This is the first post I’ve done in a long time where I don’t have a picture. Reason? I’m dead serious about the subject matter. And I’m not highlighting a shiny bit – in fact, I’m highlighting a very tarnished bit.
The American health care system is really badly broken. I know that Obama can’t fix it. I don’t think anything short of a world war or a huge economic collapse would make any difference in the system.
So here’s our story. Jay, our 16 year old, does gymnastics. In the course of that, he has had various injuries. (Just about any sport will cause some level of injury – but that’s another post.)
He hurt his back and after maybe two months of pain, we broke down and took him to a back specialist MD. They insisted that he get x-rays before seeing the doctor. The x-ray clinic within the hospital was going to charge $460 for 3 x-rays. Since we have catastrophic-only health insurance, Heather said she would pay cash. They cut the price in half. Then she asked if they could just do one x-ray. No. She said goodbye. Back to the doctor. “Is there any way he can examine my son without x-rays?” “No!” Quietly, one of the doctor’s assistants told of an x-ray place about a mile away that was not part of that hospital’s network. Their price? $60 for 3.
Back to the doctor for the exam with economy x-rays in hand. No problem. Those did the job. The doctor asked that Jay get an MRI. Normally $4,000, but they said there was a place that would do it for $300.
We said no to the MRI. Instead, no gymnastics for a month. After that, maybe we’ll do an MRI.
So it came time to pay the doctor. $480. “Can we pay cash?” “Yes.” $240.
So in the end, we paid $300 for what most people would have paid $940 (via their insurance). What other industry works like that? Imagine going to your local BMW dealer. “I’d like a 328i.” “That will be $103,400.” Then you walk down the street to another dealer. “That will be $32,000.” (Real cost, by the way.) Same exact car.
My final word? Insurance… a huge problem for our country. Massive cost over-runs. Huge medical lawsuits… an incredible problem. Our country cannot pass any laws to cap those. Shame.
We all pay for it.
My mom had surgery a few years ago. The surgeon’s & hospital’s total bills were $30,000. Medicare said that they considered about $5,000 to be reasonable, so they paid $4,000 and mom paid her 20% co-pay of $1,000 and the hospital wrote-off the other $25,000.
My daughter had surgery last year. She had no insurance and neither the hospitals nor the doctors would do anything to reduce her costs. She was responsible for the entire $10,000.
So, the hospital charges 6 times what insurance or Medicare will pay and writes-off the difference. Unless, that is, a person is unfortunate enough not to have coverage, and then they expect full payment from those least likely to be able to pay.
Broken only begins to describe this system.
When I ran for legislative office, health care was the single most mentioned issue. It seemed like everyone I spoke to had problems with insurance, no insurance, astounding bills, or bad care. And this was in 2004.
In 2006, I broke my leg. That got me up close and personal with the system. It’s just as bad as you and others have described.
I spent a lot of time researching and looking for potential solutions at the state level. I didn’t come up with much workable. I can say this about our legislative process. It’s slow. It’s ugly. It’s wrong much of the time. But that is the way we will get to a solution. Through the slow, ugly process of legislation.