Healthcare: The Price is Definitely NOT Right
…“Ventricular tachycardia and a potentially ruinous amount of medical debt, Bob!”
It’s not news that the healthcare system in this country is bad and getting worse. The quality of the providers – doctors, hospitals, nurses, drugs, technology – is top notch, though Covid has taken its toll.
How we deliver it, however, is a full-fledged clusterfuck of biblical proportions.
Allow me to illustrate with a personal anecdote.
As some readers of this newsletter know, my cardiovascular system is nothing to brag about. Unless I like bragging about how bad my cardiovascular system is. In which case, I’m a legend.
So, when I feel any kind of chest discomfort – tightness, pain – we take it seriously around here. And that is exactly what happened a couple of weeks ago on the Friday before Labor Day.
I had been experiencing a couple of days of on-again/off-again symptoms, which were ultimately mostly on. I was losing sleep worrying about it, so that Friday morning I said something to my wife and called my cardiologist. He was not in because of the holiday weekend, but the office had me come down for an EKG, administered by one of the physician assistants.
Everything came back normal, and they sent me on my way. But, the PA managed to get in touch with my doctor, who said that, given my history, I should get a blood draw to check for any kind of heart distress-related enzymes. So, the PA calls my mobile phone as we are driving home and sends us to the ER so we can get quick results.
We proceed to our local ER, which checks me in immediately when I tell them about my just-concluded doctor’s office visit and the related chest pain. (Pro Tip: Want to jump the line at an ER? Say “chest pain” and “history of cardiac arrest” and you are in clover. I’m not joking. There was a guy sitting in the waiting area with a bloody bandage around his hand. He looked like he had lopped off a few fingers, but they took me ahead of HIM. In the game of heart-fingers-bones, heart CRUSHES fingers and oozes blood & pus all over bones.)
The ER doc sees me right away, says that they must do another EKG (standard procedure, even though I just had one 45 minutes ago) and then do the blood draw.
Ninety minutes later, results came back, nothing too scary, but there was a question whether to hold me for observation. The ER staff managed to get back in touch with my cardiologist who said (I am guessing here) something to the effect of “Fuck it. Send him home.”
Which they did.
I have been generally feeling pretty good since, taking my meds and paying extra-close attention to any recurrence.
That is until today when, out of curiosity, I logged into my insurance carrier’s portal to see how much my little Labor Day weekend picnic at the ER is going to cost me.
Now THAT is a proverbial heart attack.
By any rational measure, this was - maybe - a $300 ER visit: $50 for each test, $100 for the doctor, $100 for the facility charges and the nurse.
When it was all happening, I said to Elizabeth that “This is probably going to be a couple thousand dollar round trip to nowhere.”
If wishes were fishes…
So far, we’re at $5,900 and counting.
For less than two hours of treatment.
To prove… nothing.
Basically, I am paying $6,000 for my own inconclusive health data.
And just so you have a lay of the land regarding health insurance for Elizabeth and me:
- We are too young for Medicare.
- We do not qualify for Medicaid.
- We are not wealthy enough to not give a shit about insurance and/or medical treatment costs or to self-insure.
- We are self-employed, so we buy on the Obamacare exchange.
- We can buy insurance, despite my preexisting train wreck of a heart (a good thing) but…
- … our premium is north of $2,200/month with a $13,000 combined deductible.
- After we meet our deductible, the plan pays out 80% until we meet our annual out-of-pocket maximum. (Three years ago, the same plan paid 100% after a lower deductible and had premiums that were 40% less.)
- And – AND – we are looking at a 20% price increase (just approved by our state insurance regulator) come January.
So, one must ask that age-old question we have been asking since the Roosevelt administration:
Is this any way to run a healthcare system in the wealthiest country on Earth?
Survey says (I know. Wrong game show): “FUCK NO!”
After a decade of me being one of the few people I know who buys insurance on the exchange, I can say that Obamacare is a band-aid. A necessary band-aid, but one that is fraying and the wound that it is intended to cover up (out-of-control, unsustainable costs) is infected, festering and in danger of economically killing off a considerable portion of the middle income wage earners in this country who do not have employer-provided insurance.
And, for once, instead of just bitching about something, I have a solution. Actually, it’s not my idea at all, but it seems to go nowhere anytime it is suggested:
Medicare for all.
In my version, people of a certain age (say 50+) would have the OPTION (not requirement) to pay into the Medicare program and get the same benefits as those 65+. Or they could continue buying private insurance. Their choice.
The payment would be somewhere between whatever a 65-year-old pays for Medicare and what I am paying right now for private insurance under Obamacare. So, I wouldn’t be getting it for free, but maybe, instead of paying $2,000/month for a $13,000 deductible plan, I could pay $1,000/month for a $6,500 deductible plan.
Not free, but not backbreaking. And it would make a huge difference financially.
I have contacted every representative I have in Washington about this, but since this is an election year, I get either no response or a canned email, thanking me for reaching out and telling me how wonderful they are.
So, I am not holding my breath for any kind of reform or relief, though if I hold my breath long enough, I think I could trigger an event that gets me to the front of the line again at the ER.
Stay healthy.