One night in my sophomore year of college, I was coming home for Christmas break in bad weather. I hit a big puddle on the interstate and lost control of the vehicle. Once I was off the road it all happened so fast. I just went diagonally right into a big pine tree. I’m very grateful my friend and I both escaped the accident without serious injury or worse. Now that it’s been almost five years and I’m able to talk about it more openly, I was horribly taken advantage of by our nation’s healthcare system that night when the hospital charged me more than the price of new car. If I hadn’t had insurance, I would have been ruined financially. Let’s look at how this crash shows how broken our health care system is in America, even post Obamacare, and how we need a major societal change to bring down sky high costs.
When I hit the tree, the vehicle actually flipped after colliding diagonally. My friend took the brunt of the impact but was thankfully OK. He had been knocked unconscious but woke up once help arrived on his own. The paramedics strapped him into the gurney and placed him in the ambulance. I just got up in the front seat with the driver with some blood on my shirt because no one was looking at me and I didn’t want to get left behind. The driver looked over at me and asked if I’d been involved in the crash. I said yes I was the driver. She then proceeded to freak out because they hadn’t stabilized my neck with a brace. That’s how organized the care was.
Exams, Exams, and More Exams, Oh and Some CT Scans
We got to the hospital and that’s when the tests began. I walked in under my own power and sat up on the hospital bed for a quick checkup of my vital signs. The doctor took a look at me and decided that I didn’t have a concussion or anything but ordered CT scans of my body just in case. The radiation tech then took what must have been two dozen different pictures to see if anything was the matter. After I got done with that first round of tests, they wanted to keep me longer and do more tests on my kidneys and another on some other organ. I refused the tests because I felt fine and there were no indications of blunt trauma to signify that I could have internal bleeding. There were very insistent and only my insistence back that I was refusing the tests stopped them from happening.
My friend was definitely in worse shape, but beyond the bits of glass in his forehead there wasn’t any major damage. They ordered more tests than they had on me and wanted to keep him longer for observation. Thankfully, we both got to go home with our parents that night. We were happy to be alive.
The shock came a few weeks later when this healthcare facility billed us for their services. The total came to $40,000 for my friend and $20,000 for me. HOLY COW! THAT’S RIDICULOUS! There was no surgery. They didn’t brace my neck at the scene of the accident to protect me from spinal injury. My checkup took less than an hour, and the only other test that didn’t involve household instruments like stethoscopes was when I had to give a urine sample to check for internal bleeding.
In other words, there was very little value provided in the tests that they performed. Should they have ordered many of the tests that I had done? I’m not a doctor and if someone has just been in a bad car accident you probably want to err on the side of caution and get it checked out I get that. However, taking dozens of CT scan pictures and requesting even more extensive kidney diagnostics beyond the simple tests that they did screams of conflict of interest. The hospital was located in a semi-rural area and they had the CT scan machine, so they were sure as heck gonna use it when they got the chance.
I believe the cost of something should be commensurate with the value provided. There was a remote chance that there was any major bleeding in me after that crash due to the fact I was walking fine, showed no evidence of bruising or trauma, and had never blacked out during the entire ordeal. Also, they didn’t even pay enough attention to put my neck in a brace when I was coming to the hospital in the ambulance, so any major damage that could have happened could have already taken place. Furthermore, the bill would have been even higher if I’d allowed the further testing they wanted to do.
When the Hospital Charged Me So Much, They Were Trying to Make a Profit Off a Person in a Desperate Situation
If someone has insurance, which they must have assumed after both me and my friend’s parents showed up there in the middle of the night, of course they are going to do every procedure they can possibly medically justify. They had all this fancy equipment there and they need to make a return on investment, so there’s a huge temptation to take more pictures of the patient’s body than you really need. To make sure you don’t get sued in case you miss something, you ask to run every test in the book. Then, you charge more than the price of a brand new Mercedes for 1-2 hours of work.
That value proposition is the most insane part of our medical system. We have no concept of value for what the public spends. Because this spending comes out of our federal budget instead out of our pocketbooks, the health care industry can bill for everything our politicians let them get away with. We as consumers bear no cost whatsoever directly. However, the cost of the broken healthcare system affects us hugely in unforeseen ways. We pay for healthcare mostly through our taxes and deficit spending. When we pay out billions for Medicaid, Medicare, and taxpayer subsidies for employer provided health plans, we are spending less on things like education, infrastructure, national parks, and national defense.
There is no cost sensitivity in medicine at all. If you can afford it, they will bill you a ridiculous sum and hope you have insurance. If you are poor, they will write off the care by overcharging the paying customers. I don’t often say this, but I think Europe’s cost sensitivity on medical spending is a better approach for the part of our health care provided by the government. In Europe, they are willing to reject extremely expensive treatments and negotiate better rates as a result. This more aggressive stance towards medical service providers is what led to the fear mongering about death panels in 2010.
There are so many policies we could try in this country. Now that the ACA is the law of the land and most healthcare spending in the future will fall on the taxpayers to fund, its the government’s responsibility now to get costs under control. I think giving greater legal protections to doctors is a great first step. We can reward outcomes instead of procedures like my 25 CT scan photos and kidney tests.
Obamacare Is Not Stopping the Health Care Price Explosion
As a young, healthy male, the only impact I’ve seen from Obamacare so far is my healthcare premiums have tripled. The reason is that young people may not pay less than one third the premiums that the sickest, oldest people are paying. The young and healthy subsidize the sick and old. In some ways I could be ok with that, but not under the current broken healthcare system. Healthcare reform did nothing to bend the cost curve like it promised, and the prices for those sickest, oldest people continue to rise. That means the cost at the low risk end of the spectrum for people like you and me continues to go up fast as well. The poor are immune from this because of the subsidies from the government so they can afford insurance no matter what. Once my higher income from 2015 rolls off the books, I’ll get big subsidies as well as an early retiree (there’s no asset test for ACA subsidies, only an income test, which further disincentivizes work).
I hope there is a major overhaul to Obamacare. I hope it includes loosening the restrictions on foreign doctors so they can practice in the US, imposing caps on malpractice claims, aggressive cost benefit analysis on publicly funded health procedures and drugs, and more consumer responsibility for healthcare expenses. We had a great market for high deductible health care plans operating in this country before the Affordable Care Act came onto the season and made them illegal, contrary to the President’s promise. These are precisely the kind of plans that I believe can help keep costs under control. It’s only when that CT scan is going to be $5000 out of my pocket and they’re required to tell me that it’s $500 a photo that I’ll speak up and say “hey why can’t we just take two?” It’s only when consumers ask these kind of questions that the cost curve will finally begin to bend. Our nation has a very high rate of debt, and the level of unfunded liabilities from healthcare are terrifyingly high. Let’s all agree to reward outcomes over pointless tests and try to help society by being a cost advocate against excessive medical spending. No one should ever receive a $60,000 medical bill for 2 hours of work.
That said, now you know one of my motivations for starting this site and why I didn’t feel fulfilled in my corporate 9-5 job. Since that day, I’ve wanted to help people and have a bigger purpose in my life than making money and climbing up a corporate ladder. Hopefully I’ll be able to accomplish a little bit of that here over time. It’s the only way I can begin to pay back getting a second chance at life after that night.