Donald Trump Promises Health Insurance for All

COL Vincent Stoneking - Yes, just ask someone what their appendectomy will cost and did they check with any other provider. The answer is always no because the system is the doctor tells you what you need, they go the insurance company and there is an agreed upon formulary of prices for procedures etc. and how much they insurance will cover. All the patient worries about id deductible and out of pockets. There is nothing else in the market bought like that.

COL Vincent Stoneking -
Sir, I can understand your frustration however, there are several moving targets when factoring costs for hospital-related procedures. Let me offer some industry advice. As a PA, I work in roles ranging from emergency medicine, urgent care, and orthopedic surgery. If you would prefer to keep costs as low as possible, don't wait to have a procedure until you are sick or unable to move under your own power (ambulate). I would recommend a same day surgery center where costs are much lower than a hospital, which has a much larger overhead = more costs.

Lastly, resist the temptation to refer to yourself as a Customer, Consumer, or Payer. I've seen this as a growing trend among certain populations and can attest these labels only worsen the patient/provider relationship. Speaking only for myself. where in industry can you go and request/receive a service, take over 90 days to pay and then tell the owner what you feel like paying? This is what insurance companies and the government pull on every provider every day. Do yo think the providers employees will accept less than they earned, the power company less than they delivered, or the malpractice insurer less than the agreed cost to do business?
Oh how I wished I'd have become a plumber some days :-)

Good luck and stay healthy while you have control over that which you can.

SFC Rich Combs - Thanks, but I am familiar with the industry, both the medical and the insurance sides. I've worked in insurance, and as very close adjunct to medical for pushing 18 years.

I will not resist the temptation to refer to myself as a Customer, Consumer, or Payer depending on what my role is. Because it IS an economic transaction, and I am filling one or more of those roles. Telling me that the government and the insurance industry make the situation worse is preaching to the choir - - and exactly why I insist on using those terms. The "patient/provider" relationship is made worse by the artificial separation of those three roles. The more they are merged into one, the more rational decisions will result. When you recommend going to a same day surgery center (which I agree is great advice, as is practicing preventative care), you are asking that I act in an economically rational manner, which will only happen IF I view it as an economic transaction.

I don't expect anyone to take less than they have earned, or to put a more fine point to it, I expect the price to be what a willing buyer and a willing seller will both agree to. Again, for that to happen, the economics need to be addressed fortnightly. Again, look at the dental profession, optometry, and the cosmetic surgical industry. These tend to be some of the higher netting specialties - I would argue specifically because there is financial transparency that allows for rational self-interested decision making.

For the record, I am not personally frustrated, as I am a state employee and have ridiculously good medical coverage paid for be the citizens of the great state of Washington (my personal payment and co-pays are super-low, and I know what the state kicks in) when I'm not on active duty getting it for free from the great Uncle Sugar.

COL Vincent Stoneking -
So we do agree, for the most part :-)
My best advise remains to avoid hospitals, this is where all the hidden costs come from. As for the dentist, optometrist, cosmetics, all are set in stone prices. Again, same day surgery if possible adds cost controls.
I would argue however, your relationship with your medical provider is key to your health. When I put my PCP (primary care provider) hat on, I definitely shift gears and look at the whole person. When I find myself on the other side of the stethoscope, I prefer to be referred to as a patient, which is actually a more noble position to be in than customer. We providers cringe at the word customer, which can really dehumanized the visit.
As you seem all to aware of the industry, much is this reply is for or brothers in arms who may not be as familiar.