My Biggest Fear of Doctor Visits

Why don’t you visit doctors more regularly?

By Kevin RR Williams

In the eyes of people living in underdeveloped countries, our standard of living here in the U.S. is considered affluent. I scrape by like any other Joe. Make no mistake, I grew up in poverty — living out of suitcases, cardboard boxes and back-room accommodations with newfound friends that lasted long enough for brief welcomes to wear out. There is no single neighborhood where I grew up. During four years of high school, our single-parent family moved 13 times.

The stresses, dust and mites in pay-by-the-week motels likely contributed to my childhood allergies. This kept me socially separated from others who could actually run and roll on the grass without uncontrolled wheezing sending them to a hospital emergency room. Nevertheless, the isolation yielded fruit. It allowed me to nurture drawing abilities with which I support myself to this day.

I can't say that the situation affected me much in the early years because I was led to believe that our vagabond lifestyle was no different from anyone else's. Only in my teens did I begin feeling like a "mark" conned out of a childhood. My first attempted escape to normalcy was at age 15. During six months with a relative, I tried to revel in the semblance of mock stability. Yet, there was a growing distrust of others. At age 17, I moved out and never returned. As a side benefit, the move substantially cleared up most allergies. Perhaps just as surprisingly, this dysfunctional childhood did not lead to me building a Neverland ranch.

Escalating Medical Cost

The abbreviated story of my upbringing relates to one of my greatest anxieties. More than illness, the poke of a needle or even death, I dread poverty.* My mind equates doctor visits with becoming destitute. There's a fundamental reason for this. Many self-employed scrimp by with major (catastrophic) health coverage. This means we have very high deductibles to meet each year. For me, a doctor visit has many hidden costs beyond a $45 co-pay. No one in the medical office can provide a straight answer to the basic question, "How much is treatment going to cost?"

To answer questions about dry eyes, an ophthalmologist referral was requested during a visit with my primary physician. His nurse asked me to read line number seven on a wall chart. This resulted in an unexpected $90 eye exam bill on top of this visit and the one to the ophthalmologist who referred me to an optometrist for a prescription with another co-pay. Every test, referral, x-ray and MRI, adds to a supplemental bill arriving in the mailbox months later. It's enough to make me shut my eyes and hold my breath until I'm blue in the face. But that's another billable medical condition.

Over the past 12 years, my monthly healthcare premium has increased 172 percent. Want to get that payment back down? No problem. Just double or triple the annual out-of-pocket maximum that is already thousands of dollars. Consequently, when my yearly maximum is reached, I schedule appointments with specialists for any health concerns. Conversely, when the possibility of meeting a deductible seems distant, I recoil from even the most routine doctor visits. These polarized extremes puzzle my primary care physician.

A New Era in Medical Cost Visualization

Two chicken to go to the doctor? Early in the last century, some people were able to monetize medical house calls by the value of livestock — an idea that likely won't see a resurgence. [1] This century may be the first in which people can measure medical costs by the value of technological gadgets. A doctor visit may cost me about as much as a subsidized iPhone. A broken foot costs a MacBook Air. An MRI is priced as much as the highest capacity iPad. Unable to work for an entire month due to illness? This might have the value of a tricked out 24-core Mac Pro.

Obviously, during treatment, health care is not consciously equated with gadgets by most people. I mean who in their right mind would sell an organ to purchase an iPad? Okay, there was that one little incident in China with the kidney[2,3]

When doctors return us back to healthful productivity, the fee may seem well worth it — barring the occasional over-inflated ER bill. According to The Fiscal Times, "When you visit the emergency room, you could be charged anywhere from the cost of a cup of coffee — to the cost of a new Porsche," with a difference across the country of as much as $72,952 for the same diagnosis. Sixty percent of U.S. bankruptcies are due to medical bills. [4,5] Such reports fuel an aversion to incidental doctor visits.

In 2014, pre-existing conditions for adults will no longer preclude Americans from obtaining medical insurance under the health care reform that has been progressively coming into effect in the U.S. It will also be mandatory for all citizens to have health insurance. [6] Each state is busy crafting its own rules in order to comply. Hopefully, none of us will need to decide between poverty and doctor visits so we can all remain A Bit More Healthy. What's your biggest fear of doctor visits?

* Perhaps there's an irony in becoming a starving artist.

References
  1. Bartering and whether doctors should be paid with chickens. kevinmd.com ^
  2. Chinese student sells kidney for iPad. telegraph.co.uk ^
  3. 9 on trial in China over teenager's sale of kidney for iPad and iPhone. cnn.com ^
  4. Hospital Bill Sticker Shock: How Much Will You Pay? thefiscaltimes.com ^
  5. Medical bills prompt more than 60 percent of U.S. bankruptcies. cnn.com ^
  6. Countdown to 2014: Obamacare and the states. msnbc.com ^