Understanding the healthcare system as a consumer | Seth Denson | TEDxFlowerMound

[@DOlovesmedicine]

I think Seth Denson wonderfully highlighted the negative aspects of medical finances. I once passed out while working as a medical scribe in the Emergency Department and was immediately put into a room as a patient. I had basic labs drawn and received IV fluids before I was discharged home. One month later, I received a bill for over $3000 for that single visit. Had I known some bloodwork and normal saline was going to cost me almost two months’ worth of rent, I would have refused treatment. This is the same struggle that so many individuals are experiencing today. It is unfair to assume that every patient is okay not knowing a final price for their treatment prior to receiving it. Non-maleficence is the principle of doing no harm, something all physicians are obligated to uphold during their practice. A physician might believe that ordering all the tests in the book is in the best interest of the patient, but they could be causing more harm to the patient, putting them in a significant amount of debt. On the other hand, medicine is a complicated matter; one that cannot be compared to buying groceries at the grocery store. Certain procedures or surgeries sometimes do cost an extreme amount, but that is the price we pay for high quality health care. Certain medications have become ground-breaking cures for what were considered incurable diseases, but again at a cost. In order to continue to make these advances in medicine and supply the products that are in such high demand, there has to be some financial aspect in play. If not, we risk drug companies slowing production, or medical device companies limiting their supply. I believe we need to compromise. For most routine visits requiring simple treatments, patients should be well aware of the costs associated up front. Of course, this gets tricky as conditions become more complicated. While we might not ever find common ground on this matter, patient care and safety should remain the main priority. Physicians should focus on providing the best care for the patient, while patients should focus on getting healthy. The insurance companies have a lot of improvement to do to make health care more affordable.

[@nickslaboden3492]

I would like to start this off by saying thank you to Mr. Denson for sharing his knowledge and life experience with us today. This is such a powerful talk. I really liked his analogy of getting groceries to our current healthcare system. The comparison is truly spot on and the disparity is staring us right in the face. From an ethics standpoint, where is the justice for the patient in keeping patients in the blind and influencing people to think that they do not know what is best for them? Now, I would like to play devils advocate for the rest of my discussion. Medicine is a highly daunting thing. It is a tad unfair to compare it to buying a car or finding a flat screen tv. I mean sure, most people do not know how a car or a tv truly works but it is simple enough to buy a good product. The human body is already the perfect product in need of repair. Now, when it comes to repairing your car or tv, most people will get taken advantage of because they do not know how these things work. It is the exact same with healthcare. I have been studying medicine for 7 years now and I will be the first to tell you, it's pretty dang complicated. I will spend the rest of my career doing this and I will end my career still learning, most likely having barely scratched the surface of what is possible. How can we ask our patients to research drugs that would be better for them? There is so much information that goes into manufacturing drugs and making them effective that it took a team of scientists years to make it possible. So, yes, it is inspiring to have somebody tell us that the power is in our hands, it makes us feel good. However, when it comes to putting it into practice, we are all truly at a disadvantage. I believe in the spirit of treating patients and being as beneficent as possible, there needs to be more transparency and less manipulation when it comes to healthcare. Healthcare is too much of a business these days and they hold a lot of power. There is a way to get the pendulum to swing back in the patient’s favor and I guess time will tell on what that solution is. Anyway, I would like to thank Mr. Denson for giving this talk, as I believe it is a truly powerful discussion and needs to be brought to our attention more. Thank you for reading.

[@realmollydotcom]

An interesting talk from someone who does not articulate anything but a perspective firmly planted in middle class, literate, reflective, educated, biased life. Try this on a person who grew up outside of that class and what we get is too many variables for one person, especially if he or she is very seriously ill, to achieve this rather narrow if not pleasant view. It is not as simple as having a roadmap. It requires language, social skills, awareness of differences as well as that which makes us the same.

[@nicoloferretti7435]

"it's the consumers' fault.. they don't take the time to read... we're often just lazy" but also "80% of bills are erroneous." That sounds like a systemic problem across the insurance industry, not something an ordinary consumer can address unless they have abundant knowledge, time, or protections.

[@importantoldnews5414]

The problem is also access. Being told to leave if you don’t have money or if your insurance no longer covers you is not access.

[@AngelCruz56970]

Mr. Denson brings an interesting viewpoint of healthcare that I was not all that familiar with. He mentions how our healthcare has made several advancements and how some people may have easy access to a doctor and healthcare. However, it’s the cost aspect that patients may not fully be aware of. It is astounding to me how much healthcare costs have increased by 130% when inflation hasn’t increased even 30%. It’s a unique approach and viewpoint of how the patients have the power in their healthcare by increasing their knowledge and as an opportunity to learn. By doing so, people are able to ask more educated questions pertaining to their healthcare and that is something extremely important the cost of healthcare. However, medicine isn’t as simple as fixing a household item or a car. As a 2nd year medical student, I believe that healthcare providers should be mindful of the cost to patients. The most expensive procedure or treatment isn’t always the best treatment for a patient. Providers need to consider what is the best way to provide efficient care to their patients without needing to charge ridiculous amounts of money. Not only that, but the cost burden can also be very stressful for patients when seeking healthcare and the duty of the doctor should be to minimize harm or distress in patients. I really enjoyed this talk as it brought a different perspective and this issue of cost can be approached in several ways. Having people be more aware of their healthcare can be one of many solutions for this problem.

[@virginiamoss7045]

Thanks for your perspective, too. I hope medical schools are making changes as well, particularly in their old-fashioned, arrogant, and dictatorial approach which does not foster real learning.

[@studentdrcom]

After watching Seth Denson’s TED Talk on understanding the healthcare system as a consumer, I believe that ethical considerations provide a brief eye-opening synopsis to why society should take the time to understand health insurance and healthcare billing. Denson uses the analogy of shopping in the grocery store to shopping in healthcare. It is described that grocery shopping with no labels, prices, or cost at check-out with a bill provided in a month can be compared to healthcare bills coming in the mail months later with no answers at the visit. Patients are encouraged to ask questions in the office, study insurance, and study healthcare billing. Healthcare insurance cards are also compared to credit cards. Both are used to access services or goods. Both cards involve a financial transaction. Insurance cards provide access to necessary medical care that is essential for maintaining health and well-being which is a basic human right. However, credit cards are typically used for consumer goods, which is not a basic human right. However, although I feel this comparison brings this idea to light, I feel it is over-simplified. I feel healthcare insurance cards involve a more complex pricing structure compared to credit cards. I do agree though, that this makes it difficult for consumers to understand the true costs of healthcare services. One ethical principle related to this healthcare video is distributive justice. Distributive justice is the fair distribution of resources, benefits, and burdens in society. Distributive justice requires healthcare resources to be distributed fairly and equitably to all individuals, regardless of their ability to pay. The principle of distributive justice requires that policymakers and healthcare providers work towards creating a system that prioritizes that healthcare resources are distributed fairly. Denson encourages the start of this with patient self-education and asking questions.

[@blackberries1437]

He puts the responsibility on the patient who is at the mercy of medical providers. The cost for that IV bag? It’s criminal price gouging.

[@virginiamoss7045]

Yeah, though the only avenue available, the patient is the most vulnerable of all the players, being used and financially abused in exchange for often poor value healthcare. I kind of resent that, but also know that that is the only cure which is never going to happen.

[@jamesganiere001]

Heath care has long been a hot topic and Seth doesn't hold back on shining a spotlit on some of the inherent flaws that keeping it from functioning at the optimum with which we all wish it did.

[@jclint1953]

Very interesting, thanks Seth!

[@tiarratompkins8917]

Love this! We absolutely can make so much more difference when we get involved!

[@DustinMichels]

This sucks so bad!!! "It's impossible to tell what anything will cost and you're totally at the mercy of big business and insurance companies. Are there political alternatives that could reform the system into something more sane and effective? Nah that's impossible. But you can be a more savy consumer and ask questions at the doctors office!"

[@kay-2388]

While I am not sure if your comment is pure sarcasm or frustration about the system, I can understand the frustration behind it, the system somehow feels quite complex for no reason. I do agree with your opinion about being proactive and asking questions to be informed, but with the rising cost of healthcare, i honestly feel a political intervention to make the system more affordable and accessible would be appropriate. Regulation of drug prices across the board to prevent price markup, transparency, and healthcare cost, expanding access to public insurance programs or a public-private insurance type deal and more emphasis should be placed on preventative care and education. Raising awareness of issues like this and supporting policy changes that prioritize the needs of consumers and the general public would be the only way to ensure a change occurs. Afterall, We never know when we will be in such a position where we would be tasked with dealing with the convoluted system of the healthcare industry.

[@JennyMulksWieneke]

Such a great way to explain and look at the way we are not dealing with the hidden costs of healthcare. Thank you for your gifted insight and inspiration to take action.

[@jeffreylane3303]

Absolutely great! Very down to earth informative.

[@ivasivas9730]

i ask questions but no one seems to have the answers. doctors and insurance always point the finger at each other and no one knows anything

[@virginiamoss7045]

This! Always the run-around. Health care is like legal issues; we have to hire a lawyer (also expensive) before we can make any headway with a legal issue because the law is so highly complex that it takes years of higher education (like health care) to be able to even begin to enter the fight. The average Joe is powerless in both arenas.

[@MichaelLloydMobile]

He missed an influencer: the pharmaceutical industry.

[@RealNewsCommunicationsNetwork]

This is great! Such a good explainer.

[@Weblurker]

I really didn't think this was very helpful. Seth seems to say that not much can (or should) be done to fix problems with healthcare providers, healthcare insurers, or government health programs and oversight. I strongly disagree with this position. Positive changes can be made, like using evidence based medicine as a way to standardize care. For instance, if doctors learn (after looking at the results of different treatments over 5 or 10 years in a bunch of different US states) that treatment "A" works 30% better that treatments "B" or "C" then treatment "A" should become the national standard of care. Also it has consistently been shown that introducing competition among health insurance providers lowers the costs of premiums, yet in far too many states there are only one or two insurance providers and they often have gentleman's agreements not to compete with each other in certain counties thus allowing each company to control certain areas of the state. As far as changes in government the FTC and DOJ should start investigating and enforcing anti-trust laws when health insurance companies have monopolies of coverage and large healthcare providers buy up all the hospitals in an area and merge the care into one giant healthcare system that allows neither competition nor transparency of prices. Those are just 3 examples of what could be done to help without disrupting and toppling the system. As far as Seth's comments about being a more "active" consumer, well, it just doesn't ring true to me. Healthcare is not like buying a new big screen TV or a new car. When most people experience a healthcare emergency they do not go online and check prices for treatments, they get to the nearest doctor or ER as fast as they can. Once they arrive at the ER they do not start haggling over the price of care, they just want help. Seth also is mistaken that even if we did try to be better consumers (for routine care) he assumes we would be able to get the pricing information from the doctors or hospitals. Good luck with that. There is a huge problem with transparency of pricing in US healthcare. All of the examples he gave were from billing AFTER the treatment or care was given. What leverage does Seth think a consumer has arguing the cost of care AFTER the care has been administered by a hospital that is part of an enormous healthcare system that has a monopoly on all healthcare for 25 miles in every direction. I like TED Talks but, in my opinion, this talk was a dud.

[@lugohstsotofitness7817]

Take advantage of the free market!!!

[@thomast3570]

Who? The one's making the money?

[@olga.aleksandra777]

Amazing video.

[@Christina-sk6bq]

Cost is only part of the problem. The other part is our doctor's cannot diagnose and it is so fragmented that you cannot even get the help you need. It has become almost completely useless. No one thinks it is their job to do their job anymore.

[@strategic1710]

I don’t like the grocery store analogy. It’s funny and seems ridiculous, but the experience is too different to be analogous.

[@MarsOnStars]

Amazing explanation. Not enough people have watched this video. Lol

[@jenniferbryn]

this should be called "how Aetna's customer service representatives use their 'authority' to make you suffer. i record my calls. do the same.

[@belenabutler9807]

He clearly doesn't understand healthcare.