Medicine, As I See It

Reading "Are Health Savings Accounts Good Medicine?" I've come up with my own answer to the question: Not really.

I'm a person with health issues. I get a lot of medical things done on a regular basis. I can tell you right now that I'd be less likely to do them if the cost was coming out of my own money. It's not that I don't want to take care of myself, it's just that medical procedures cost so very much. Take, for instance, my hospital stay of last April - I was there for 6 days, and the insurance company reported that the last 3 were "unnecessary" and "alternate arrangements" could have been made for my care. I objected, by the way, seeing as I was being fed through an IV and feeling pretty damn bad. But my point is that the cost for those three days came to roughly twenty-seven thousand dollars. Just thinking about setting up a payment plan for that much makes me dizzy. There's no way I'd have that much in a personal health savings account, and I make a fairly decent living. What would a less fortunate person do?

The article quotes a doctor, Dr. William J. West, Jr., an obstetrician/gynecologist in Reading, Pa.. Doctor West says

"When I deal with a patient who has a health savings account, we make decisions about treatments together and we discuss costs," West says. "This is likely to mean doctors practice less defensive medicine, because if you have discussed a treatment with a patient they have agreed to it, it's harder for them to sue you over it."

Whoa. I forget that people treat doctors like some sort of magic person. I talk about treatments with my doctor and discuss costs *now*. Shouldn't this always be the case? Shouldn't the biggest concern be the most efficient, proper way to solve whatever health problem you're facing? My doctor and I discuss outpatient treatments vs. inpatient, and name-brand drugs that have no generic equivalent vs. a similar drug that does, and whether or not it will do the job.

Now, if the "deductible insurance policy to cover major medical needs" part of this plan would have covered my $27,000 bill, then maybe the health care spending account wouldn't look so bad to me, but I'm suspicious. I don't trust insurance companies to pay for the things that the policies say that they will, and I suppose that the spending account idea just makes me think that they'll even less willing to hold up their end of the bargain. I know it's complicated, and that our lawsuit-happy society is equally to blame, but in this case, I'm looking out for me first.