Earlier this week, I wrote a story for the Globe on James Dichter, a patient who complained about a medical supply company charging $83 for a flimsy sling he later found online for just $7.
I was surprised at how strongly the story resonated with readers, many of whom wrote in to describe their own frustrating experiences with high-priced medical items, from $398 boot casts to $115 ace bandages.
Common themes ran through the comments. The growth of high-deductible health insurance plans means that patients are paying closer attention to the cost of medical products. They can more easily comparison shop because of the abundance of online medical retailers. And many were shocked and upset about what they perceive as waste in the health care system.
Mark Lowenstein of Brookline e-mailed about his 9-year-old son’s broken toe two years ago. He brought him to the emergency room at Boston Children’s Hospital.
They said he needed a “boot cast”. It’s a glorified boot. We purchased it at the store at Children’s. I was shocked at the price—$398. Had to pay the full amount because I am on a high-deductible plan. When I expressed surprise at the price I was told I am “lucky” because that is the insurance negotiated price and that full retail price (if I had walked in off the street to buy the item) is closer to $600. I went home and searched for the boot online. I found it on Amazon for $69.99, plus free overnight shipping.
Lowenstein added in an interview that he owns a small business and switched to a plan with a $5,000 deductible to save on monthly insurance bills. Now “there is a lot more visibility to the cost,’’ he said.
Paul McDermott, 49, of Quincy, wrote that he recently ordered a continuous positive airway pressure, or CPAP, machine to treat sleep apnea. He called Denmarks, the medical supplier in his insurer’s network, which said it charges about $700 for the item. McDermott was shocked because he knew he could order it online for as little as $350. McDermott ordered the more expensive machine anyway because it would be covered by Blue Cross Blue Shield of Massachusetts—he has a $750 allowance per year for medical equipment under his plan. If he ordered the model online, he would have had to pay the full amount.
The most astonishing example in my view was not about the priciest item, but one of the least expensive and most common. This from Pamela Derringer of Marblehead:
I had the same experience about five years ago when I badly sprained my ankle. Insurance charged about $115 for a wrap which I could have purchased at CVS for $11. The fact is that healthcare providers should be purchasing supplies from wholesalers or purchasing networks to minimize costs, similar to the business move from small stationery stores to office superstores.
In Dichter’s case, the company that provided the sling, Surgi-Care in Waltham, said its price includes fitting—although Dichter said he was never fitted.
In response to McDermott’s situation, Blue Cross executives said Denmarks’ CPAP machine may be more expensive because the company tracks patient compliance with a recording device in the machine. And proper use may prevent expensive emergency room visits and hospital admissions down the road, said Michael Reinemer of the American Association for Homecare.
The high price of the ankle bandage seems a bit harder to explain, at least to me. I am interested in insights into this issue.