Thursday, October 8, 2009

Personal Cost of Health Care

Last Friday afternoon I went to see my family doctor. I had been having some intestinal issues that were of concern and was sent immediately to the hospital for a CT Scan. After the scan I was given instructions by my doctor and sent home. Sunday evening my condition was worsening and at 1 am on Monday morning my husband took me to the ER where I was admitted. We pay a $30 co-pay for regular office visits, a $50 co-pay for urgent care and/or specialist visits, and $150 co-pay for ER visits and it is always expected that those are paid at the time of each visit. Our prescription benefits are on a tier system which means that we either pay $20, $30, $50 or 20% depending on which tier the drug prescribed falls in. We also have a $1500 deductible per person per year. Our out of pocket medical expenses are usually around $7,000 a year. That is with good insurance.

While I was still in my hospital bed a lady from accounting came in to see me. At that point I had been in the hospital a total of 34 hours. She informed me that our bill was in excess of $5,000 and wanted to know if we would be able to take care of our portion of the bill that day. My husband was not there and they had instructed him to take my purse home with him so I told her no. She then handed me an envelope and told me that they like to see no less than $250 before leaving the hospital but that I could mail it when I got home. I was a bit dumbfounded. We paid our $150 co-pay in the ER and we always pay our medical bills. I also know from past experience that that $5,000 does not cover the ER doctor, the radiologist, the floor doctor, or the gastrointerologist. We will be receiving bills from them shortly.

Why so expensive? Well... different people pay differing amounts. Our insurance will no doubt cut the cost of the bill because they have a set standard they pay for different procedures. If the hospital charges more than that they will write off the difference because they have a contract with the insurance company to do so. In many ways our insurance company keeps the cost down for us by having restrictions like that in place. But the cost is still too high. There is a lot that most do not understand about how health care works. On the surface someone may look at this post and take it as an example of the need for universal health care. It just is not that simple.

I wonder if I would have been able to get an appointment on Friday if we were under a government controlled health care system. Would I have gotten a CT scan the same day? My condition could have potentially become life threatening if not treated. What if I had to wait?

I know a lot of families that are not as well off as we are. There are health care programs for them. They do not go without care. What I hear about and what I know do not add up. I definitely agree that something must be done about health care costs but what is being proposed is not the answer. Why would it not be implemented if passed until 2013? The deductions from all of our incomes will take effect immediately. Does that not raise a red flag?


paul mitchell said...

If there were not half of the LEGAL population that did not pay for their medical costs at all, I am sure that would make the bill be half of what it is.

In case you were wondering, you just paid for three illegals to have babies born addicted to alcohol. That is why it costs so much.

Just saying.

Coffee Bean said...

Believe me when I say I am aware that the paying population is also paying for those who don't... Through taxes and then through the misfortune of getting sick and having to pay for yourself at a higher rate in order to help cover those that don't.

One thing my husband and I found quite disgusting was all the comercials on the TV in the waiting room where the lawyers tell the people, "Let me help you get what you deserve." Where does that come from? Everyone believes it now! Get in an accident... someone must pay and pay BIG. Go to the doctor and request prescriptions for medication heavily advertised on TV and then have something go wrong for a percentage of the people taking the drug... join a class action suit. Ugh.

Hmmmm... maybe we should add television to the list of health care costs. The constant onslaught of messages telling people to sue and then political propaganda that people buy rather than research things on their own and then voting for people who push crap through our legislatures has surely got to have an affect.

Susanne said...

I am sorry for your recent sickness, but I hope you are feeling better now. I enjoy reading your thoughts so thanks much for sharing about this.

AmusedMomma said...

This blog post seems worth a gander by the Uneducated Housewife in regards to health care.

I'd interested to see what you'll make of that proposal for health care reform.

One Salient Oversight said...
This comment has been removed by the author.
One Salient Oversight said...

To see whether your experience in a public system would work you'd also need to get sick in a country that has public health insurance.

A few years ago my son had a number of bouts of croup. As any parent knows, kids suffering from croup can be quite distressed.

So on the night my son came down with croup, I took him to the nearest hospital. He was admitted to A&E straight away and the doctors and nurses looked after him quickly.

In order to rule out other causes, he needed a chest X-ray as soon as possible, which was done straight away. As they were waiting for the X-ray to develop, the doctors made the decision to move him to a hospital nearby with a paediatric unit.

So my son and I jumped into an Ambulance and headed off to the other hospital. As he lay in the paediatric section of A&E, the first hospital emailed through the x-ray images so the doctors at the second hospital could see it.

After concluding that there was no obstruction (an inhaled object) they decided that it was a case of croup and administered a steroid to stop the swelling around his throat.

A few hours later we were home.

So we were admitted to two different hospitals and an ambulance had been used to transport us between the two. An X-ray was also taken. Total cost? $0.

I thank God for our universal health care system in Australia. It potentially saved the life of my son.

paul mitchell said...

OSO, in a system without forced government mandated health services, our doctors would have known instantaneously that there was no obstruction.

"Potential" is unrealized success. It means NOTHING.

One Salient Oversight said...

OSO, in a system without forced government mandated health services, our doctors would have known instantaneously that there was no obstruction.

Without X-rays?

Whatever you say Dr Mitchell.

paul mitchell said...

No, OSO, you use the fact that the medical services did their job by transporting your son to the other hospital to get diagnosed. In the US medical system, all hospitals have the equipment and electricity that "universal healthcare" countries don't have.

You posted your personal anecdote as a success, I see it as an utter failure. The vast majority of our local CLINICS have x-ray machines, by the way.

One Salient Oversight said...

I'm laughing hard at you Paul. Really hard.

My anecdote has the following sentence:

As they were waiting for the X-ray to develop, the doctors made the decision to move him to a hospital nearby with a paediatric unit.

In other words, the original hospital x-rayed my son and then emailed the x-ray to the paediatric unit at the second hospital.

Do you even know how to read? My lack of respect for your opinion grows.

paul mitchell said...

Glad to be the source of humor for you, OSO. My work is done on this Earth.

Roland Hulme said...

Fascinating post as always, CB.

I'd come to America SO disgusted with universal health care in the UK - and while the care we've received in America has always been top notch, it's been BLOODY expensive - and exactly because of what Paul said - our health care costs are bloated to cover the costs of the people who AREN'T insured, but are guaranteed health care.

The biggest lie in the liberal argument for universal health care is that 46 million Americans don't have insurance. They DO. Just walk into a hospital and they can't refuse you service. But that service costs money and it's covered by the people who are responsible and actually pay for health insurance.

There's an argument to mitigate the cost of 'free' health care to the uninsured and place the burden on the taxpayer, not the health insurance customer. That's what the 'public option' obama proposes would do. It's not universal health care and it's not socialized medicine. It just means that more people cover the cost of providing 'free' health - instead of leaving people like you and I to carry the burden.

paul mitchell said...

Eeeeek!!! Roland is a neo-con!!!

SabrinaT said...

I found your blog today and wanted to add a few things to a very old conversation. I realize that the proposed health care we were expecting will now not happen.. But, here is a bit more insight.

My family and I have Tricare Prime. This is insurance that is provided to active duty military and their dependents. It is paid for by the government. We do not pay for medical coverage.... So long as we stay within the network. This means that as long as we are seen on base, or by a network doctor (a doctor that will take Tricare insurance) we pay nothing. Sounds WONDERFUL doesn't it..

Here is the reality. My husband is the only member of the family that is covered 100%. He can walk into any hospital at any time and be treated. So long as he remains active duty. When he retires things change dramatically.

For my kids and I we MUST see a Tricare approved doctor. For example if one of my kids need to see the ENT specialist we are given a list of doctors to call. We MUST see one on that list. Still doesn't sound so bad does it. Well the reality is very few doctors are willing to accept Tricare for one simple reason. They are NOT paid a fair market value. Most doctors see Tricare as providing free care. If they see my son, and it takes 3 visits at 1 hour each visit they are giving up 3 hours of paid work.

There have been many cases where people with Tricare are made to wait days and even weeks to see a doctor that will take our insurance. Having insurance doesn't mean anything if doctors are unwilling to accept it!

As far as care in Australia. I am sure urgent care is good. Most urgent care in the US is good. That is the problem. To many people do not have regular doctors so they are forced to seek urgent care. I would like to know how long the waiting list in Australia is for a hip replacement? How long do you have to wait for routine surgery? The quality of urgent care does not give the proper tone for over all health care. That is something Americans know and understand all to well!

My prayer is that those we have elected can come together and have a REAL discussion on what is best for the American people and NOT the drug industry, or insurance companies. Will that happen? Probably not. Not until we as Americans take personal responsibility! I agree with you Coffee Bean 100% to many people have their hand out and we are raising a generation of people that expect things to be handed to them!

Sorry for such a long comment..