You do the math

Criminentlies. At what point is the United States of America going to get a clue? Our health-care system is jacked. Bad.

One of the robust editors at this fine organization was ordered by his cardiologist to get a stress echocardiogram, which is essentially a sound picture of the heart. Sort of like those black and white ultrasound pictures of fetuses that we are all so familiar with from Facebook and the Republican agenda for women in the 21st century.

That’s all just great.

Now, here’s the not-so-great part, and the part that just about anyone can relate to, maybe enough to get irritated enough to vote against anyone who opposes Obamacare, also known as the Patient Protection and Affordable Care Act: That test was going to cost that editor more than a thousand dollars. And that voting part is based on the hope that our undemocratic U.S. Supreme Court doesn’t toss out the whole thing, likely announcing its decision before the end of its term in June.

All right, since it’s early in the year, the editor’s entire $500 deductible has not been paid. Since that robust editor had a colonoscopy this year, some has been. Admittedly, he received an envelope in the mail from said ass doctor, but he has not opened it, preferring not to know just how hard he’d been reamed yet and thinking it still might be some kind of reconciliation (see “Dear Dr. John,” RN&R, April 26). But when he was called to pre-register for the echo, the administrator mentioned the deductible was going to cost him $300.

“And then you have to pay 30 percent of the cost,” she said, matter-of-factly, “so your cost will be slightly more than a thousand dollars.” Just to round numbers, that would put the price of a heart scan at more than $2,100. (Media consumers will recall the great investigative piece Frank Mullen did over at the Reno Gazette-Journal on this topic last November. It was called “Cardiology wars: patients’ wallets are casualties.”)

Upon hearing a strangled voice on the phone and the clutching of shirt fabric, the office kindly offered to allow the patient to make payments, probably of around $50 a month.

But throw in one more factor: The editor’s office might—repeat—might be changing insurance carriers in July. That means, the $500 deductible would be wasted because a new $500 deductible would kick off on July 1.

The appointment was cancelled. At least until July.

But here’s the thing. Even with insurance, patients are avoiding necessary medical care because costs have skyrocketed. Echo scans are old but reliable technology. They’re cheap to perform.

But a heart attack. A heart attack isn’t cheap. According to the National Business Group on Health, in 2010, the average total cost of a bad heart attack was about $1 million.

And as things stand, guess which editor of the RN&R does not have a million in the bank? That’s an almost guaranteed medical-cost-caused bankruptcy—the most common reason for bankruptcy in the United States.

Insurance companies have a choice, but they don’t calculate the way we hope they would. We think, “They could pay a thousand bucks now, or they could pay a million bucks after the heart attack.” But they think, “Forty percent of first heart attacks end in death.”

You do the math.