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Medical Care Bargain Hunting With Bret Stephens


Excellent comment thread here, but I especially recommend this from LosGatosCA:

I think I’m starting to see the brilliance of the conservative Republican market driven, outsourced delivery model. For example, consider a massive heart attack strikes a 55 year old man without a health insurance policy but a HSA with 6 month’s of contributions.

Step 1 – call Uber, not 911. Pay the peak pricing gladly – it still beats a fully loaded EMT response . Plus, if they don’t show up you get a $5 credit, should you survive

Step 2 – remember to not go comatose. Such lack of discipline at this critical pricing decision point could adversely impact your ability to make a rational decision on the services you may be willing to pay for and which supplier in your particular market you may want to utilize. You can ignore this if you live in a rural market and the nearest regional hospital with an ICU is 25 miles away.

Step 3 – direct the Uber driver to the nearest accredited hospital while you use your iPhone to solicit quotes from alternative medical retail establishments (hospitals, clinics, etc) don’t forget to read the reviews. At these times it’s also especially helpful to bring up your pre-defined Excel template that you cribbed from Consumer Reports to plug in the quotes as you are making your way to the first medical retail establishment in your itinerary for this medical emergency. Be glad you aren’t a rape victim so you can be sure that whatever fully informed facility and treatment path you decide on, the hospital won’t refuse to treat you according to your wishes. OTOH, the medical retail establishment might not treat you unless you can produce a current liquid net worth and credit score that meets their patient treatment scoring index. Subprime can lead to restricted options.

Step 4 – If your are alive and still conscious when you reach the first medical retail establishment remember ‘you don’t get what you deserve, you get what you negotiate.’ Just think of the ER staff and attending physicians as Turkish rug merchants. They need your business, keep in mind that you may need to just walk away if they refuse to bargain in good faith. Beware of hardball negotiation and scare tactics like:

You should have called 911 instead of Uber, now it’s going to cost you an extra week in ICU.

If you had been getting regular checkups and lowered your cholesterol from 525 you wouldn’t need the bypass and the stent.

You should take our offer because you won’t make it to the next medical retail establishment.

Don’t let these medical financial predators stampede you in to making rash split second decisions that they claim are life or death. Take your time, gather all the data, read all the reviews and make a carefully considered, rational decision. Don’t treat this like that impulse buy when you bought that overpriced, red convertible that had that incredibly hot model in the magazine ad.

Good luck, with a solid plan and the patience to not panic under pressure you’ll be able to get a great deal. Should you die, it’s not your problem anyway. If you have severe brain damage, you might still have gotten a bargain by not paying for services you didn’t get. Plus using Uber is a major savings opportunity. Not everybody needs trained medical technicians administering CPR, oxygen, or other stabilizing procedures.

Next week: how to determine if you really even need Uber to reach your local medical retail establishment.

Previous articles: How to have physicians bid for your business when your appendix has burst

Thinking of selling your blood, plasma, organs – read this first!

Hard to see any flaws in this plan. I mean, would you like to be “shunted” to mere insurance, like you lived in any other liberal democracy or something?

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