costs

[update below]

With all the health care reform debate going on, I feel a little apprehensive about throwing my largely uninformed two cents in. But here they are anyway.

I have been paying for "disaster insurance" for the last four years. This insurance initially cost me $130 a month, and would cover my ass if my yearly medical bills were over $2000. As of this summer, this insurance costs me $250 a month and will cover medical bills over $5000 a year. I am fully responsible to pay out of pocket for all annual exams, incidental doctor's visits, emergency costs & medications up to that limit. Despite the apparent absurdity of paying $3000 a year in case I am hit by a car or perhaps by lighting, stories of people having freak accidents and ending up hundreds of thousands in debt had me scared enough to keep paying up.

This is a story in two parts, with no conclusion. Just so you know.

Part One: Ankle
In July, I was attempting to bikejor with Pico when he went after a whitetail deer and the bike rolled over my ankle. I did the usual Rest, Ice, Compression, Elevation for the first 48 hours, but still could barely bear weight by day three. On day eight I decided to eat the cost of an Urgent Care clinic and an X-ray, since the stability of the injured limb seemed to be deteriorating. I was told it wasn't broken and sent on my merry way, with a bill for $300 showing up in the mail in Alaska a month later followed by another for something like $80 in unexplained administrative fees. Two months later, it was still slightly swollen, painful & unstable. Because I was trying to complete the Firefighter I class at the time, I went to an Orthopedic PA clinic and ate the cost of another X-ray and exam hoping for a definitive answer and maybe some physical therapy exercises to do at home. Instead I was told that there was an old break and calcification which was probably impeding the healing, and that the Firefighter class would have to wait. That was it. That was two months ago. It is still a little swollen, still a little too sensitive to lateral movement, and I am now over $700 in the hole.

Part II: Fever
I started a job at a community health clinic a month ago. Inevitably, all the germy air caught up with my immune system and I came down with a nasty sore throat & fever on Wednesday night. Certain I'd gotten a flu of some kind, I was bracing myself for a week or more of feeling like a bug on a windshield. My supervisor told me to come in and be seen by one of the clinic docs, primarily because she doesn't yet know that I only skip work when I can literally barely walk. I called the human resources department, only to find out that my insurance at work doesn't kick in for 60 more days. SOL is the appropriate acronym here, I think. This morning I checked myself in and screened myself before anyone else arrived, to avoid spreading my gunk even further. The internist I work for came in and decided I had bronchitis, not the flu, due to an already broken fever & junky lungs, and prescribed me a Z-pack and a second day not further infecting his patients by staying in bed. I went home sick from my full time with benefits job at a sliding scale health clinic, and by 10AM my little cough had eaten up $200 more dollars in medical fees and pharmacy costs as well as all of the sick-time and vacation-time I have managed to accrue over the last six weeks.

I know that compared to most of the health-care stories, mine is a minor one. I am a healthy young person without any chronic medical conditions, and full-and-part time jobs that cover my tail for all the little medical issues & expenses I've sunk into over the last few years.
At the same time, I have paid nearly a grand for a sprained ankle and a one-day fever over the last six months. (I somehow neglected to mention my $700 visit to the Urgent Care clinic two winters ago, for six stitches and fifteen minutes of the good doctor's time. Or when Peter was told to go to the ER by a triage nurse because of body-fluids exposure [see previous post] and was charged over $1000 for the doctor to tell him not to worry about it.)

Now I work in a clinic where the majority of patients we see are either uninsured and paying out of pocket or on medicare/medicaid. Some work part-time, some are self-employed, and others can't or don't work. All of them are dealing with much higher bills and much more dire consequences if they don't seek and get the medical care and medication they need. Sometimes they get it, sometimes they don't, and the difference between the two is almost universally measured in money.

update: as of 11/06, add another $104 to the ortho bill. apparently they forgot to bill me for the 10 minute follow up appointment two weeks after the x-ray.