THE PUBLIC MIND: AMERICAN CONSUMERS HAVE NO ADVANTAGES IN STUDYING THE HIGH COST OF HEALTH CARE

To the Editor:

In a recent editorial you advised people to take preventive care of their health and be a good medical services consumer. I wish that it was possible to be a knowledgeable consumer. However, there are so many variables and unknown prices and policies dealing with doctors' and hospitals' fees that the average person (without medical knowledge) has very little chance of making informed choices.

Most often we pay $40 or more for each second opinion as to the medical diagnosis and treatment; not to mention how hard it is to get an appointment within a reasonable amount of time with various doctors. We try not to go through the first doctor to get a referral to a second doctor for an opinion because we'll not get an objective opinion. What we'll get is two first opinions. Are you following me?

If you have a medical problem that needs attention fairly soon, you'll run out of time or money. So much for comparison shopping for doctors!

Have you ever seen this sign in doctors' offices: "We do not accept Medicare assignment"? Do you know what that means? People on Medicare know and we all need to learn it. It means that doctor does not accept the fee that Medicare will pay them for that service. There will be an extra charge that you, the consumer (or your insurance company) will pay.

Those of us below age 62 but covered by insurance have the same problem! There should be another sign in doctors' offices that says, "We do not accept (insert your insurance company's name) assignment!" It means there will be an extra charge that you, the consumer, will pay.

When I asked my insurance company why they would not pay, they said that they pay only the Usual & Customary (U&C) charges for that procedure and I must pay the rest because the full price is too high! So write to your insurance company ahead of time and ask what the U&C charges should be for that service. It's not as good as Consumer Reports magazine to compare prices; but it'll have to do. Where else does a person who doesn't have medical knowledge go to find out if the amazing cost on a doctors' or hospitals' bill is correct; or did the data entry person add one too many zeros by mistake?

So let's say you need surgery and need to choose a hospital. Call them up and ask their charges for:

1. Daily rate for a semi-private room.

2. How much per hour for operating room, recovery room, etc.

3. Lab fees for prerequisite tests, EKG, X-ray, etc. before surgery. Check the cost the hospital charges as well as what the pathologist(s) charge. (You may have to call them separately and good luck).

4. How much for medicine provided in the hospital? Does a Tylenol tablet really cost $7?

5. During surgery what are the extra charges like oxygen in the room just in case it's needed? How many other doctors will be in surgery (anesthesiologists, etc.)? You may have to call them separately and good luck.

6. How much is the charge for post-operation physical therapy if needed. (You may have to call the physical therapists separately and good luck.)

7. Other charges that someone without medical knowledge has no idea about!

My point is that it is impossible to make an informed choice. Perhaps hospitals keep all these charges separate in order to keep the public confused. Consumers will give up questioning and they can charge what they will.

What if I went to a grocery store and wanted to buy a can of peas? They tell me the cost of the peas and then asked, do I want them cooked and packed in a can? (That has an extra cost.) Do I want salt added? (That is an extra cost.) Do I want a label? (Never mind, the government says it must have a label! Extra cost.) Do I want a checker to take my money? (Extra cost, you may have to call them separately and good luck!) And last do I want it in a bag? ($ .04) Are you following me?

If the grocery store can simplify costs, so could hospitals if it was to their advantage. Evidently the present system works to hospitals' advantage. We consumers have no advantage.

Name withheld by request