This whole thread makes me want to burst into angry tears. Anyone who thinks you can pay for your own cost of medical care probably hasn't had serious medical issues. So I thought I'd re-produce something I wrote a while ago to express how angry the American medical system makes me.
Just how much does open heart surgery cost?
My brother has always had his treatments at the Mayo Clinic. He was born with a congenital heart defect - he had a pulmonary atresia, i.e. his pulmonary valve did not exist. This condition meant blood couldn't flow from the right ventricle into the pulmonary artery and on to the lungs. As an infant and until his first surgery, he appeared blue (cyanotic) because there was far less oxygen in the blood circulating through the arteries. The only source of lung blood flow is the patent ductus arteriosus (PDA), an open passageway between the pulmonary artery and the aorta. The ductus arteriosus is a normal fetal structure, allowing blood to bypass circulation to the lungs. Since the fetus does not use its lungs (oxygen is provided through the mother’s placenta), flow from the right ventricle needs an outlet. The ductus provides this, shunting flow from the left pulmonary artery to the aorta just beyond the origin of the artery to the left subclavian artery. The high levels of oxygen which it is exposed to after birth causes it to close in most cases within 24 hours. When it doesn’t close, it is termed a Patent Ductus Arteriosus.
If my brother's PDA had closed, his lung blood flow would have reduced to critically low levels. This would have caused very severe cyanosis - or death. He was put on medicine for the first few years of his life to give his body a chance to mature a bit before undertaking surgery; at the same time, Mayo Clinic wa pioneering a pilot surgery to include just twenty-five patients. My brother was number 25. The surgery these days is this: a surgeon can create a shunt between the aorta and the pulmonary artery that may help increase blood flow to the lungs.
My brother's first surgery was actually a pig's valve, placed on 2 May 1984, when he was just 3 1/2 years old. It was his pulmonary valve until he was about 11 1/2, in 1992. His second surgery was the shunt-style, as was his third. His third surgery was in 2001, at the age of 20.
Children with pulmonary atresia require lifelong follow-up by a cardiologist to check how their heart is working. These children risk developing infection in the heart's walls or valves (endocarditis) before and after surgery. My brother has been on heart medication all his life. (It costs a shitload, something like $350 per month, I think.)
So how much does it cost to save my brother's life? The most expensive surgery was in 1984, before Blue Cross and Blue Shield made a deal with Mayo Clinic regarding the cost of medical care. We were stuck with paying my brother's first bill - which totalled somewhere around $45,000.00, which is more like $145,000 in today's money - throughout all of my childhood. Poor doesn't cover it. We were beyond screwed. My dad only earned about $22,000 a year, and my mother, on workman's compensation, was on about $26,000. We lived on tiny amounts of money coming in, some loans and way too many damned credit cards. His second surgery cost us another $3,000-$5,000 (I can't remember the exact amount). On top of this, I had my own surgeries for my hands - my thumbs did not move - and those were only partially by the Blue Cross & Blue Shield.
So how much in 2001 for the cost of state-of-the-art medicine?
Statement of charges for the actual surgery, from Mayo Clinic:
Clinical lab301.00
surgical pathology138.50
diagnostic radiology247.00
Surgical procedures14,960.00<-------- There's the cost of a human life, apparently.
Anesthesiology3,124.00
Exams/Consultants3,134.00
Total ancillary charges:$22,084.50
Estimated payment due from: Blue Cross & Blue Shield$22,084.50
Estimated personal amount due:$0.00
Charges from St Mary's Hospital (one of the two hospitals at Mayo Clinic)
ALL CHARGES IN US DOLLARS
Intensive care, 1 day at 1905.001905.00
Special care, 6 days at 1020.006120.00
Total room charges:8,025.00
Pharmacy5011.61 (mmm tasty percocet!)
Drugs, take home16.43
Drugs, IV IRRIG 352.22
Sterile Suply2,859.75
Supply/Implants6,110.00
Laboratory3,801.50
Path Lab 43.50
DX X-Ray (Chest)289.00
Operating Room costs11,485.00
Anesthesia 360.00
Blood/Admin560.00
Blood/Other Storage1,200.00(this was my brother's own blood, which they drew and used in his surgery)
Respiratory Service871.50
cardiology2,131.00
EKG/ECG114.00
Total ancillary charges:$35,205.51
Total charges:$43,230.51
Estimated payment due from: Blue Cross & Blue Shield$43,214.08
Personal responsibility: Non-covered charges:$16.43 (that's the take-home drugs!)
In my mother's hand writing, at the bottom of this bill, it reads:
Check #2830
$16.43 Mailed 7/3/01 (July 3, 2001)
So the total cost of my brother's 2001 surgery, bearing in mind that these costs do not reflect the total amount because Mayo Clinic subsidised this surgery by something like 60%: $65,315.01
I love the little penny on the end. It's so cute! So tiny! A little Abraham Lincoln makes it all good. It is only because my mother had Blue Cross & Blue Shield with her employer, the Veteran's Administration, that she was able to provide us health care. Now that my brother is 26 and in college, he is no longer covered by her insurance as a dependent. And he has no health coverage now at all. My brother's had this surgery three times. He will require another one in about 15-25 years' time, depending on when the shunt fails again.
Can you imagine that? Knowing you're going to need another surgery that will cost upwards to $150,000 at least, knowing you have no health coverage, are not going to get good health coverage because of this pre-existing condition, and if you do manage to get coverage of some type, it won't even dent the amount that you have to pay just to keep living? How the hell is that a fair deal for a hard-working average American who pays his taxes?
When we were eating beans and rice and little else, we kept payments up for the insurance. When my parents couldn't agree on anything else, they pulled together for this. Wouldn't you do the same?
I think about this bill all the time. I live in the UK now, and I think about this bill every single time I walk into the National Health Service (NHS, otherwise known as free-to-the-public healthcare) hospitals here. Everytime the NHS is on the news. Everytime I have to get a treatment, or a doctor's visit. I know intimately the cost of medical care, and so I salute the NHS. The first time I went to a hospital in London, I walked around afterwards trying to find the place to pay. I went up to a counter eventually and asked, and the woman said in the most starchly annoyed British accent ever, "This is the NHS. You do not pay for your health. Good day to you." I walked out of there in tears, because it suddenly occurred to me that the misery we went through to save my brother's life repeatedly did not have to exist.
My personal belief: health care should be a human right, and in America, I was taught that if you wanted something badly enough, if you worked hard and paid your taxes and lobbied enough people together, you could change the world. I don't see why we can't have universal healthcare.
My parents were fortunate they had the choice to pay for private health coverage. My friends in America - most of their kids too - don't get medical care because their jobs don't give them insurance. They can't afford to pay for private health cover unless it's subsidised by their employer - so their employers don't give them any insurance. They're the poorest Americans, and they have to get on the government's Medicare service, which is so broken it's laughable to call it medical service at all. It means they and their children don't get seen most of the time, and when they do, they are crippled with the cost of medications and treatments. The doctors usually say they can see their kids in a month or so, but by then their health is so deteriorated it costs even more to treat them. It's a vicious, horrible cycle.
Getting the choice is important. My friends - my brother - we had no choice but to let the insurance companies decide our fates.
It's inhuman, uncivilised, and awful.
Long before Michael Moore (*spit*) made his film, it's become so obvious that a privatised health system based on profiting from the backs of sick people is a perverted system that doesn't work in the long run. A privatised system is meant to make money, but the money should be funnelled into research. Instead, money goes to the drug companies and insurance. What option remains if a privatised health system is so obviously not the answer for long term health care, for situations where technology exists to give someone a chance at living for a while? Isn't the only answer left is to take it out of private companies and make it something that everyone pays for equally, at a decently low cost, so everyone can get covered when the time comes?
