What are you really paying for?

This morning I played chauffeur to the two crippled ladies in my life. My wife and my dog. My wife had foot and ankle surgery in May and today she got her cast replaced with a boot. Unfortunately, the healing process ahead is also preparation for several more surgeries so we have a long journey ahead with more pain and discomfort for her. My dog needed blood work because she is aging and needs pain relief for arthritis and bladder control help. Thus periodically we have test her kidney and liver functions.

Medical issues are big in my house.

So, when I was finally headed to the office and scanning satellite channels, I stopped on NPR for the last bit of a show from KQED about price-shopping for medical procedures, using MRIs as an example. This interests me. I have had a lot of MRIs – 14 or 15 since New Year’s Eve 2009. All but the first have been at VCU. My co-pays on these have typically run between five- and six-hundred dollars until we meet our maximum annual out-of-pocket expenses.

While I listened, I thought about procedure costs and my views on insurance. I believe in being a responsible consumer. I don’t really want the insurance company to pay for something I would not be willing to pay for out of my pocket. So, why don’t I shop around for the best MRI price?

Convenience. Quality control. Service. Peace of mind.

It is unlikely to find an MRI facility other than VCU that I can walk to and from in 10 minutes from my office. There is no place that close to home.

Most MRIs have limits of accuracy and precision within the range of one to two millimeters. Since we are now dealing with a tumor about the size and shape of a triple-thick Lima bean, the difference of a couple millimeters can be hugely important to the reader’s interpretation of the images. Whenever possible it makes a great deal of sense use the same machine.

VCU Neurosurgery is really good about scheduling everything a year in advance – on the same day. For example, I may be scheduled at 8:00 am for my 35 minute MRI and then at 9:30 upstairs to see my neurosurgeon for the results, and the next morning with my radiologist.

This last thing is really big. Many of the brain tumor survivors, or those in pretreatment status, often have to wait days or weeks to get their results. I’m done in a few hours and my doc will spend whatever time I need with me to answer my questions or discuss my case.

This is why I don’t shop around. Sometimes the lowest cost is not the best deal.

And I don’t think higher education is really any different. When a student or family makes a choice about college and how much to pay, they should really think about what they are getting for the money and how it fits within their value system. The same logic applies to legislators and institutional leaders. Think about what you are paying for and why it matters to you.

What really matters is whether the educational experience meets your needs. Of course, for it do so, because it is not a “laying on of hands,” the student must invest effort, must invest themselves, in the education experience.

And the institutions, those supporting them, must make it possible for each student to be successful.

Be nice. It won't hurt either of us.

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