I’ve been a huge fan of Health Savings Accounts (HSA’s) since I started working full time 5 years ago. It didn’t take me long to realize that the HSA/HDHP combo is a great plan for young and healthy people like myself who rarely visit a doctor. Over the years, my HSA balance has grown to about $15,000 with the help of employer contributions, premium savings and my own contributions.
During that time, I’ve racked up a couple thousand in various reimbursable expenses (acupuncture, massage, OTC meds, contacts stuff, etc) and since I paid for it all in cash I’ll be able to re-imburse myself at any point in the future. Meanwhile, I’ve got my HSA fully invested in an aggressive mix of stocks and bonds that will one day come back to me triple-tax free.
Just Don’t Get Sick (Or Injured)
That sounds like a pretty sweet deal doesn’t it? Well it is as long as you don’t get sick or have to see the doctor. Unfortunately for me though, I had a little incident at a bachelor party where my knee collided with a paintball from about 15 feet away. Within a day, my knee was the size of a balloon, I could barely walk and I was in a lot of pain. Drinking seemed to help though.
I’ve seen people tear ligaments and although my injury hurt, I was fairly sure it wasn’t a tear. If you don’t hear blood-curdling screams, it’s probably not a tear fyi and yes that is my medical opinion. Even though I technically had insurance, my deductible was $1,250 so there was no way I was going to the ER – just a cheek swab in there would have wiped out my deductible.
I’ll Tough It Out
I thought about visiting an urgent care facility but in the end I decided to just tough it out. I was in a lot of pain but there wouldn’t be much a doctor could do anyways until the swelling was completely gone. So I iced, rested and in general, just tried to take it easy. After a couple weeks, I was still in pain but things were getting better. I kept telling myself as long as things were getting better I didn’t need to see a doctor.
Eventually a couple weeks turned into a couple months and my recovery had pretty much plateaued. I was at about 70-80% but my knee just wasn’t getting any better.
Help Me Find An Orthopedist
At this point, I decided it was time to see a doctor. I went on Yelp of course and found a few good orthopedists in the area. I thought to myself: Ok this should be fun, time to negotiate some prices.
But every single place I called quoted me in the range of $250-$600 just for a first visit! I might have been able to stomach $200 but what could a doctor possibly do in 30 minutes that could warrant $600? This didn’t even include the cost of x-rays and/or an MRI which would have added another $100-$750.
The thing that irked me the most though was that they couldn’t give me a specific price – every receptionist I talked to all said that it depends on the services performed. Which of course means we get to charge you however much we want and you can’t do sh*t about it. In my book, that was just unacceptable so I refused to make an appointment.
Let’s Try A Physical Therapist
After some google-ing and recommendations from two different people, I decided to see a physical therapist. The problem with doctors these days is that they don’t have much incentive to make treatment affordable for patients. It’s in their best interest to order un-needed x-rays and MRI’s in order to cover their ass in case they get sued. I don’t blame them, I blame the system of incentives that is placed upon them. Doctors don’t have the right monetary incentives to make treatment affordable and for patients to get better.
I ended up finding a great physical therapist who charged me $100 for the initial consultation and treatment plan and $75 for subsequent sessions. The pricing was transparent and since I paid with my HSA, I was able to pay with pre-tax dollars. I’ve only done two sessions so far with this physical therapist but my knee is already seeing a ton of improvement.
I wish I would have seen this guy sooner since he was still able to do all the ligament, stability and pain checks that a normal orthopedist would have done. If my injury would have been more serious, I would have had to bite the bullet and pay an orthopedist but the PT doctor ended up working out pretty well.
Your Money Matters
Most people don’t understand the point of the HDHP/HSA combo and I’m sure there are lots of people out there who would say this is the perfect example of why you want ‘real’ health insurance. But I couldn’t disagree more. If I would have had PPO/HMO health insurance I would have gone to the first orthopedist I could find and probably spent over $1,500 when it was all said and done. That sounds like a great system until you think about who will ultimately bear that cost.
Doctors and insurance companies sure as hell aren’t going to take a loss so the inflated cost of my hypothetical treatment and MRI will be passed on to subscribers. That’s me! Now imagine if everyone that gets injured does the same thing. And that right there is the reason why health insurance is so damn expensive and premiums are always going up!
The problem with our current health insurance system is that there is no consumer choice. Prices aren’t transparent and we never have to pay a direct cost. That means that we’re free to spend the insurance company’s money on whatever damn doctor we want but in reality that is our money. We’re just taking a loan from our insurance companies that we’re going to have to pay back next year with higher premiums.
HSA’s will always have their naysayers but anyone who truly cares about the money they spend should see that it is the best health plan on the market. If everyone cared about how much an initial consultation with a doctor cost I wouldn’t get these bullshit $250-$600 range answers. Doctors would have to list their pricing on their website like a normal business and then there would be a healthy level of competition.
I don’t think HSA’s will ever catch on but for now I’m going to take advantage of them for as long as I can and do my part to reduce the cost of healthcare.
Readers, what do you think about my knee injury and how I handled it? What would you have done differently and what do you think about the HSA/HDHP combo?
Track All Your Accounts With Personal CapitalPersonal Capital lets you see all of your accounts in one convenient place. Sign up now for free.
-Harry @ PF Pro