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The first rule of the American healthcare industry


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The first rule of the American healthcare industry is that under no circumstances do they say what anything costs, and especially not in advance. Generally they will flat out refuse to tell you beforehand or immediately afterwards, and any bills you get later will have a bewildering variety of numbers just to make sure you still don't know.

My health insurance is atypical in that it closely resembles actual insurance - I pay for everything unless something calamitous happens and after a several thousand dollar deductible, so I do care how much things cost. I needed some lab tests done and wanted to find out how much they would cost when I pay cash directly. It took talking to 5 different people on the phone at the lab service used by my doctor to finally get some numbers and they were outrageous. For example a hemoglobin/A1C test is $66 plus a $21 fee for the blood draw - you can get a kit at Walmart for $9 for the same thing. It also looks like they would have refused to do the tests unless my doctor faxed them an order, and the total would be huge.

Eventually I managed to discover Health One Labs. In an astonishing violation of the first rule they put the prices right up there on the website. The value packages are well priced, most being under $100 with individual tests around 20% of the price the normal lab the doctor uses.

I tried it out. Four minutes after entering my credit card information, I received a PDF with a lab order on it (and no need to get the doctor involved). The actual blood draw is done at a company named Lab Corp - they have 13 locations within 25 miles of me - no extra fees or charges, or appointments and was seen immediately. 24 hours later (almost to the minute) I received my results.

This should be the normal experience, but is so remarkable in the US healthcare system that I had to write about it.

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