"Trust Me." (Except sometimes you can't. How do you "comparison shop" for blood work?)
I am of the opinion that capitalism is an insane system when it comes to health care. We have some excellent posts on DU talking about health care issues and associated costs, and I thought I would share my story. (Please feel free to add your own.)
My husband and I went through eight years of infertility treatments. The majority of the expenses associated with this "choice" on our end were not covered by insurance, so we paid out of pocket. This was "normal" at the time, and the local clinics had policies in place to get "immediate payment" for services like blood work and ultrasounds. Trust me when I say that women desperately trying for a child will sign a check for anything "necessary" to achieve that dream, and women trying to get pregnant measure success in only one way: holding a healthy baby in your arms.
Our last attempt (which resulted in my beloved twins - yeah!) was done with an out of state clinic. We picked them because they had some of the best success rates (healthy babies!) in the country, and they were economically reasonable / comparable to the clinics that *didn't* have the same reported success rates. (Delete curses on Ronald Reagan's name for the years of delay in implementing standards of care, and blessings on Bill Clinton for telling NIH to fix it!) The "out of state" system was already well established in our area: we would have "local monitoring" (blood work and ultrasounds) and the "big/important stuff" done out of state.
My local gynecologist had been part of one of the local infertility clinics, and I had gotten pregnant/first miscarriage with her; we had an excellent relationship, so when she left her old practice, I followed her. She continued to be affiliated with a well known and respected hospital, so I went with her facility for blood work.
The new doctor decided to do some extensive blood work just to make sure nothing had been missed previously that could be corrected/would help increase my odds of carrying a pregnancy to term. He ordered a battery of tests, including one to determine if I had ever had a common virus; a large percentage of the population has had it, but it is only "bad" if a women contracts it while pregnant, at which point serious birth defects occur. (Its been years - I used to know what it was, and will look it up if anyone cares.)
The blood work for that test came back so wonky, I was sent back to "bleed again." Again, really *weird* results - so strange, it looked like I not only currently *had* the disease (which typically lasted about a week to ten days), but still had such high numbers two weeks later (with no symptoms ever), that maybe I was a carrier?
I was devastated - perhaps this was the reason I had miscarried three times? If it was true, I would not be able to carry a healthy child to term.
But the doctor wasn't satisfied - the results were just too "out there" - so the whole thing got escalated up the head of the laboratory, and it turned out there had been "a mistake" (made twice), and the results were WRONG.
Just flat out WRONG.
I had never had the disease, and wasn't a carrier. Somebody at the laboratory had messed up (still don't know how), and I had come "this close" to stopping our pregnancy efforts, which would have meant my twins would never have been born.
There is a "Part 2" to this story, and in hindsight, I am grateful for that "reality check" that blood tests can be messed up.
After our "two week wait" (I started doing home pregnancy tests early - and they were POSITIVE!), I went in for my "am I pregnant" blood work. To my shock, I received a call from my doctor telling me that my beta level was showing "38" which meant I was pregnant, but was going to miscarry again. (I needed to see at least "50 or above" for a singleton, "100" meant twins, and "200" was going to mean "more than two".) Eight years, three miscarriages already -- I left work in utter and complete despair -- and then I got mad.
I had a conversation with God (sorry, this is a truthful story), and took some more home pregnancy tests -- all of which were showing pregnant. I was CONVINCED beyond all reason I was pregnant, and "knew" I was going to have twins.
Beta numbers have to double in 48 hours if a pregnancy is going to viable. When I went back for my "48 hour check" I drove to three separate clinics and presented my arm for blood work.
The numbers all came back in the "200 range" - yeah! - and I've already mentioned my fabulous now-six year old boy/girl twins.
I asked the original clinic to "double check" things since it is mathematically impossible for a "38" to "double" to "200" - which is when it came out there had been ANOTHER mistake at the laboratory.
Apparently someone had written my progesterone level "38" in the beta level column, and put the "96" in the progesterone spot.
I had been pregnant with twins the entire time. It was just a lab error.
I cannot adequately explain the horrors of the emotional roller coaster I was riding during this process. There was simply no way I could have looked at the numbers and "caught" the mistakes. The same standard tests were done at every facility, and the price I paid varied between $45 and $200 depending on the facility.
The folks who made the TWO errors I just mentioned were neither the cheapest nor the most expensive, and to this day I have no idea who made the mistakes - a new trainee? An exhausted experienced person having a bad day? A glitch in the computer programs? How the h*ll could I have "interviewed" or "investigated" or "prevented" myself from doing business with the people who made the error? The first one was supposed to be a "one-in-a-million" mistake, but carelessly writing numbers in the wrong column? How many *other* people had this happened to?
Wait a minute: No Clue. And no one else knows either.
You pay your money, and take your chances. You *trust* them.
I paid money, and *trusted* that meaningful, accurate data that would be used to make health care decisions would be provided. In multiple cases, that turned out to be "wrong" -- but there was no way *I* could have figured that out on my own.
In an emergency situation, I wouldn't have had time for "three tries" before getting to the right answer. If I am bleeding to death on the table, I can't count the medical personnel operating, and competent professionals aren't going to "negotiate" with me to save a buck ("I don't need an anesthesiologist, and I certainly don't need an IV!"
while they are doing their jobs. And depending on the procedures, one can't "refuse" to use the "in-house" laboratory if you've had some bad experience with them.
There are standards of care that simply need to be "across the board" and my cynical nature says that numbers can be fudged to make a facility appear to be in compliance, which is why auditors/regulators whose paychecks aren't dependent on making people look good need to visit regularly.
And seriously, we need to get to a single payer system. The only reason I knew about the price differences on the blood work and ultrasounds was because we went through it for so long; "comparison shopping" for blood work pricing is just not a reasonable way to spend limited time and energy in most cases.
I think the "for profit" health care system sucks. I hope "Obamacare" is the first step on the road to dismantling it.
But my children? Let me tell you: they were worth it. Totally, utterly worth it. 
= new reply since forum marked as read
but you can order one for yourself on the web $155. (my recent experience)
Single Payer Health Care for ALL!
you can set up an account and get your results online, all much cheaper than going through most doctors (although my GP uses the same, I got a TSH and T4 tests for $55 total. too bad he doesn't really know anything about thyroid issues
)
Time mag cover story by Steven Brill. Totally aligns with your story. Glad you, at least, had a happy ending!
the health care / health insurance system on her own. What she is encountering are health professionals questioning why she is doing preventive care...why not just wait until the situation is emergent? 
Frustrating. As you obviously know!
They tell me it would be devastating to me if I were transfused with the wrong blood--but nobody tests for this antigen. It's very rare, so it's not a big deal for me.
But I'm sorry for what you have had to go through. That must be a horrendous ordeal for you. 
I wonder if that was what happened for me. I'll never know, of course, but at a certain level it scared me half to death -- at the time, everything revolved around getting/staying pregnant, but if it could happen there, how seriously should I be taking tests about cancer, etc?
Later, when I ended up with pre-eclampsia and the blood work was coming back about my kidneys failing, my battle cry (REALLY stupid in hindsight!) was "I FEEL FINE!" I trusted my own intuition at that point more than I did the hospital tests (it was a different hospital), and it could have ended up badly Very Quickly.
Your story is terrifying, because I think it illustrates what happens when "life or death" becomes "just another day at the job."
