Saturday, October 22, 2011

Why American health care costs so much

I've been waiting about a year for this post. On October 9, 2010, I had the pharmacist at Osco Drug (one of our local chains, similar to Walgreen's) administer my annual flu shot. The charge, in sum, was $26.99. I paid this out of pocket and submitted a claim for it to my health insurer, Blue Cross-Blue Shield of Illinois. It was rejected outright because Osco is "out of network." I knew that would happen, and was reimbursed instead from my health care flexible spending account (a handy little arrangement by which working persons can arrange for their employer to withhold an elected amount of pre-tax money from their paychecks from which to be reimbursed for certain out-of-pocket health-related expenses).

This year I decided the best revenge would be to get my flu shot "in network" and I just received my statement from the in-network University of Chicago Medical Center for $121.00 for services identical to those provided by Osco Drug. Of course the Medical Center had initially sent the charges to Blue Cross-Blue Shield. According to the statement, BC-BS paid the Medical Center $85.72 of that total. Compare that to the approximately (allowing for a little inflation since last year) $26.99 they could have paid had they been willing to reimburse Osco Drug. Or perhaps BC-BS would have preferred that I not have a flu shot at all (no cost to them!) and taken the chance that I wouldn't contract a case of the flu severe enough to require, say, 5 days hospitalization.

Oh yes, and the amount I owe the Medical Center is $35.28. By playing this game, $8.29 more comes out of my flexible spending account. It is worth it just to prove a point about the state of our medical insurance system in this country.

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