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This appeared at Huffington Post on September 24, 2009.
Only in America can you spend $8500 on health insurance and get stuck with a $1700 bill for your child’s trip to the Emergency Room.
Jackson is a rambunctious, brainy seven year old who likes fossils and Greek mythology. In August, he was sitting in a chair when he fell asleep and struck his nose on the metal support of the table leg, cutting a deep gash at his septum.
After cleaning and examining the wound, his mother Googled the nearest urgent care facility. She was aware of the higher costs of ER treatment and tried to avoid them, but could not; Jackson was in good spirits, but complained of sleepiness and vomited in the examination room. The staff concluded he had a concussion and sent them to the nearest hospital for CAT scans and stitches.
Leigh has no complaints about her son’s care, which was excellent. Her beef is with the $1700 bill she has to pay.
Leigh works as a multi-media specialist for a non-profit agency. Needless to say, she’s not rich, so she does not live beyond her means. In fact, Leigh is frugal enough to make Dave Ramsey proud: she has no cable TV, credit cards, or consumer debt, and drives a 14-year old Honda. Nevertheless, between her student loans, rent, car insurance, and internet access (crucial for telecommuting), she simply cannot afford an insurance plan with a low deductible — so she had to settle for a $2300 deductible for each family member.
Moreover, she makes slightly too much to qualify for public assistance, but makes too little to weather financial hurdles. “In the best of times,” she says, “after bills, we make do on $500 a month for food, gas, laundry, and anything else like clothing and school supplies. I work in St. Paul, so gas is a big thing.”
Leigh’s employer has spent a total of $5200 on insurance premiums this year. She has kicked in an additional $2300 from her bare-bones, limited budget. Yet when she received the $282 radiology bill this week, her insurance had paid only $3.
“My child falls off a chair and I am looking at 7-8 months of payments,” Leigh complained to me in an email. Another disaster will force her to raid her 401k or declare bankruptcy. “I am in an unsustainable position, with no safety net or people I can look to in a crisis.”
Leigh also suffers from a chronic, inherited autoimmune condition that requires regular blood tests to make sure her medication is working. As a result of her high deductible, her health savings account is severely depleted. “I can’t go back to the doctor this year until I can get a handle on these other bills,” she says. But “going off the meds is not an option, since the consequences can be catastrophic and would directly affect my ability to work and take care of my child.”
Leigh had to apply for a deferment on her student loan to make $200 monthly payments on Jackson’s bill for the next seven months. She also plans to sell artwork in an upcoming show to raise additional funds. But in just three more months, the policy resets and Leigh will face another $2300 deductible if anything else happens — and she still won’t be done paying Jackson’s bills. Another catastrophic illness could destroy her finances.
Her premiums are going up next year too, but Leigh refuses to ask for donations. “I don’t want anyone to give me money. I do want people to call their congressmen and women and urge them to support a public option,” she says. “We need affordable care.”
