Jim M.

From Dr. Centeno’s article I agree 1000% except the advice that high disposable income is important. I am an upper middle-class single wage earner, with wife 1.0. Saved some money and didn’t make too many financial mistakes. I am still employed as an hourly worker with a “Cadillac” health plan. The only Cadillac aspect is the cost $2,023 per month between myself and employer. That being said I buy 2 of 3 prescriptions without insurance since it is cheaper for me to buy outright rather than the copay, and I don’t have to fight about a “formulary”.

Healthcare decisions should not center around if insurance covers it otherwise I can’t do that! To many people think that because they have seen the so called explanation of benefits form and think that the cost of treatment is the first number they see. For example an MRI of a pair of knees, EOB says $1,500 negotiated rate $999, you pay 700 deductible (if not met yet) plus 15% in my Cadillac program,don't forget the 2-3 hour appointment for the doc to order the image, or a second specialist to that’s another $35 copay each. Also a feature is a 2 month wait and insurance approval before facility will schedule your imagery. Alternative call a private clinic , they get you in the next day, and cost is $400 due when you leave with your data disc.

Folks to get the best health care you need to actually participate, that means everything from paying attention to your own body, making notes, research, then seek advice. And advice is exactly what it is, you still need to make the decision. I was a patient at a fee for service clinic, literally I could make one appointment and the doc was empowered to get tests run and move the ball forward, but after 2 years the clinic began to take HMO patients, wow what a turn around in culture and attitude. Now which insurance you had totally dictated what “treatment could be done” yes the white-coat was saying what could be done as if outside of insurance is forbidden territory. That attitude had to directly transfer to patients, and that attitude only took about a month to take hold. Want to blow a mind say “ I don’t care what insurance will or won’t pay for… what do I need?” Happened with some orthotics, why would I continue to injure myself to save $400 on orthotics which should last 10 years?

My advice, actually get involved and learn. Look for providers who are on their own, they are responsible to only their own families and employees for their practice to succeed. You will spend allot of time looking that search is the most important one especially if your over 50 and active. Get a circle of medical providers who’s first greeting isn’t what is your insurance. Second, you must add up the total cost of treatment, and don’t be afraid of valuing your time off or time spent going to useless appointments. look at the whole cost, you just might find that a high deductible plan might be your best choice if you can. An HCFSA gives you better ability to say I don’t care what insurance allows, or I am not waiting for approval.

Might even evolve to regular massage therapy rather than endless Physical therapy with co-pays, the difference really isn’t that much, that falls in the once of prevention category!