An envelope arrived today from the insurance company and I knew immediately that it would be the paperwork for E2′s trip to the Emergency Room. Every time we’ve got one of these envelopes before, it’s always been bad news — thousands of dollars worth of bad — and so my hand nearly shook as I began to open this one. I quickly scanned past line after line of itemised costs and focused on the big number at the bottom…
Just over $3000. My heart stopped. $3000 in one night!
And then I looked over to the box marked “Amount You Owe Provider”. It said $25. I closed my eyes with relief and lent my head back against the wall, and thanked God in his heaven that my kids are covered by the state’s CHIP programme (the only policy that I could find in the entire marketplace that they qualified for). To owe so little for a bill so high is really quite extraordinary here in the US. Even most “good” policies here would require me to pay a percentage of that amount and the most common split I’ve seen is 80/20. That would put our portion of E2′s impromptu night in hospital at $600 and — with a gas bill that was higher than that last month and M’s hours ever fluctuating — even that reduced amount would have been a crippling bill for us to pay. And if, God forbid, we’d been uninsured…
This is why I believe, wholly and completely, that the US healthcare system is fatally flawed and needs to be overhauled entirely. I have heard the arguments for the status quo — argued with passion, most often, by people who have never been in a position of being trapped by their (un)insurance. I understand the concept of a person neatly choosing the coverage they need, of deciding how much deductible and max-out-of-pocket they want to budget for. But the reality is simply not that neat. Most people can’t choose the coverage they want, because their healthcare options are dictated by their employer. And buying the policy that suits your pocketbook best simply doesn’t work once you have a pre-existing condition — and we will all have one eventually — and so you can no longer pick and choose freely in the marketplace. And even when you can, the cost of buying that coverage outright is completely prohibitive for most people on average wages.
Buying healthcare coverage is completely unlike any other purchase a person usually makes in their entire lives. Nothing other than healthcare is so fundamentally compelling — truly life and death — and yet has such devastating potential to create skyrocketing and utterly unmanageable costs literally overnight. Healthcare provision is quite simply in class by itself and, as such, it has to be treated differently. To leave to the marketplace as if it were any other ordinary commodity is… well, is to create an unacceptable situation like the one we’ve got at the moment.
And it’s unacceptable because of this horrifiying thought: if, when that on-call doctor told me to take E2 to the Emergency Room… if I’d had to think about what 20% of that trip was likely to cost, then I might not have been hesitating solely on account of the snow and my mistaken belief that things weren’t yet that bad. I might well have been weighing up the doctor’s advice — and my daughter’s well-being — against my wallet. And if — as so easily could have happened to us — we’d been completely uninsured, I think it’s quite likely that I would have followed my own flawed judgment and waited to see how the night went, and thus brought on all the unthinkable consequences that could have created.
It was not us that night, but there are 47 million others.
Stumble it!
The abject fear of socialized health care (the horror!) in the States is a puzzling one for me. Do these peope really not care about the bills that people are saddled with? They certainly don’t understand that some people literally cannot afford/find health coverage and go into a massive debt hole or go untreated.
I find it rather infuriating that come non-existent caricature of our healthcare system is bandied about like the gospel truth: “Look at Canada! They have it and people wait for days in the emergency room!” You’d think that isolated incidents like that never happen in US hospitals.
What I know is this: we’re covered for anything that happens. From cradle to grave, we’ll be taken care of. There’s no such thing as a pre-existing condition, because you’re covered from the moment you’re born. There’s no worrying about a monstrous bill arriving down the road, so there’s no weighing of pros and cons at 2am when a child wakes you up with a raging ear infection and a 40C fever. We just called my Mom to look after the oldest and sped off to ER.
I couldn’t agree with you more. Every time I see an envelope from a hospital or our insurance company, I feel sick.
“Fatally flawed”….exactly.
I am so glad they qualified for CHIP. We are currently unisured for the second time since we came back. It is so frustrating. At least this time I know that we can qualify for COBRA if we need it, but even THAT would put us so much more in the hole than we already are. And I can’t believe how many AMERICANS, the ones who like to fight tooth and nail for their rights, will just sit back and take it like there is nothing that can be done about it. Or that this is the best way to do things because any other way would cripple research. ACK, I wont go on…
Somewhat (well, almost totally) tangential — if your gas bill was that high, I would call the gas company and find out if that’s consistent with last year’s reading. I am wondering if they may have a bad meter. Or you are keeping it 100F in the house! Or your house is enormous-er than I thought! Or something. I just mention because our renters kept our very leaky and inefficient house at 85 degrees 24 hours a day through a MN winter and didn’t pay the bill for at least six months and that unpaid total was about $2500 including the electrics.
You really need to understand the American psyche to be able to understand why so many Americans don’t want Universal Healthcare. Americans are still very much in tune with the pioneer days of rugged individualism. You take care of yourself and your loved ones by the sweat of your brow. You make your own success and don’t want the gov’t making decisions for you, which is the downside to universal healthcare. Whether right or wrong is not the point I’m trying to make, just explaining a bit.
Myself personally, I’m split on the idea. If I got the same level of care I get now at the same price, I would be okay with that, but not sure I would. I would have to see how it’s set up before I would agree to it. My belief is that once the gov’t gets involved in anything like this, they tend to screw it up with their bureaucracy. I don’t think healthcare in America is perfect, but neither do I think the plans that the UK and Canada have are perfect either. Wait times are too long, it’s frequently underfunded, some bureaucrat decides which drugs you can have for this or that condition, etc.. I’ve read that Germany has the best. It’s a mix of private and gov’t.
We all know Americans are about the most unhealthy people in the world. Think about it, do you really want to pay for the plus size families who gets the Big Mac at lunch then goes home to get the deeeeluxe bag of cookies or nachos for dinner? I hate the idea of paying for someone else to run to the doctor because of some health issue that they won’t control through diet and exercise (or maybe just good old fashioned self control). Think about it next time you’re in Walmart whether you really want to pay for their bariatric surgery.
Julie — the short answer to you question for me personally is, yes, I am happy to pay for their surgery if it means that everyone else is covered for the things they need and no ends up making choices between what they can afford and what is medically necessary for them. The reason I say that is that I did exactly that for 15 years in the UK, and I can see that it works well enough to be preferential for me. To be honest, I think a large part of the reason that Americans are, as you put it, “the most unhealthy in the world”, is that they don’t have the same access to healthcare as the rest of the (developed) world. It stands to reason — certainly just as much as the idea that junk food (which is equally plentiful in the rest of the world) is the culprit. And besides all that, I do believe that the number of healthcare issues that could not have been prevented through diet and exercise would significantly outweigh those that could.
As for the government running healthcare… well, there is nothing set in stone that says a universal healthcare system has to be government run — though that’s an assumption most people immediately jump to when the subject comes up. But even in the case of socialised medicine, which would by definition be gov’t run, I find the general panic and outcry to be a bit overdone. After all, we are happy to have government-run schools, government-managed roads, government-provided law enforcement and national security (military) and prison systems and garbage collection and social services and public transport and curbside recycling and vehicle registration and on and on and on. Though I am no socialist and would like to see the government’s role kept as small as is possible, I do believe that healthcare is one of those areas that is so critical to the state of economy, so burdensome to business, so crucial to the defense of the country, and so crippling in its potential devastation to the individual that it is one of those few, special cases that requires unusual treatment.
Stacey — yeah, I know… done that. It is consistent with last year’s reading, sorta. Last year, there was a single guy living here on his own, so I’d expect us to have a higher bill just for the extra cooking and washing we are doing. Now (stay with me), November’s bill was an actual reading, December’s bill was estimated based on last year, and January’s bill was another actual reading. So you can take Dec and Jan together and divide by two to get what it actually should have been for each month. Doing that, our bills for those months are a 66% increase over last years — but given that the number of residents has increased 300% (or 200% if you count the girls as a 1/2 person each), I guess it makes sense for the bill to increase so much.
However… however… we cannot live with bills that high for long. We keep the heat at 65F and I am ruthlessly careful with our hot water usage (and the house is perfectly normal sized!
), but the furnace is circa 1970, so obviously that isn’t helping things. M will replace that as soon as we’ve saved the funds for a new one. In the meantime, I think it’s just our tough luck. :-/
Yeah, I should have known you’d thought of that! Sorry.
No, no, don’t be sorry. I am open to all suggestions because, well… even though the bill makes sense based on last year’s bills, it still seem incredibly, horribly, painfully high — this year and last — and I’d love to find out that there’s some magic reason (beyond, y’know, the obvious stuff like sealing the windows and turning the thermostat down) and we could just somehow *fix* it!
[...] The coverage was excellent; the price surprisingly affordable. The programme is funded by the state, but administered through a choice of several large insurance companies. I picked the one that we’d been on with M’s previous job, out of sense of familiarity more than anything, and got the girls signed up as fast as possible. Each month a bill arrived with bold letters telling me that one missed payment would result in permanent cancellation of the policy — I began sending the premiums in two months in advance just to make sure I never paid that price. In a world that felt like it was falling apart, knowing the girls had such excellent coverage gave me a sense of stability that I clung to like a rock in a stormy sea. [...]
[...] the moral of the story? The lesson to take away? It could be about the system, but that’s all been said before. Today, the lesson is a personal one: do not climb up on your daughter’s rocking-balance toy [...]