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.