hospitals are currently making huge profits these days, and now I know one of the reasons why. We're all getting soaked.

And what about the person with no insurance, or not very good insurance? What do they do? Do they even know that they might be paying out of pocket for something that could be costing them 6 times less??

So, the next time you're signed up for a scan, please ask some questions. Because right now, the system is way out of balance.

And speaking of balance, Traci Stein's new guided imagery/hypnosis for Healthy Weight & Body Image is rocking the warehouse. Both the one to listen to during the day and the one for nighttime while asleep are flying off the shelves, neck and neck in popularity.

If you have either one, we'd love to hear how you like them. Everyone around here thinks they're pretty terrific, but as always, we love and appreciate your feedback.

Take care and be well.

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Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award.