loss absorption

I will begin by recapping something which happened to me back in September. It began with waking up feeling a bit nauseous, and ended with a trip to the ER several hours later; well, at least one would think that’s where it ended.

Don’t worry, I’m fine, but the aftermath of my experience has truly woken me up to the realities of our health care system in this country. I should also add a disclaimer saying I do not know much of the propositions of any of the candidate on this issue, and I’m not sure at this point how to get out of this frightful mess, so I will not profess I have the final answer to this health care nightmare. That all being said, here’s a breakdown of my experience.

June 16^th, 2007 – I officially graduate from UCLA, thereby beginning my tender first steps to the “adult world,” and also thereby losing all my health coverage which until you graduate, is covered by your parents health coverage (assuming they have it).

June 18^th, 2007 – At the urging of my parents (despite thinking it a terrific waste of money at the time), I purchase ‘interim’ health insurance from UCLA amid advertisements from the Alumni Association about what great coverage I was getting and for such a good cost. ($90 per month, major medical only)

September 25^th, 2007 – I wake up feeling a bit sick, but brush it off. On my drive to work I get violently ill. Once at work I tell my boss I have to go to the doctor because I think I have food poisoning. After debating with them for a while I finally go to the doctor, where I can only see a nurse because all the doctors at the office are booked with appointments and do not have scheduled times for emergencies. I was told I had food poisoning, to get some rest and it will clear up in a few days.

September 26^th, 2007 (1AM) – Far too sick to be any food poisoning I have ever known, I am unable to even drive myself to the ER, so I call my dad to take me to the hospital. I am seen by a triage nurse who also believes it is food poisoning, and told there will be a substantial wait since my case is not urgent.

September 26^th, 2007 (3AM) – After getting so sick I can’t even raise my head, I am finally taken back to see the doctor, who diagnoses me in about 2 minutes with not food poisoning, but a severe case of vertigo. (No, not the movie, which seems to be the almost universal first response when I get to this part of the story) I am given 3 bags of IV fluids and medication, 3 different oral medications, and told if it didn’t get any better in a few days I would have to follow up with my own doctor.

September 30^th, 2007 – Still no change in vertigo (pills given to me by the ER doctor very ineffectual, especially since they turned out to be OVER THE COUNTER DRAMAMINE, but in a prescription bottle, which apparently made them cost 3 times more). I call my own doctor and over the phone she prescribes a heavy dose of decongestants which kicked in finally and I begin to feel better.

October 1^st, 2007 – My health insurance from my new job kicks in (just in time, right?)

November 26^th, 2007 – I get my first hospital bill; $5,000. $5,000!!!!!!!!! Then I get a doctor’s bill ($800), bills for the IVs ($50/each), for the lab to process my blood test ($300), and an extra fee for $200 because I was seen at the ER “after hours” which began at 10PM. Oh, and my insurance from UCLA’s deductible was $8,000. I guess when they said ‘major medical only’ they REALLY meant ‘major medical only’.

Here’s the real kicker and the point I’ve been building towards. Despite saying on their bills that financial assistance was offered and payment plans could be discussed, upon calling the hospital, I was told that there was nothing they could do to help me and I owed all the money that was listed or else they would turn me over to a collection agency. I was told, point blank, by the hospital, that the reason my bill was so high was because I had insurance.

What? Apparently, there are so many patients that come for emergency care without insurance (and they have to, by law, treat them anyway), the hospital purposely inflates the bills of patients with insurance, to try and get more money out of the insurance company, to fill the gap with how many uninsured patients they have to treat. It was just too bad that my insurance sucked so much.

Now, I was able to talk my way down to about $4,000 total for all the bills, but that still doesn’t mean I have $4000. I am barely out of college, did not make much money at work, had school and car payments (not to mention car insurance), and have now been hit with this debt which I will be paying off for a long time to come, because most other people don’t pay for insurance.

Now I of course believe that everyone should get medical treatment when it is an emergency, no matter if they have insurance or not, no matter if they have money or not, but the drain on the health care system (ERs mostly) comes primarily from non-emergent cases such as people not paying for health insurance, then going in when they have a cold. My father, who worked in an ER for 10 years and saw these abuses every day, confirmed this. He even spoke with a woman once who was very proud that she had found a way to cheat the system which meant she didn’t have to pay for insurance for her 5 children; when one of them way sick she would simply take them to County Medical Center and tell them she had no insurance, no money, and then give a fake address. The hospital had thus far just written her off as a charity case and they never paid a cent to the hospital. Incidentally, she drove a brand-new Mercedes when my dad spoke to her.

Most of the problem lies in the lack of affordable insurance and the bureaucracy of the entire system coupled with a lack of doctors and nurses, facilities and equipment (oh and don’t get me started on drug companies). But even if these problems are addressed, there will still be people who feed off the system because they are allowed to. The more we are willing to just ‘absorb the loss’ of some, and then translate it to overcharging others, the more screwed-up we are going to make the situation. This isn’t a problem exclusive to ethnicities or immigration status, either, although all these topics collide in one mushy mess. I really think universal health care would be the best way to ultimately solve the problem, circumstances what they are, but even it is not a total fix. But until we get even there, there has to be a fundamental change in people’s attitudes about taking more than what they are entitled to and feeling justified in doing so. Although, maybe we’ll see coverage for everyone before people start taking responsibility for themselves. All I know is when the hospital billing department asked me why I didn’t lie and say I had no insurance, I told her I didn’t because it was wrong. I really hope more people will do that when they’re in my shoes.

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