neel shah


$1,000 Prize For Tales Of Health Care Costs — Or Savings

Costs of Care founder Dr. Neel T. Shah

Wow, has it been a year already?

Last September, we wrote here about the inaugural “story contest” held by Costs of Care, a Boston non-profit. It sought hair-raising and heartbreaking tales of health care costs to help “illustrate the importance of cost-awareness in medical decision-making.” The stories came rolling in, well over 100 of them, from patients and medical staffers alike, describing horrifying bills and stymied efforts to determine prices. Here’s a recap of the results, including the two truly disturbing prize-winners.

Now the contest is back — deadline for stories is Nov. 15 — but with a few tweaks. (Details are here.) There are four $1,000 prizes instead of just two. Different, though similarly prominent, judges. And a somewhat more upbeat focus on positive stories of savings in addition to the negative focus on profligate spending. I asked Dr. Neel Shah, Costs of Care’s founder, for an update.

He writes:

The goal of our first annual essay contest was to collect stories from patients and care providers across the nation that illustrate the importance of cost-awareness in medicine, and then make these stories part of the public discourse by widely sharing them.

From the tremendous response we got to these stories, we demonstrated that there is a clear need to make healthcare costs more transparent. The stories showed how transparency helps patients financially plan for their care and helps doctors keep medical bills affordable.

However we also learned that knowing what tests and treatments cost is only the first step. Continue reading

Medical Costs Horror Story #1: The $11,000 Bill For Indigestion

Brace yourself. The stories are starting to roll out and they are just as horrifying and heartbreaking as expected.

In September, we wrote about the $1,000 prize that a Boston non-profit group, Costs of Care, was offering for “the best anecdotes from patients and clinicians illustrating the importance of cost-awareness in medical decision-making.” The judges include former Gov. Michael Dukakis; Jeffrey Flier, the dean of Harvard Medical School; and surgeon/New Yorker writer Atul Gawande.

The responses came in from all over the country, 115 in all, said Dr. Neel T. Shah, the founder of Costs of Care and a resident physician in obstetrics and gynecology at Massachusetts General Hospital and Brigham & Women’s Hospital. The field has been narrowed down to six finalists, and the winners — one patient, one clinician — will be chosen on Dec. 15. Costs of Care plans to post the finalists’ stories in the coming days and then one a week from among the other entries throughout 2011.

The first finalist is up already here. I highly recommend you read the whole thing to get the full effect, but here’s my summary: Unemployed guy gets chest pain after sharing an anniversary pizza with his wife. Ambulance; ER; tests and chest CT scan; unnecessary hospital stay; diagnosis of gastric reflux and an $11,000 bill for a couple with no money.

Writes the Tulsa doctor who sent in the story:
What would have been a 15–minute office visit providing reassurance and education to a patient we knew quite well became a 72–hour ordeal by a health system treating a disease and not the patient, trading a patient’s pain for financial poverty. Surely we can do better.

I have to confess that I’m looking forward to reading the other entries, in a rubbernecking, train-wreck kind of way.

Neel offered some previews: A man who couldn’t get anyone to tell him how much his radiation treatment would cost, even in terms of whether it would be closer to $1,000, $10,000 or $100,000.

Neel T. Shah

A pregnant woman in her forties who got such a high bill for an ultrasound that had not been covered by insurance that she had trouble putting food on the table for her other children.

Stories from five different women who were told to get breast MRI’s because they were at heightened risk for cancer, only to then face thousands in dollars of bills for them.

And I particularly anticipate these: The $75 coke. The $500 Motrin. As itemized on bills in black and white.

Neel says: “We got stories from Alaska and New York and they were the same stories. These are things that not only can you imagine can happen easily any time, any place, but they, in fact, do happen.”

“We’re trying very hard to make sure we’re not demonizing any particular party,” he said. “Not the patient, not the payer, not the doctor. But we’re most interested in stories that illustrate just how difficult it is for doctors and patients to know, when you’re deciding what to put on the bill, what it’s going to cost.”

So maybe, then, we could all demonize the lack of transparency???