High Cost of Healthcare

It’s hard to believe that this summer will mark 12 years since I had my first two heart stents, which would be followed a couple years later by a double bypass. (You don’t know the meaning of pain until you’ve had your chest cracked open.)

During the cardiac rehab program that followed my stents, I met a man whose heart attack had landed him in the intensive care unit for a week. He ultimately spent a month in the hospital before returning home.

The Shock of Reality

The cardiac program generally lasted two hours, three days a week. Halfway through our exercise routine, we had to stop for a rest break and a glass of water or juice.

One morning as we rested, I said to the heart attack victim, “I spent one night in the hospital and my bills were $35,000. Since you were here a month, I’m curious: what did yours end up being?”

With a slight smile on his face, he replied, “Four hundred and ninety-seven thousand dollars.”

I nearly fell out of my chair as I contemplated the reality of half a million dollars. How does the average person deal with such a staggering sum of money? The answer: they can’t. Without health insurance, they’re a goner.

Healthcare Beyond Reach

The popular notion, that medical debt causes more than 600,000 bankruptcies a year, was called into question last spring by Snopes.com.

And yet, even if the problem is overstated, I contend that health care bills are often beyond the reach of the average household, especially those working in low-paying occupations.

I got a reminder recently of the reality that even Medicare is no guarantee of avoiding a calamity because of possible exceptions, exclusions, and other fine print that make up our convoluted healthcare system.

It came in the form of an email from an old friend whose husband had to have a biopsy right before Christmas to check for the possible resurgence of prostate cancer. Since I hadn’t heard anything, in early January I wrote to ask how his tests had turned out.

She replied that he did have a small spot of non-aggressive cancer. Since he had radiation the first time, he couldn’t go through that again. The solution was a specialized treatment that costs $25,000.

The downside: insurance won’t pay because this procedure has been performed in the U.S. for only 16 months so far. Medicare won’t even assign a treatment code until it has been done for three years.

“We will be taking out a withdrawal of $25,000 from our IRA to cover the cost, then trying to get some reimbursement from insurance after reduction in PSA has been proven,” my friend said.

Without a Prayer

While this couple can cope, what about others who would have no prayer? For some people, twenty-five grand might as well be half a million.

Congress is about to tackle the issue of Obamacare and its attendant impact on Medicare. Republicans will promise a better, more efficient system, while Democrats will argue for maintaining what’s in place.

Somehow, I see the average person on the street getting overlooked during the debate. When I read last summer that Sen. Bernie Sanders—the “man of the people”—bought a $575,000 vacation home, I said to a friend, “There’s proof that our political leaders live in a completely different world.”

It’s a world where too many of us out here don’t think that those in Washington, D.C. even understand the challenge of a $25,000 medical bill.