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Life Health > Health Insurance

Out Of Whack

By Steve Piontek

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Flash from the health care front: The medical system in this country is out of whack. OUT OF WHACK!

OK, so now you’re probably saying, “Tell me something I don’t know.”

Yes, you and I both know that going to a doctor is expensive and getting more so all the time. But every once in a while something happens that hits you over the head like a hammer clunking one of our beloved Looney Tunes characters, say, Daffy Duck.

So, let me relate one such instance.

In January a friend of mine who is in excellent health suddenly had unbearable and unremitting stomach pains one Saturday evening. So bad were the pains that finally he told his wife he had to go to the emergency room because he couldn’t stand it anymore.

When they got to the emergency room of the nearby (and excellent) hospital, the treatment was courteous. During the course of the five-hour stay he was given a CAT scan but received no other form of treatment besides occasional visits from the nurses on duty. The pain, which could have been appendicitis, passed and he was released.

Imagine my friend’s shock when he got the bill from the hospital just recently. The five-hour stay in the emergency room amounted to $4,161. Of this amount, he said the adjustment made by his health insurer amounted to roughly two-thirds, meaning the company paid close to $1,400 minus my friend’s co-pay, which was $100.

Profoundly relieved that he had to pay only $100, my friend was still incredulous that the bill came to over $4,000.

Is this situation unusual? I think not, which leads me to believe that we have begun to truly reconcile ourselves to living in the Twilight Zone.

Now, my friend is not one to abuse the health care system–in fact, just the opposite. It takes something unendurable just to get him to the doctor.

All of which leads me to the current debate over consumer-directed health care. Reacting to the circumstances related above, proponents of CDHC plans would say, ‘If your friend had to face paying the entire $4,161 instead of only $100, he would have thought a lot harder about running to the emergency room, even if the pain was unbearable. And see, it passed away by itself.’

CDHC opponents would say, ‘What’s wrong is that a visit to the emergency room should cost over four grand, potentially bankrupting a lot of people. And what if your friend did have appendicitis?’

My own feeling about the situation is that people in the health care business and government are pinning their hopes on CDHC plans because when you come right down to it nobody knows what to do about skyrocketing medical costs, how to pay for them and how to make sure people get the health care they need and deserve.

Like past panaceas, this one will probably burst in a few years, too. It wasn’t too long ago, remember, that HMOs were all the rage.

There are a couple of problems with making consumers responsible for their health care. For one, they are more than just consumers; they are patients depending on the (expensive) knowledge of experts. And second, in many cases involving illness or injury, we’re talking about more than health, we’re talking about life.

And how, my friends, would you expect anyone to put anything but the highest value on that?

Steve Piontek

Editor-in-Chief

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