I blew the collective mind of the BJC laboratory I went to today.

My doctor ordered 12 blood tests. He gave me the form ordering them and I showed up with that form and asked how much the tests were going to cost.

The research I had done indicated that many of the tests weren't as urgent as others, and since I have high deductible insurance, I would probably have to pay for them out of pocket. Because of this, I didn't want to end up getting a bunch of tests that cost me a ton of money.

Anyway, the people at the lab were dumbfounded by the question…they had no idea and no one knew how to find out! I'm supposed to call tomorrow when someone who might know this esoteric information might be there.

I can't help but think that a system where no one knows how much their product costs, and apparently no one asks how much the product costs, is somehow vulnerable to excessive prices and inefficiencies.

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17 Comments.

  1. Jeez, after 12 blood tests you'd be anemic, wouldn't you?

  2. It certainly complicates things if patients have market influence.

  3. I've had the same experience, not all the way to a form for pricing, but with dumbfounded looks when I asked about the price. From what I can tell, contracts between the insurance companies and providers must include an NDA on pricing because no one can ever say until after the bill comes. The best I can get out of them is the maximum price for a service should insurance not pay a penny.

    If it's that inefficient and opaque for a service that's elective and routine, imagine how bad it must be for emergency and in-patient care.

    Personally, I think the prices should be the same regardless of who pays. If you have insurance, that covers up to some limit so you can pay extra for service in a higher quality facility.

  4. A: How much does this product/service cost?
    B: Don't know.
    A: Good-bye.

    At least that's how it should be.

  5. I love my CDHP+HSA insurance, but I have found the same strange looks when you ask for a price. It's too bad this style insurance isn't promoted more, it's a real, easy, solution, or at least step, to controlling costs.

  6. Up here in British Columbia, Canada, our provincial government sets prices for procedures and diagnostic tests which are covered by the BC Medical Services Plan insurance.

    I don't know how they arrive at the prices, flip a coin, negotiating, private meetings with large brown envelopes, whatever. The private corporation labs seem to be happy to take the governments money.  The entire provinces private labs are owned by LifeLabs. Or at least I've never seen competition beyond hospital labs.

    There is a set of fee schedules for almost everything here:
    http://www.health.gov.bc.ca/msp/infoprac/physbilling/payschedule/
    and the one for laboratory services is here:
    http://www.health.gov.bc.ca/msp/infoprac/physbilling/payschedule/pdf/40-laboratory-medicine.pdf
    in case your interested in comparing when you get your list.

  7. I have no idea what blood work costs. Never paid a dime for it.

  8. +Gert Sønderby of course you have paid for it, assuming you have had it. Why do so many peeler think healthcare is free. Unless you don't work, and don't pay any taxes, then it's free.

  9. +Eric K So how much do you pay for the road you drive on, then? Or to be equally specific the third road sign you see on your way to work. What'd that cost ya?

  10. +Gert Sønderby dunno, but I don't go solicit those, or choose where who to buy them from. (Toll roads excluded)

  11. Same relationship I have with blood work, then.

  12. But that's part of the problem, it's why many of us have moved to the CDHP. I ask for price before anything I do now, unless I know I am going to hit my Max out of pocket for the year, which I seldom do.

  13. You miss my point: That's the relationship I have with all healthcare. Sure, there's copay, maybe $150 for a year on treatment. Medication is covered beyond ~$300. I live in Sweden.

  14. Unless you have some bizarre syndrome that's got everybody puzzled, consider changing docs. Is the testing at that lab, or are the samples shipped out for analysis by a third party? I don't know how much the software I work on (large hospital info system, as it happens) is sold for. I'm a developer, not a sales negotiator. Maybe the phlebotomists and receptionists at the lab don't know costs for the same reason.

  15. The doctor hasn't done anything wrong, so I don't think I need to switch.

    He says "You need to get these tests".

    I go to the place that gives those tests and say "I want to buy these tests, how much do they cost?"

    They go "just get them and then we'll tell you".

    I wouldn't expect you to know how much the software you develop sells for.  I would expect the people at the interface between your company and your company's customers to know (or be able to find out) how much to charge those customers.

    In your analogy, you're the equivalent of the person drawing my blood, not the person at the front desk.

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