Why you should pay for your mammogram, office visit and more

Social media is obsessed with politicians (Republicans of course) taking away your “health care.” Much of the rhetoric is associated with “old white men” and women’s health care, but, of course, it applies to anyone needing health care. Some of the concern is changing the required essential health benefits under the ACA. This in an attempt to allow people to pick only the insurance they need. It’s a very bad idea that will lead to more adverse selection and higher premiums for the majority of people.

But to clarify, none of what is being talked about interferes with anyone’s health care, it interferes perhaps with who pays for that health care. There is a very big difference and that difference is the essence of why we can’t solve the health care “affordable” problem.
In many instances, people cannot separate obtaining health care and paying for it. In other words, if I have to pay for it, my access to health care is blocked.

Let’s use the example of a mammogram because it seems to be the target of much rhetoric and is a primary issue for women. However, the same is true for a routine office visit of any kind for anyone.

According to the Health Care Blue Book a fair price for a mammogram in the Northeast is about $200. Let’s say your insurance no longer covers that service. Has your health care opportunity been changed? No. Has government taken away any access to health care? No. Are you still free to obtain the service? Yes, you just have to pay for it.

But for the average woman that’s unaffordable! Is it? [we are not, repeat not talking about the poor]. Now take a piece of paper and list what you spend on non-essential things, anything from morning coffee, to eating out, the movies; anything. When you add all that up, does it equal or more likely exceed $200? Sure it does.

Now what if you put that mammogram or office visit at the top of the list and every other thing you spend money on comes after your essential health care. What is unaffordable now?

Now you may say, my mammogram costs more than the fair price, they charge my insurance company $325. Well they might, but why? Because your insurer is paying for it and you don’t care what it costs because it’s “free” to you.

Another argument may be that having routine and preventive care saves money and improves health. That is true in some cases, but those benefits accrue to the individual, so why aren’t we willing to pay for those benefits?

Of course we all need insurance to protect from those expenses truly beyond our means and that varies by person, but most people do not need insurance for very basic routine and preventative services. However, we have been conditioned to think we do, that all health care money from our pocket is unaffordable. What we fail to realize is that prices for those services are what they are because we have insurance and that those costs are buried in the premiums we pay.


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