Health Insurance Nightmare: Wake-up Call!


The health system is getting uglier, and you are responsible for more and more of the cost. Those out-of-pocket health expenses are growing fast. More than 25 percent of American families have insurance deductibles of $5,000+ per year.

But families and small businesses can save on health care costs by teaming up with a savvy membership medical practice. If you visit a doctor a few times a year -- or if you have routine tests and scans -- it all adds up. For many, cutting these outlays can easily cover the fees at a membership practice and save much more besides. If you're in "open enrollment" now or soon, there are even more advantages.

At my Oak Park family practice we limit the number of patients to a fraction of what's typical, so we know them well. We can often make decisions about treatment with just a call or an email, and our patients can contact us 24/7 for that service. Most traditional practices have to insist that you come in to be seen, though, even for rather small problems -- otherwise, they won't be paid by insurers. That costs you time and money, not to mention convenience.

Prescriptions add up, too. I can offer free samples of pharmaceuticals on a trial basis to see whether they are effective for the patient. Large medical practices may only make money when they issue a prescription. Some independent and private practices like ours have arrangements with labs for a lower rate, too.

And our practice subscribes, at no cost to you, to an online service called Health Engine that analyzes your insurance to calculate ways to save out-of-pocket costs for surgery or radiology. This service also compares costs among facilities in our area, to show you to the least expensive option for the treatment you need.

For example, if you need your tonsils out I can refer you to an excellent surgeon who may practice at several different hospitals. Health Engine picks the option with the least cost for you. It sometimes contracts with the facility to provide lower costs, too.

As Dr. Eric Crall has written, "Insurance is only intended to 'insure' us against low probability, high-cost events. Our car insurance hasn't spiraled out of control because we still pay for oil changes and tire rotations out-of-pocket.

"So the strategy moving forward to lower cost, for both individuals and employers, is to buy a low cost monthly membership" -- like a gym membership, he adds -- "and complement that with a true catastrophic insurance plan."