Why pricing transparency does matter

The reality of what it's like to be a patient without health insurance hit home for Andrew T. Gray, a physician assistant at a Beverly Hills HIV clinic, when earlier this year he suddenly needed an emergency appendectomy. New to the job, he just became eligible for health insurance but had neglected to fill out the necessary paperwork.

"How did this happen to me?" wrote Gray of his experience in the September issue of Pulse Magazine. "How could I, a healthcare provider, not have insurance?"

In pain and panicked at the mounting bills headed his way, he quickly faxed in the insurance paperwork but waited until the following day to seek treatment at a local hospital emergency room. While waiting, he looked up a Swedish study that touted the success of treating appendicitis with antibiotics. The ER resident and the attending physician weren't impressed with the study findings or Gray's concerns about the cost of surgery. They ordered a CT-scan and scheduled surgery for later that same day.

Later when his nurse came to his room with a hospital survey, Gray again expressed concern with the cost of his care. She urged him not to worry about it and he'd sort it out after he was healthy again.

"So many times, I'd heard myself say these very words when a patient expressed concern about treatment expenses," Gray wrote. "But now I realized the truth: No one involved in my care actually knew the cost of any of the treatments they were suggesting."

When Gray's supervisor from work called to see how he was feeling and Gray reported his pain had subsided, his boss told him to leave the hospital and he'd schedule an appendectomy as an outpatient the following day. "You'll save a lot of money," the supervisor told him.

So Gray signed himself out of the hospital against medical advice, and asked his supervisor for prescriptions of the antibiotics used in the study. By the following day, he felt better and cancelled the outpatient surgery.

His bills for the emergency room visit, the CT scan, a dose of IV antibiotics and hospital admission totaled more than $30,000 without the appendectomy. The cost for his two-week course of oral antibiotics: $50.

"It's easy to tell a worried patient, 'Let's worry about the cost once you're healthy,' but having been that patient myself, if only for a day, I know how thoroughly the fear of medical bills can obliterate any concern about health or healing," Gray wrote.

So now, when a patient asks about treatment costs, Gray finds out.

For more:
- read Gray's first-hand account in Pulse Magazine

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