"In business, as in life — you don't get what you deserve. You get what you negotiate."
– Chester Karrass
My husband Hugh had a mantra for life and business, "Everything is negotiable." Remembering these words after his TBI helped me many times over.
Feeling overwhelmed by Hugh's needs — surgical, medical, rehab, counseling — I felt like I was at the mercy of everyone who knew how to help Hugh when I didn't. How could we afford all the help he needed?
With Hugh's voice in my head, and feeling desperate, I decided to learn how to negotiate. I read a few how-to articles online and asked myself, "What have you got to lose?"
My First Attempt at Negotiation
I was worried sick about money. Hugh spent 33 days in the hospital and suffered numerous deficits. I checked our insurance policy and learned that he qualified for sixty rehab visits per year. At first I panicked when I realized that Hugh was attending rehab five days a week. At that rate, his visits would only last a few months. But then I decided to try negotiating the situation. I visited the accounting office of his rehab center.
First, I did my homework. What was my insurance company paying the rehabilitation center? How much were they going to charge me? Which therapies were most important? Could I learn to do some of these therapies at home? What exactly did I want to get out of this meeting?
Armed with that information, my knees knocking, I made an appointment to speak to the head of the Accounting Department in a face-to-face meeting. My approach was respectful (I aimed for charming). I said I was impressed with the hospital's quality of care (I was). I complimented the rehab hospital and staff, and made it clear I wanted my husband to be able to attend rehab for as long as possible. Then I simply asked my questions:
- Is there room to compromise the $600/day rehab rate?
- What can be done to reduce that cost? What services should I cut?
- Can we structure a payment plan that works for both of us?
- Would it be possible for me to get instruction from his therapists so I can work with Hugh at home and cut back on the number of days he attends rehab?
- What other ways can we cut costs? What do you suggest?
I did not meet resistance. Our discussion was cordial, and this accounting professional was open to my needs, in large part because I was sincere, well prepared, and reasonable.
I did not complain: "This is a rip-off!" And I didn't use emotional pleas like: "You don't understand. This is so hard!" Instead, I used logic: "I want the best outcome for my husband, and this hospital can deliver that; but my resources are limited. Help me keep him on track. I'm sure patient satisfaction is important to you, and we both want to achieve the best outcome possible. We agree on that. I want to be part of the solution here."
In that one meeting, I received some version of everything I requested. I could not believe it worked, and I thanked my husband for his wisdom. This one meeting boosted my confidence, and I grew better at expressing my needs in medical and financial situations.
Hugh attended rehab for over a year with much less financial strain. Instead of five days a week, he attended two or three days a week while I worked with him at home. I feel certain that this continual therapy contributed to his good outcome.
Negotiating may not work for everyone, but it's worth a try. Negotiating with insurance companies, doctors, and others can cut costs, too. Getting samples from your doctor or requesting generic drug changes can help cut down on prescription costs. Sometimes negotiating begins with simple honesty about a situation, and it never hurts to ask for something sincerely when it's needed.
Here are a few helpful things to remember about negotiating:
- Before negotiating, make sure you know exactly what your desired result looks like. Staying focused on the goal will help you build a strong case for what you want.
- Negotiating is not demanding. It's a respectful discourse between two parties where each side tries to arrive at an acceptable solution for all by considering the other party's needs and limits.
- Consider what you have to offer: patient satisfaction. You will recommend their services.
- You may not get everything you ask for, but you may get something that makes your life easier. Every little bit matters.
A great way of thinking about negotiating is to think of it as persuading and compromising.
Negotiating for what we know we deserve as caregivers is an important aspect of our role, and the way we negotiate makes all the difference. If you know what you need and want, if you arm yourself with information, prepare and plan, and articulate your case persuasively, you may be able to overcome obstacles more often than not.