Recently a friend of mine experienced the pain and discomfort from a back injury. Actually the injury occurred several months ago and since then he has been to several doctors, had a MRI, along with a few x-rays. As of today he is not sure what is wrong with his back or if anything can be done to ease his pain. He is stretching and doing exercises to help control the pain but is still not back to his normal active self.
Now enter, the healthcare system. During his last trip to the doctor he was informed that the first MRI did not extend low enough to observe the problem. I don’t know, dear reader if you have ever had an MRI, but they are terribly expensive in this country. So, he was instructed to have an additional MRI done. After scheduling it at Hampshire Memorial Hospital, he received a phone call from his insurance company informing him that if he had the MRI done at Hampshire, which is part of the Valley HealthCare System, it would cost him close to $800 out-of-pocket; but if he was willing to drive an hour to Berkley Springs Memorial Hospital, (which is part of WV University Healthcare) then it would cost him less than $200 out-of-pocket. Valley Healthcare as well as WV University Healthcare are very large and ever-expanding mega-healthcare systems.
Now, I want to make sure you understand what I am getting at. If my friend is willing to drive an hour to another hospital rather than use the hospital right down the street, he can save almost $600. He chose to drive an hour. The question here is: why? Why would one hospital work well with an insurance company and the other would not? I assume the equipment costs are similar. Their operating cost should be similar as well, so what is the reason for this huge difference in out-of-pocket expense? Get ready for this! I was told by one individual that Hampshire Memorial Hospital was owned by an out-of-state company and the Berkley Springs hospital was owned by an in-state company. The obvious question here is, why does that matter? I have watched TV shows that explored this phenomenon of variations in cost, but never actually saw it in real life. Stated another way, we need to shop around for a hospital system that charges more consistent reasonable rates. This is rather bizarre if you think about it enough, but we never discuss money with a doctor when we have something done medical. It is not in our culture customary to ask the hospital or the doctor how much a procedure will cost, so we just pay, along with the insurance company, whatever they ask.
To sum up, my advice is to shop around. Ask the hospital what a procedure costs. Ask the doctor that same question. Talk to your insurance company as well about different cost options. As usual, you are the only one watching out for you!