We often hear about the big ideas in politics, and national politicians like to paint issues in broad strokes, and one of the best illustrations is the healthcare debate. Pre-existing conditions, mandates, lifetime limits…most of the time, all of these are policy issues. But for nearly everyone at some point, those policy issues become personal issues. I recently had one of those moments where the big ideas that I have written about became personal experiences.
I now understand how truly messed up our medical system is, and just how badly it needs an overhaul. I am not an expert, nor a psychic, so I cannot say whether or not the Affordable Care Act can or will change anything, but I can say that something needed/needs to be done. The following is my latest experience with the American medical system, with as much transparency as possible.
It was hot. It was hot and I was covered in sweat, having just come back from a two mile run in which i proved to my wife that yes, I can still run two miles in fifteen minutes. I bounded up my front steps and into our kitchen where I poured a cold glass of water and reached into a bag of cherries that had been sitting on our counter all day. This morning, that bag was full and now there were a handful left. Even fewer as I topped off my glass of water with a couple of the sweet fruits as I went upstairs to get a shower.
When I got to the bathroom, my eyes were watery and my nosy was itchy. Being no stranger to the blight of seasonal allergies I opened up my medicine cabinet and washed down a Claritin with some water out of the tap, knowing that my typical response time to medicine is about 20-30 minutes, I knew that once I got showered and changed, I would be just fine.
I turned the shower on and began sneezing. Powerful sneezes. Sneezes that shook my chest cavity and left me gasping for air. Sneezes that my wife overheard while she was working in the backyard garden. I left the water wash down over my eyes and my face, hoping that the water would wash away the pollen or other allergens that were being so bothersome. More sneezes racked my chest, and I began to feel the old familiar tightness in my lungs.
When I was a kid, I suffered from some pretty serious exercise induced asthma, meaning that I was the kid who needed to have the inhaler with him at every sports practice I went to. I knew what it felt like to have my throat close up and leave me gasping in wheezing, except I hadn’t had an asthma attack in almost ten years.
My throat began to tickle and close up, even as the sneezes kept forcing their way through the minimized airways. At this point, having overheard a dozen sneezes from the upstairs bathroom, my wife walked in to find my leaning up against the wall of the shower.
“Are you ok?”
“I don’t know.”
“I feel weird…I itch all over.”
I got out of the shower, grabbed a towel and walked to the bedroom. I began to dry off my hair and my face when I realized that something was wrong. When I patted my face dry, it felt, well, different. I walked over to mirror to find that my nose had swollen up so that each nostril was completely closed up. My eyes were puffy and watering and my chin and lips were numb and swelling as well. This was weird.
My wife had followed me into the room and it wasn’t hard to read the alarm on her face. She geared herself up for what she thought was going to be a protracted battle with me and told me that we were going to the doctor. Knowing my usual reluctance to seek medical treatment, I could tell that she was surprised at my answer.
“Yeah. Let’s go.”
We loaded up into the car and having no experience with medical emergencies, she drove me to a local MedExpress. By this time, I felt like the worst may have been passed. I could still see through my watery eyes, my chest had loosened up, and I was a little anxious about the whole ordeal, but coherent.
They admitted me right away and took me back to an examination room. When I relayed my symptoms, it was pretty obvious that I was dealing with some sort of allergic reaction. They hooked me up to an IV to deliver a steady stream or steroids to combat the reaction and continued to asked me questions.
“What else do you feel?” the doctor was quizzing me.
“I don’t know, weird.” I answered.
“Well, my chest is still a little constricted, but I can breathe alright.”
“If your throat closes up, we don’t have the necessary equipment to keep you breathing. We’re sending you to the ER.”
I really didn’t want to go to the ER, but I guess I had to.”OK, well I need the IV out so I can get in the car.”
The doctor gave me a look that both scolded me and made me think that I might not even understand the seriousness of the situation. “No.” She said, “we’re calling the ambulance.”
The ambulance arrive about 15 minutes later. At this point, I had been on a steroid IV for about 20 minutes and frankly, I felt fine. The swelling had gone down on my face, I was breathing freely again, and I really didn’t want to leave my wife and my baby boy.
When the ambulance came, it was awkward really, because I really felt okay, but I had to get on the gurney. I stood up off my bed, held my IV bag over my head and hopped up onto the bed. Inside the ambulance waved off the EMT as she tried to hook up an oxygen tube to my nose.
“My nose is swollen shut, so no air would get in any way. Don’t bother.” She looked at her coworker warily and I guess decided it wasn’t worth the fight and let me go. We got to the hospital in seven minutes.
At this point, I was embarrassed. The steroid IV had controlled my reaction so that most of the swelling had gone down. They rolled me into the ER and into a room full of sick people. I saw the look on the faces of the nurses as they tried to figure out why this seemingly healthy and fit twenty-five year old male was being rolled in by a couple of EMTs. I got down of gurney and into an open bed, and then I waited.
And then I waited some more. After about an hour, the doctor came over, “I saw you come in and you didn’t appear to be in any distress, so I was taking care of some of the other patients first.” That seemed reasonable. They checked my vitals, and when they looked good, and asked what I was allergic too. I had no idea…my best guess was the cherries. The docotr seemed alright with that explanation. I was told that they would keep me in for observation. After another hour, They came back with some paperwork to sign and a Claritin. I told them that I had already taken a Claritin a couple of hours before, so they left it for me. I was told after about two and a half hours of sitting on a bed in the Emergency Room, that I was free to go home, but was given a prescription for some antihistamines. My wife came and picked me up about twenty minutes later.
So to recap, the treatments that I received were: A doctor’s examination at MedExpress, a steroid IV, an ambulance ride, a doctor’s examination at the Emergency Room, and a Claritin (that I never took).
The total amount that was billed to my insurance company (and that I would have been responsible for if I were uninsured) was $3,247.34
The billing broke down like this:
MedExpress Medical Visit: $210.00
MedExpress Diagnostic Services: $135.00
MedExpress Prescription Drugs: $60.00
Manheim Township EMS (ambulance): $908.00
Emergency Room Medical Visit: $763.00
Hospital Misc Services: $1,171.34
For a simple allergic reaction, which we tried to respond to as appropriately as possible, we accrued a medical bill of over $3,000. The billing for the MedExpress seems more reasonable… a couple hundred bucks to get admitted and seen by a doctor, and $60 for an IV. When I was sent away in the ambulance (against my wishes) I was never told that I could receive a bill for almost a thousand dollars to drive three miles.
But the real infuriating part of the bill was the hospital bills. I can’t stress enough that I never received any actual treatment in the Emergency Room. The only thing that they did was to remove my IV, and have a 45 second conversation with the doctor. Otherwise, I sat on the bed and drank some ice water that the nurse had given me. I could understand the Emergency Room Medical visit. $763 to be admitted to the ER and have a doctor’s evaluation seems a little steep, but still within the realm of feasibility. But why in the world was I charged over a thousand dollars for miscellaneous services?
I have to imagine the line item breakdown looked something like this:
Give patient a cup of water: $100.00
Give patient a bed at $250/per hour x 2.5 hours: $625
Have nurses look at patient from across the room while he sits there uncomfortably: $75
Talk to the doctor at $5 per second: $225
Take out patient’s IV: $146.34
It seems absolutely absurd. Luckily, I have insurance, which helped to knock down some of the exorbitant fees, but since our deductible for the year had not yet been met, I am still responsible for $2,216.84 in medical bills for an allergic reaction in which my most serious treatment was an IV.
I won’t begrudge the insurance company because I chose our plan knowing that we had a $2500 deductible on the year. I am OK with the insurance company’s stance. What I still cannot fathom is how the services rendered to me were worth over three thousand dollars. How can anyone look at this system and believe that it doesn’t need to be fixed? How can we properly incentivize hospitals and doctors so that the most menial trips to the emergency room don’t become a financial burden?
I don’t have any answers for those questions here, but what I do have is a newfound understanding of the plight that over 30 million Americans face without insurance. Luckily, my family was able to weather the burden because we knew what our deductible was and had planned accordingly. But if someone can’t afford insurance, how can they afford these costs? People face much worse emergencies everyday as the result of accidents, how can someone afford to pay for care for a real emergency and not just an allergic reaction that was simply treated? Even if the Affordable Care Act isn’t perfect, and even if it doesn’t do everything that was promised…wasn’t it worth trying something?