Anesthesiologist With Late Onset Diabetes Realizes He Has Health Coverage that Doesn’t Cover Much

By Consumers For Quality Care, on November 19, 2019

Anesthesiologist With Late Onset Diabetes Realizes He Has Health Coverage that Doesn’t Cover Much

Todd Rice is a 48-year-old anesthesiologist who, until recently, was in perfect health. Then, one summer, he lost 20 pounds and found himself with an unquenchable thirst and blurry vision. He later learned the cause of his symptoms was diabetes. As Rice writes in KevinMD.com:

I’m a healthy 48-year old, ASA physical class I anesthesiologist. At least I was healthy until an unintentional 20-pound weight loss over the summer, accompanied by an unquenchable thirst, insatiable appetite, blurry vision, and the bathroom frequency of an elderly prostatic.

Rice soon learned he would need to start using a variety of doctor-prescribed medication and medical devices to manage his condition. What Rice did not expect was that paying for all his drugs and devices out of pocket with no insurance would be $4,000 cheaper annually than going through his insurance.

So, of the $5,618 subtotal, insurance will pick up the remaining $2,618 after my $3,000 deductible.

That seemed a little pricey for a technology that cannot be more complicated than my Android cell phone, Chromebook, or Playstation 4 — any of which cost me about that of one single, quoted glucose reader. So, I started looking for direct pricing. Goodrx.com priced me readers and sensors for about $70 and $55 each, respectively. That calculates to a year-one cost of roughly $1,600 — by paying out-of-pocket at Walgreens. Hmm … $1,600 versus $5,600. 

For the exact same products. A $4,000 difference! A 350 percent markup, if my math is correct. 

Rice’s experience led him to wonder whether a more transparent system, where the actual costs of supplies and services were widely available, would save consumers money.

This physician-patient, for one, has been awakened to the power of price transparency and interloper-reduction. Health care “coverage” is, admittedly, very expensive. In contrast, what do the actual medical services and supplies cost, absent the interference and markup? What if we could cut the price tag of our health care by 350 percent just by pulling the costs out into the sunlight and eliminating the unnecessary intermediaries in exchange for direct and transparent care models?