Three years ago I had surgery on my knee. I’d done a typical out-of-shape middle-aged man thing and played soccer (or football, for you international types) when I was not fit. A wrong step on uneven ground caused me to rip out my ACL and tear up some cartilage.

The thing that amazed me about the medical treatment wasn’t the quality of the doctors, nor the amazing advances in medicine (they took a ligament from a dead person and transplanted it to my knee through a tiny incision!), but that nobody could tell me how much the procedure would cost. It was exasperating.

It’s no wonder U.S. health care costs are out of control. (Are they out of control in the rest of the world, too?)

Given the same information, one doctor’s office told me I had a $15 co-pay for my insurance, while another doctor’s office told me I have no co-pay (despite my insistence that yes, I really did). I was sent for an MRI, but nobody knew how much it was going to cost me.

“You have insurance, don’t you?” they asked. Well, yes, but that’s not the point. Insurance isn’t some magic cure-all that makes the costs just go away, you know? It’s this kind of attitude that drives up costs in the first place, and it’s ridiculous. Insurance doesn’t make health care free. (And my insurance only covered 85% of the costs, anyhow.)

I had an initial consultation with an orthopedic surgeon (Dr. Black — ominous, eh? Not to worry: he was young, probably my age, and he looked like a squeaky clean kid.) The news he had wasn’t good — it was rather depressing actually — yet when I asked him to give me a ballpark estimate for the costs of the procedures he was recommending, he couldn’t (or wouldn’t) give me one. He was a little defensive, actually, explaining that his fee was only a small part of the overall cost. I wasn’t looking to blame anyone for how much this was going to cost me, I just wanted to know in advance. Why was that so difficult?

He told me to call a woman, and she passed me off to another woman, who said she’d try to gather some information for me. I waited for days.

“Why is this so difficult?” I asked. “Is it so rare that people ask how much these procedures cost?”

“Well,” she explained, “Most people have insurance that covers this.”


Funny, yes, but funny in a sad way.

I suspect that there’s some sort of tacit collusion between all parties. The drug companies charge high prices to the doctors who charge high prices to the insurance companies who charge high prices to the consumers. I know that Health Savings Accounts are all the rage. I hear good things about them, and I hear bad things about them. I don’t know what to believe. Fortunately, my wife has good insurance…

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