For the past five years I relied on individual health insurance plans with high deductibles. A minor, in-office surgical procedure cost about $2,300 including lab work. I paid all the cost out of my pocket. The annual physical was covered as preventative care except I asked a couple of questions and those were coded as diagnostic and resulted in billings that I paid. In 2017 it appeared that each question was worth about $130.

This year I am in a more generous healthcare insurance setting and was cautious about asking questions at the annual physical. The explanation of benefits arrived this afternoon with a cool $1,042 charge. Holy cow! I’m not responsible for paying that amount, but am blown away that just the physician component could be so costly. Lab fees haven’t been posted yet. We’re talking five minutes of rooming by a CNA and about twenty minutes of physician time in a regular clinic setting. No technology or specialty care.

When your doctor tells you what immunizations need updating and suggests you go to the drugstore or a drop in clinic because they charge about half of what the medical practice will bill, that’s uncomfortable.

For all who are self-employed, under-employed, or employed in a small company with no insurance, these stories can be game changers. Unfortunately this isn’t a new story unless you are one of the thousands who have decided to start your own business. About 30% of the U.S. workforce are self-employed or work for someone who is according to the Pew Institute.

Have leaders in the healthcare world lost connection to reality? What percent of annual after tax income should an individual, or family, be expected to commit to basic healthcare?

The integrated healthcare delivery systems that grew out of giant mergers and acquisitions of physician groups were supposed to provide improved quality with greater efficiency. I worked in that sector during the first decade of consolidation. The thousand dollar physical suggests the experiment didn’t work.