There are a lot of words pinging around in that space inside my head -- sometimes they come together and make some kind of sense. When they do, I put them here, to make room for more.

Friday, July 2, 2010

The cost of a good deed

I recently did something I thought was a good deed: I registered my bone marrow. I had been meaning to do it for awhile, and was walking through the mall when I saw a table, with nice people collecting cheek samples. So convenient, and so simple, really. Especially since they can now do it with saliva, instead of the far less enticing blood sample.

Did you know only 30% of people needing bone marrow can find a match from among their relatives? That leaves a whopping 70% to look to the rest of us for their chance at life. So it really did seem like something I ought to do.

The nice-looking young woman behind the counter had me fill out some forms, then instructed me on the correct way to swab the cells from inside my cheek, and in a matter of minutes I was done. And for my trouble they gave me a lovely synthetic tote bag with the obligatory t-shirt inside. I left feeling I had done a good thing.

But a few weeks later I received an email from this particular bone marrow registry, informing me that "if a testing laboratory has billed your insurance company for the testing of your sample you may receive an Explanation of Benefits advising you of these charges." And the following day, I did indeed receive an EOB, and found to my surprise that the amount they charged for tissue-typing my cheek swab was a whopping $4000.

Shocking, especially when you consider that the average cost for this type of test is $52. I wonder what the other $3948 went to?

When I called the bone marrow registry to express my astonishment, they rushed to assure me that this wouldn't actually cost ME anything, and if it did, they would cover those costs for me. They apparently have donations for that. And they claimed they had told me they would be charging my insurance company, and it turned out they were accurate here: they had placed a postcard in the bottom of that "gift" bag. However, nowhere on that card does it say $4000, or, in fact, ANY amount they might be charging. And as I informed them, I don't generally spend $4000 without knowing about it, and without at least enjoying the experience.

What the postcard did tell me was that "legislators in several states...have passed laws that make it mandatory for most insurance cover HLA testing costs for its members who volunteer to join a national donor panel...The insurance company will reimburse the laboratory at a contracted rate." A contracted rate. I find it hard to believe that my insurance company, so quick to discount any other medical service I receive by half or more, would pay almost 90 times the cost of simple tissue typing. It just doesn't add up.

And while I know that, right now, I didn't have to take a dollar out of my own wallet to pay for this, it's exactly this kind of inflated pricing that makes all of our insurance rates go up. And that's what really gets me. They like to say "this won't cost you a thing", as if there's a mountain somewhere with a big pile of money in it, and they're just making sure they get their piece of it. But that big pile of money comes, of course, from you and me, and when someone else takes more than their share, that is less for the rest of us, and we all have to pay more to replace it.

This bone marrow donor registry raped my insurance company, and me, and has now left me with a really bad taste in my mouth. And sadly, I will now think twice before doing another good deed.


AmyCS said...

Hi Stefanie,

This is a shocking story. $4 K is an unbelievable amount.

I agree that the testing agency should have informed you because, as you say, insurance companies eventually pass the costs on to us.

I like the mysterious mountain of money image. It's hard for people to make smart decisions about health care when it's all "paid for" by the insurance company. But as you point out, we all get burned.

jeff03064 said...

We just went through this with our insurance company. (Blue Cross/BS) Same thing. Wife got a cheek swab at a fair to be a marrow donor. They said insurance would cover it but if they didn't don't worry, they would pay for it. They never mentioned the cost. Insurance DID cover it thankfully. Same price... just under $4000. We didn't pay for it directly... but we all pay for it in the end. Infuriating!!