Wednesday, May 16, 2012

A Rant About the American Healthcare System

If you are a Canadian reader, you can probably skip this post and bask in the comfort of your universal medical care that comes compliments of your government and your taxes.  If you are an American, this post will probably be like preaching to the choir but I feel ranty so here goes...
A few months ago I had a sudden, weird, medical condition that sent me immediately to the hospital ER to find out what was wrong with me.  Now, a few months later, I get the fallout from that hospital visit, namely a massive amount of bills.
In a nutshell, my body was feeling weird, I didn't think I was critical or anything, but since I was out of the area for my insurance they told me to go to the closest ER.  I Googled the symptoms before I went to the hospital and found that many people have this problem but none have been able to get an actual diagnosis for it.  So I go into the ER in the evening and wait...and wait...  They take some blood and ask some questions and the ER doc tells me they need to do some tests because it could be a heart problem or a brain problem (note that ER docs are mostly there to put people back together in trauma cases, or in cases where the problem isn't evident, rule out things that can immediately kill you like a heart attack or stroke, and then send you on your way).
So they say they can admit me and I can stay over night (in the ER, the rest of the hospital was full) then get the tests done in the morning.  I decided to go home (and save my insurance company from paying for my overnight stay) then I came back at 6am the next morning.  I was there the entire day--for like 12 hours--and they performed about 30 minutes worth of tests (CAT scan, MRI, vein ultrasound, and EKG).  Five doctors came in and checked on me, and one even pointed out that she had seen this problem a couple of times before but she doubted if they would be able to give me a diagnosis. Um...OK.  After many, many hours in the ER, they sent me home with a "we don't know what is wrong with you but we don't think you will die from it" (I'm paraphrasing) type of farewell.  So to this day I still have the same on and off symptoms and I have mostly just gotten used to ignoring it.
Then yesterday I got the bill in the mail for my ER stay and nearly fainted.  Fortunately (and this is huge), I will only have to pay $25 for the entirety of my care in the ER because I have exceptionally good and exceptionally cheap insurance, BUT I am horrified that sixteen hours spent waiting in the ER twiddling my thumbs cost over $20,000(!!!).  Like the hubby said, if we had been average, hardworking, wage-earning people, this visit to the ER would have bankrupted us!  Which is a really scary thing because there are so many average, hardworking, wage-earning people out there without health insurance who could easily find themselves in such a situation.  One little trip to the ER for something that seems like it could be serious could send a person spiraling down into debt that they can never get out of.  That is horrible!!!
Sadly, Googling your symptoms to find out if what is wrong with you is serious enough to warrant a hospital visit (generally a really bad way to determine if or what kind of medical care you need) is sometime's people's only option.  Obviously something needs to be done to fix this problem before people die from lack of care (I've actually seen this happen a few times as clients we worked with felt they couldn't afford care so they stayed home and tried to take care of themselves.  One young guy ended up dying from undiagnosed, untreated late stage cancer and a woman barely survived an internal hemorrhage that she though was a stomach ache).
Obama has tried to fix the problem of so many Americans without health insurance with his "Obamacare" universal insurance plan but unfortunately it wasn't very well thought out (the plan would insist that people buy health insurance but if people could afford health insurance they would already be paying for it! Duh).
To top it off, I checked the print out of my bill (see photos) and it listed a whole bunch of IV drugs it said that I received however I didn't receive anything other than one baby aspirin (which the hospital charged $3 for!  Hubby said he could have ran to Walmart and bought me two bottles of baby aspirin for that price!). So while my insurance paid the entire bill without question, I did request a review of my records so my insurance company could get reimbursed for the treatment they paid for that I didn't receive.  I also called my insurance company to point out the mistake but they didn't seem very concerned, in fact the lady said that if I wanted to I could talk to the hospital about it and the hospital would probably send them a revised bill.  If I had paid out thousands more than necessary I would have been all over the problem but the giant insurance company didn't seem worried about it.
So that is my long and disjointed rant about the state of American medical care.  Medical care itself is excellent in the US buy paying astronomical prices for that care, prices that the average person can't afford, often leaves people the choice of not seeking care that they know they can't afford (and risking everything up to and including death) or seeking care (at US ERs they must treat you even if you can't pay.  They will, however, bill you for every single moment of your stay and send the bills to collections if you don't pay up afterwards) and then having to file bankruptcy no matter how hard they have worked over their lifetime and how good they have been about paying their bills and staying out of debt.  That isn't much of a choice at all.


  1. Yep, I get this one. I had a overnight stay over 15 months ago that ended much like that - " we don't know whats wrong with you but we'll bill you thousands anyway". Its a mess. The whole medical, insurance thing is a mess. You're in a very good position in that you only pay $25 though!

  2. The mandate is important so that healthy people who think they're going to live forever don't free-ride. (The insurance market is broken because of something called "adverse selection" which raises prices... basically when the healthy avoid getting insurance, that drives prices up which causes somewhat healthy people to choose not to get insurance, which drives the prices up even more... leading to unaffordable insurance in non-group markets. And insured people paying for the healthy people's emergency room visit when the healthy person gets hit by a bus and doesn't pay the bill.)

    In terms of affordability, the ACA has a LOT of provisions for that. First, the adverse selection problem will go away so the average cost will go down (technically, the average cost will not go up as much, though it may actually drop in private insurance markets). The poorest get access to expanded Medicaid or SCHIP, less poor folks get tax credits, the amount of income going towards insurance will range between 2% and 9.5% for families.

    There's a number of other provisions in the bill experimenting with different ways to improve health outcomes and decrease costs.

    Jon Gruber has a great comic book called "Health Care Reform" that explains the provisions of the bill.

  3. $20,000?!?!?!?!? *FAINT*

    I'm thankful for our Canadian health care system today especially!

  4. The part that really gets me mad is that you pointed out the mistakes on the bill and your insurance company didn't care. GRRRRRRRRRRRRRRRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!!!!!! The whole system/country/government/schools/basically everywhere I look..... is corrupt! I HATE IT!!