So, I've got a friend who got her final bill in the mail the other day from the hospital. She had gone through kind of a big thing; having been in and out of the hospital for the better part of 5-6 months, and during that time there were a lot of specialized services administered. Anyway, my point is not to detail the hospital services, or to itemize her bill. Rather, my point is to address the bill as a whole, and determine exactly what type of alternate universe the medical community is currently inhabiting.
The total bill, for services performed in a roughly six-month time frame? $869,841.90. Not including a slew of other items that were billed separately, like anesthesia, radiology, and visits by specialists. The total amount, with all bills added together, was well over $900,000.00.
Have you fainted? Died, perhaps? I'll wait a few moments for you to compose yourself, because I nearly had a heart attack when I heard the news myself. NINE HUNDRED THOUSAND DOLLARS? Umm....WHAT?
That's more than the average American makes in a LIFETIME. And she just got a bill, sent to her house, for that amount. A bill for services rendered over a relatively short amount of time (just a few months). Does anyone else feel like we've totally lost touch with reality?
It's kind of like the California real estate market as compared to the real estate markets of 95% of the rest of the country (yeah yeah, NYC/Boston, I'm not counting you). People who live in California, and have for a long time, have just come to accept that buying a 1500 square foot, 2 bedroom 1.5 bath house is going to cost them somewhere between $500,000.00 and $1,000,000.00 depending on where in Cali they live. That's just the way it is, right? And yet the rest of us, living in the other 95% of the nation, see figures like that and think it must be a joke. I mean, I could literally pick my house up with a crane, put it on one of those big house-moving trucks, drive it all the way to SoCal, slap it down somewhere, and it would have quadrupled in value. Just like that! It's ludicrous. And when someone moves from California or NYC and goes house hunting, they feel like they've jumped up at least three tax brackets, because (gasp) they can easily afford an ENTIRE laundry room AND their own washer and dryer, not just the one they feed with quarters down the street.
It's like a little bubble - the Ridiculous Bubble. It somehow seems normal to spend $700K on a completely average, needs-some-work home if you live in San Francisco. It seems normal to cram your bed, dining room table, couch, dresser, and whatever else you can squeeze into your 500 sq ft studio if you live in NYC. Who needs all that space? And the rest of us, outside of the Ridiculous Bubble, are like "ummm....you don't actually have to do that, you know". Only difference is, at least you get the BENEFITS of living in the Ridiculous Bubble as it applies to real estate. If you're paying an arm and a leg to live in a tiny box, chances are, that tiny box is set right in the middle of some seriously awesome stuff. Maybe your box overlooks Central Park, and you can just run down the stairs and get groceries, great Chinese food, any magazine you can think of, and a hot dog at 4am. Maybe you live in the epicenter of business and finance. Maybe you live in the arts district in an amazing city. Maybe you live three feet from the beach, and can listen to crashing waves all night long, and enjoy 70 degree afternoons every single day of the year. My point is, I GET that for the most part, what you sacrifice by living in the Ridiculous Real Estate Bubble you more than make up for in culture and excitement and lifestyle.
So what are we getting in sacrificing our sanity and life-savings by living in the Ridiculous Health Care Bubble? Really, really rich doctors, and even richer pharmaceutical giants. And that's it! No really, THAT'S IT. I could try and write a moving, persuasive piece on how America's health care system needs a major overhaul, but I have neither the time nor the inclination to do so, when so many others are writing about it right this minute and doing a better job than I would be. I don't know everything that would have to change in order to make our health care not just AWFUL, and I'm not up for getting this whole thing torn apart because I didn't fact-check that one reference I made to whatever hospital statistic I used. I think it's pretty clear that our health care system is completely wack, and as further proof, I offer this as evidence:
The Three Types of Americans Able to Consistently Access Good Health Care:
1. Rich ones
2. Old ones (over 65, because Medicare kicks in)
3. Ones who work for mid to large-sized companies who are able to provide their employees with insurance
And that's it. All the rest of us are totally left behind, left to figure out what insurance we can afford (pretty much none of them), how high of a deductible we have to get (pretty freakin' high to have ANY hopes for a low monthly payment), and whether to get insurance at all or just cross our fingers and hope for the best. It's just absolutely ridiculous. I am self-employed, and so is my husband. To look at us from a health care perspective, you would think that I just said we are both UNEMPLOYED, and sit outside on the porch steps all day, drinking malt liquor out of a paper bag and listening to "Just A Friend" by Biz Markie on a giant boom box (and if you got that reference, my heart belongs to you 4Evah).
We're being punished for being small business owners! For being self-employed! For WORKING for the small businesses; businesses who can't afford health insurance plans for all their employees. I mean, is small business not what America is kind of ALL ABOUT? Isn't it like, I don't know...the LAND OF OPPORTUNITY? Or some such? And yet, if you do move here, and grasp your opportunity to make a living by doing what you're good at, you better hope you can A) get super rich doing it or B) get employed by a big company to do it because otherwise C) you're gonna have NO health insurance. And then you're gonna have to shop around for health insurance for individuals, and it's all going to be super expensive, and to get the monthly payments down, you're gonna have to have a $5000.00 deductible and so anytime you're not feeling well and you have to go to the doctor, you better be prepared to fork out another $300, just to have the doctor give you a well-exam and tell you you're okay. Because well-exams and strep throats and the occasional minor injury aren't enough to meet a $5000.00 deductible. And that means you're paying for your monthly premiums AND every ridiculously overpriced doctor's visit, because you're too scared that something REALLY bad might happen and then you'll need the insurance. And why would you be so scared, you ask? Because people get hospital bills in the mail for $900,000.00. That's why. So everyone is scared out of their mind that they'll get cancer, or in a terrible car wreck, or have pregnancy complications, and the hospital bills will bankrupt them in a heartbeat. So we all scrounge up our monthly premiums that pay for absolutely nothing but a catastrophic policy, and we try to avoid all the little doctor's appointments, because we know that we won't have met the deductible, and the doctor is going to order a minimum of three tests (because the more they order, the more they can bill!) and the total is going to be $700.00 just for stepping in there and breathing.
And the whole reason insurance is so freakishly expensive in the first place is because the insurance companies are playing a huge game of blackjack, knowing that although they can be smart and win most of the time (see: every single person who pays their insurance premium each month and never has anything go wrong), there will be plenty of times they are going to lose, and some of those times, they will lose HUGE (see: $900K hospital bills). So, you say, it seems like it's all easily traced back to these outrageous medical costs, right? And if it's so easily traced back there, then that seems like an easy enough solution - STOP BEING SO GREEDY AND CHARGING SO MUCH, MEDICAL PROFESSION. And yet, that clearly ISN'T the solution, because they keep charging more and more...and the doctor's houses get bigger and bigger...and the pharmaceutical companies will soon take over every commercial slot on television...and every American will be on at least five prescription drugs...and we'll STILL be the least healthy country in the world. Oh, you didn't know that? Well, we are. Of all the Tier One (First World) countries, we have the biggest, most advanced medical community, and yet we have the sickest populace. LOOKS LIKE IT'S WORKING GREAT, GUYS!
So, there's my rant. And if I ever DO get a medical bill in the mail for nine hundred thousand dollars, I am going to pull out the return envelope, go over to my Monopoly box, grab a handful of that pretty-colored, paper cash, and toss that in as payment. It's every bit as reasonable as them sending a bill like that and expecting compensation. Maybe I'll print this out and throw it in the envelope as well. Or maybe I'll make my letter a lot more succinct, something more brusque and to the point. I feel sure I could come up with something.
Despite my best attempts to avoid it, I'm going to the doctor tomorrow. Wish me luck that I don't come out crying, broke, or both. If there's a donate button at the top of this site tomorrow, you'll know why.