March 13, 2012

The Most Expensive Nap

*Disclaimer* I am not a medical expert of any kind. These are just my personal thoughts.

I was somewhat baffled the other day when I got the non-bill from the hospital just letting me know that the MRI on my knee cost my insurance nearly $1800. That sum made me almost glad that the MRI showed I have a torn meniscus. I’d feel kind of guilty if it had turned out to be nothing major that had caused my knee to hurt for the past five months.

That's not my knee. Just an example.

What makes up the cost of an MRI? Why are they so expensive? And why does the cost vary from place to place? For my end of it, I lay nice and still under a blanket for 20 minutes listening to music and almost falling asleep. Most expensive nap ever. Clearly the cost must include overhead (lights, rent, heat, etc.), cost and maintenance of the machine, the technician’s fee, and the radiologist’s fee. Even looking at all that, it feels like someone is making a good profit here. After all, those machines last a long time and they do a pretty good number of MRIs in a year.

What really bothers me about health care in general is that, like this MRI, you often have no idea what medical costs will be or what goes into those costs. My grandfather got a pace maker installed (this was several years ago) and stayed one night the hospital. His bill was over $100,000. The vast majority of that cost was the actual pace maker. Considering how many people have pace makers, I have a hard time believing that it could possibly cost that much to produce. Unless they’re made entirely out of diamonds, which I don’t think is the case.

To my mind there are two problems here. First, there’s no good system for consumers to evaluate costs ahead of time. Second, you will pay any amount of money to not die. Both of these problems are compounded by the fact most people would rather have splinters shoved under their nails than try to read and understand the finer points of their health insurance policies.

Just think, if you are buying a car, a washer, a computer, or just about any other thing, you probably spend a good bit of time researching models and price before hand. You go to the store armed with a wealth of knowledge about GBs, upload speeds, and options. You ask hard questions, and when you do make a purchase, you feel like you got a good value.

How would you translate that to health care? Clearly, buying a service is different from buying a product. Take the example of choosing a hair stylist. There is a certain intangible of feeling comfortable, being set at ease, and liking the end product that is actually pretty similar to choosing a doctor. You can get the same result from lots of different, qualified people, but you usually end up with one person you’re devoted to. The big difference is that it’s relatively easy to find out what salons charge for their services. They will give you an easy to read and understand menu of prices. How do you do that with a doctor?

To my knowledge there is not a good tool that can show what various doctors’ offices charge for their basic services, let alone lab fees or other extras. Most people pay some kind of co-pay, so that’s no indicator either. How do you know without going if the doctor will be a good fit? I found four websites with reviews of doctors. I searched for my pediatrician on all of them. Two didn’t have her listed. One had her with four reviews; the other had two reviews. When I was researching a recent DSLR camera purchase, there were hundreds of reviews for the camera I was considering.

The tools that we use as savvy consumers just do not exist in the same volume for health care. How can we be informed consumers? It would require quite a bit of effort on an individual’s part to call every office and try to match up different pricing, if they’d even give it to you. Then there’s the question of matching it with your particular insurance.

What we’re left with is a blind consumer who mostly just guesses. If you get referred, you just go. If they tell you, it’s Dr. Smiley, then you go and as long as he doesn’t try to cut off the wrong leg, you’ll probably do what he tells you. And more likely than not, you’ll have no idea of where his fees fall from cheap to expensive, and there’s no particular incentive for you to wade in and find out.

All I can suggest is that if McDonald’s has to list calorie counts right on its menu, then doctors should list their fees right on their websites. Insurance providers should offer a way to search not just for network providers, but for effective, reasonably priced providers. And doctors and hospitals should compete for our business by offering good service and reasonable fees instead of banking on the fact that we can’t say no or we could die. I can’t help but feeling that if we start there, at the very root, we could both improve health care for individuals and reduce costs by eliminating the huge price swings that are currently in place.

March 6, 2012

Baby Shower Favorites

I have been to an amazing number of baby showers over the past three years or so. A few years back it was weddings; now it’s babies.

Since becoming a mom, I’ve found some must-have items that I like to share with new moms for their showers. In case you’re ever stumped trying to find something to buy off the registry, try some of these great items. Just make sure I’m not invited to the same shower.

There are no high-priced gadgets on here. Just simple, little things that you only discover once you’re a parent. These are the sorts of things I love to share with new moms because they are things that often don’t make the registry.

For Mom:

New moms need some lovin’ along with their sweet babies. One sure-fire winner for a mom who plans to breast feed is a nursing cover. These go by the name nursing cover, hooter hiders, or udder covers. If you’re handy with a sewing machine, these are pretty easy to make. I can’t sew to save my life, but my wonderful mom made me one for half the price of buying it in the store. For those of you, like me, who break out into a cold sweat when you hear the words “sewing machine,” sign up for the email list at They have beautiful covers, and better yet, they occasionally send out specials to get free covers! You just pay shipping. I’ve been known to stock up when I get those deals to have them on hand for future showers.

Another great item for breast feeding moms is nursing pads. I personally prefer cloth pads. All disposable pads are lined with plastic, which means they can trap moisture and possibly lead to nasty problems like thrush (a yeast infection on the nipple/baby’s mouth). For the cost of about two boxes of disposable pads you can get enough cloth to last you your whole nursing relationship (for every kid), making it a sound economic investment. These come in cotton, flannel, organic cotton, and I’m sure a few other options. You can get them in the same aisle of Target or BabiesR’Us as the disposable kind. You can also order them from most makers of cloth diapers.

For Baby:
Our shampoo rinse cup is still the best $5 I’ve ever spent. We don't have the exact one pictured, but it's very close. The silly thing is great because the soft plastic front bends to match the baby’s forehead and keeps water from getting in babe’s eyes when you rinse out the shampoo. Changed my life, I tell you! Just make sure you store it upside down so you prevent any nastiness from growing inside.

Infant nightgowns are the best for newborns. The sweeties stay warm, most come with hand covers to prevent them from scratching themselves, and they’re a breeze for those frequent diaper changes. Newborns aren’t really using their legs much, and most of the time they prefer to have them pulled up close anyway. H used to pull her legs out of her PJs all the time. Empty cloth legs flopping around, with the belly filled with her curled up legs. Sometimes these even have snaps to allow them to transform from gown to legs.

Kimono-style t-shirts and onesies are equally wonderful for newborns. These don’t go over the head at all, which is really most comforting for new parents negotiating those floppy necks.

Munchkin Arm & Hammer dirty diaper bags are a God-sent for blow outs. I have friends who would ask, not unjustly, why would you spend money on bags that are meant to hold poop? This is true. But this little gadget is compact and the bags are deodorizing. They saved us several times when we had to break out the emergency outfit after a blow-out ruined H’s outfit. Bad enough you have a ruined outfit; you don't want to smell like it too. You can find it in any baby store.

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