{"id":97,"date":"2015-01-30T23:26:17","date_gmt":"2015-01-30T23:26:17","guid":{"rendered":"http:\/\/commoncents.blogwyrm.com\/?p=97"},"modified":"2023-04-01T09:09:42","modified_gmt":"2023-04-01T13:09:42","slug":"regular-maintenance","status":"publish","type":"post","link":"https:\/\/commoncents.blogwyrm.com\/?p=97","title":{"rendered":"Regular Maintenance"},"content":{"rendered":"<p>See if you recognize this typical scene, played out from time to time in workplaces all around the country.\u00a0 One of your co-workers is late coming to work.\u00a0 Upon his arrival, he meets the office\u2019s quizzical looks with a verbal response that amounts to something like \u201cYeah!\u00a0 My car had problems this morning.\u00a0 I think I need a new\u2026\u201d.\u00a0 I am willing to bet that most everyone has been on both the giving and receiving end of this exchange.<\/p>\n<p>The next segment in the exchange goes something like this.\u00a0 Everyone gathers around and discusses the problem.\u00a0 Opinions fly as to what is exactly wrong, how much to pay, where the best place is to go to get the repairs done, and how to make sure that the mechanic doesn\u2019t cheat.\u00a0 Typically, there is a lot of varying ideas about the specifics.\u00a0 \u201cTake it to the dealer\u201d, says one.\u00a0 \u201cNo! don\u2019t go to the dealer.\u00a0 I know a guy.\u201d, responds another.\u00a0 \u201cCheck the internet first\u201d, comes yet another bit of advice, and so on.\u00a0 But there are really no differences in the general goal.\u00a0 Everyone involved is trying to find the best value, the best repair relative to the price.\u00a0 And every one of them is engaged and has knowledge that can be put to use.<\/p>\n<p>Let\u2019s be specific and consider the case where you need a new set of brakes for your Honda Civic.\u00a0 A simple internet search with the search string \u2018new brakes cost honda civic\u2019 returns as one of the top hits a link to <a href=\"http:\/\/www.civicforums.com\/forums\/43-wheels-tires-brakes\/149893-how-much-you-pay-new-brakes.html\">Civic Forums<\/a>, where the same type of dialog happens in the medium of the chat forum.\u00a0 For this particular repair, the generally agreed upon estimate of the cost is $150.<\/p>\n<p>Also note that no one suggests that the owner file a claim with their car insurance.\u00a0 No one even entertains the notion, since replacing the brakes is part of the regular maintenance on a car.\u00a0 Everyone recognizes that car insurance is meant to hedge the risk of an accident that damages life, limb, and property.\u00a0 Most people go through life hoping that they never have to draw on their car insurance policy.<\/p>\n<p>Now consider another type of regular maintenance \u2013 maintenance of the human body.\u00a0 The comparison between this activity and the situation described above is quite stark in the differences.<\/p>\n<p>To begin, our natural shyness about the body tends to dissuade us from talking about the standard types of treatments we all need.\u00a0 Few have the same enthusiasm for discussing trips to the doctor with their co-workers as they do trips to their mechanics.\u00a0 But wait, you say, here is where the internet comes into play.\u00a0 A person can set up an avatar, assume a cyber-identity, and maintain his personal dignity while getting answers to some of the more delicate questions that can be posed.\u00a0 And this is absolutely true.\u00a0 One need only surf the World Wide Web for a while to see that people are quite willing to discuss (and display) just about any matter concerning their body with the mask of anonymity that a computer account affords.<\/p>\n<p>So then, why is there so very little general knowledge about how much various medical treatments will cost?\u00a0 And what questions should be asked?\u00a0 And so on.\u00a0 As a society, we know far more about how to be informed and savvy consumers in almost every other market that is out there, and yet we are total dunces when it comes to the medical markets.<\/p>\n<p>Again to be concrete, let\u2019s look at a specific medical maintenance issue.\u00a0 Suppose you\u2019re now of the age where your doctor wants you to get a regular colonoscopy.\u00a0 Where do you go?\u00a0 How much should you pay?\u00a0 How good is the doctor and how much risk is involved?\u00a0 All of these are valid questions, but I am willing to bet that very few know meaningful answers.\u00a0 Let\u2019s take a look at the first two questions in detail.<\/p>\n<p>A simple internet search with the search string \u2018colonoscopy cost\u2019 returns as one of the top hits an article in <em>The Health Care Blog<\/em> entitled <a href=\"http:\/\/thehealthcareblog.com\/blog\/2014\/08\/27\/how-much-is-my-colonoscopy-going-to-cost\/comment-page-1\/\">\u2018How Much is My Colonoscopy Going to Cost? $600? $5400?\u2019<\/a> by Jeanne Pinder.\u00a0 As the title suggests, there is a vast range in the costs of a colonoscopy ranging, according their research, from $600 to $5400, a factor increase of 9 from the lowest value to the highest value.<\/p>\n<p>Pinder lists six items in the total cost that should be examined before committing to the procedure.\u00a0 These are:<\/p>\n<div class = \"myQuoteDiv\">\n<ul>\n<li>Doctor\u2019s fee<\/li>\n<li>Anesthesiology cost<\/li>\n<li>Lab Tests<\/li>\n<li>Facility Fees<\/li>\n<li>Pre-procedure consultation<\/li>\n<li>Preparatory costs, including medications required for the procedure<\/li>\n<\/ul>\n<\/div>\n<p>However, Pinder points out that it is difficult to get straight answers for most of these items.\u00a0 The doctor, anesthesiologist, lab, and facility all bill separately.\u00a0 All play the shell game between listing the charged price and the paid price.\u00a0 The charged price seems to be the cost that these service-providers initially ask, while the paid price is what they settle on once the haggling with the insurance company is completed.\u00a0 Having so many moving parts also makes it easy for each group to avoid accountability and, indeed, their usual response, as cited in the article, is \u201cwe don\u2019t quote prices in advance.\u201d\u00a0 Imagine going to your mechanic and being told something to the effect \u201cwe\u2019ll let you know how much it costs when we figure it out\u201d \u2013 you would never put up with it.<\/p>\n<p>Recently I discussed the stark contrast between regular maintenance for a car and for a boy with a co-worker.\u00a0 He raised the objection \u201cdo you really want to have a procedure performed by the lowest bidder?\u2019\u00a0 On the surface this may seem like a cogent argument but some reflection shows that it is inadequate.<\/p>\n<p>What logical connection is there between paying more and getting better health care?\u00a0 There is some truth in the old maxim \u201cyou get what you pay for\u201d, but that really only applies to situations where the consumer is trying to get a \u2018sweet deal\u2019 by cutting corners. This maxim is utterly devoid of meaning when the consumer knows next to nothing about the goods or services he\u2019s buying.\u00a0 Perhaps a doctor who charges more for his services may be worth it.\u00a0 On the other hand, he may be a shady character who talks a good game, gives poor or even dangerous service, and is putting his profits before the patient\u2019s needs. \u00a0\u00a0He may have to charge high prices to cover his malpractice claims and you just don\u2019t know it.\u00a0 It is also possible that a good doctor is one who possesses enough skill that he can diagnose your problem without groping through unnecessary and costly tests which consume your time and put you through needless pain (both physically and mentally).<\/p>\n<p>There is a related objection that asks why would you want to skimp when it come to your health.\u00a0 This objection is also patently fallacious.\u00a0 My health depends intimately on a day-to-day basis on the condition of my brakes and tires but that doesn\u2019t stop me from seeking the best price. By seeking the best price, I am actually conserving my resources for other things that also have a positive impact on my health, like going to the gym, or buying better food, or moving to a better neighborhood. \u00a0\u00a0The word \u2018skimp\u2019 is merely a red herring that is meant to stop us from realizing that purchasing medical services is done, like every other purchase in life, in a market.<\/p>\n<p>The short of it is that when it comes to car, home, or appliance maintenance, each of us is reasonably knowledgeable in the marketplace.\u00a0 Each of us tries to find the best value and each of us understands what insurance covers and why.\u00a0 In the medical market, few if any of us have enough knowledge or enough courage to seek the best value and to understand what the role of insurance should be.\u00a0 We trust that doctors and hospital and medical practitioners will protect our interests in a way that we don\u2019t trust mechanics.\u00a0 But this trust is predicated on nothing more than the fairy tales we\u2019ve been told on television and in the movies.\u00a0 Until each of us takes responsibility for being informed health consumers the system will remain in critical condition.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>See if you recognize this typical scene, played out from time to time in workplaces all around the country.\u00a0 One of your co-workers is late coming to work.\u00a0 Upon his... <a class=\"read-more-button\" href=\"https:\/\/commoncents.blogwyrm.com\/?p=97\">Read more &gt;<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-97","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/posts\/97","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=97"}],"version-history":[{"count":4,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/posts\/97\/revisions"}],"predecessor-version":[{"id":1101,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=\/wp\/v2\/posts\/97\/revisions\/1101"}],"wp:attachment":[{"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=97"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=97"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/commoncents.blogwyrm.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=97"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}