Can You Afford To Be Sick?

Can You Afford To Be Sick?

“I wish I could afford the luxury of being sick.”

By Kevin RR Williams

HEALTH INSURANCE No one really wants to be ill. Therefore such an obtuse statement may sound callous but must be taken in context. At a time of vibrant health and steady workflow, taking off a few days to be ill seemed like a luxury.

Years later, with an HSA, I consult the calendar and weigh carefully referrals made by my primary care physician. If treatment overlaps calendar years, it could be necessary to pay an aggregate of two annual maximum out-of-pocket expenses totaling thousands of dollars. It seems that referred specialists have no idea how much their services cost. They may ask for $45, $90 or even $300 in advance. But later a supplemental bill arrives with more fees.

The Price of Sickness

Though I appreciate the secure email capability of my HMO, there are times that this can lead to unexpected costs. The day following a visit, I emailed the physician to upload photos highlighting something I failed to mention. Within a half hour, he phoned and advised that I immediately go to the emergency room. Appreciating the dispatch but concerned over the urgency, I cancelled appointments and hurried off. After some discussion among doctors, I was sent home untreated. Later in the mail I received a $900 bill for basically wearing a cotton gown and sitting on a gurney.

A dermatologist prescribed an ineffective ointment that was more than 95% petroleum jelly by volume for which my co-payment was $500. Additional prescriptions exceeding $400 were tried. Nothing worked. The problem was, even after a biopsy, the doctor had no clue what he was treating. I happened to mention it to a friend who surprisingly had the same condition and shared what worked for him. That's what cleared things up.

On another occasion, I was scheduled for a minimally invasive out-patient procedure. However, it was determined that anesthesia was required. My co-payment swelled from $300 to $2,000.

Such anecdotes truly make getting sick appear to be a luxury. They cause me to favor more than a hurried office consult followed by a long list of referrals or prescriptions for undiagnosed or improperly diagnosed ailments.

Rising Employer Health Care Cost

Despite my sticker shock, I thankfully have insurance. The financial woes are multiplied for employers. The cost of health insurance is escalating out of control.

  • Since 2002, employer-sponsored health coverage for family premiums have increased by 97%, placing increasing cost burdens on employers and workers. [1]
  • According the Centers for Disease Control and Prevention (CDC), in 2007, national health care expenditures in the United States totaled $2.2 trillion or 16% of its gross domestic product, a 14% increase from 2000. This represents an average of more than $7,400 per person. [2]
  • Average annual premiums for employer-sponsored coverage are $5,049 for single coverage and $13,770 for family coverage in 2010.

Many U.S. schools are compensated for each day a student is present. (Roll call is not just to learn pronunciation.) So when children are out due to illness, it is more than a concern; it represents a financial loss. Around the world, health care costs are skyrocketing but in some areas, like Canada, it is subsidized by other taxes so patients have little or no out-of-pocket fees.

The U.S. Health Care Reform is the most significant change in decades. Many praise it in hopes that more insured patients will offset rising costs and lower rates. Others claim that it will devastate an already crippled system by requiring those with pre-existing conditions to be covered and forcing medical staff to see more patients in the same amount of time.

For me personally, I have come full circle. My opening statement is still valid but for different reasons. I wish I could afford the luxury of getting sick. In this context, even if I am ill, it's barely affordable. Interestingly, my father is covered by the same HMO but because of his retirement benefits, he has a fixed $5 co-payment for everything so his impression of the plan is quite different from mine. How do you cope with rising health costs? Is Concierge Medicine looking more attractive?

Tags: high price of illness

References
  1. U.S. Health Care Costs: Issues, Modules, Background Brief. kaiseredu.org ^
  2. Rising Health Care Costs are Unsustainable cdc.gov ^
  3. Photo by RocketEgg licensed from iStock Photo.