Reporter’s Notebook: U.S. health care system: What doesn’t kill you makes you broke

By on January 16, 2013

The healthcare system in the United States is broken. Everyone, it seems, knows that. Fixing it will be such a monumental and thankless task, it’s unlikely the answer will come from the political realm. Who would be fool enough to try?

Don’t believe the hype? The World Health Organization’s latest ranking of the world’s health care systems by country listed the U.S. as 37th. This list did not take into account any cost-per-care ratio at all. Better healthcare, period, can be found in 36 countries before ours. And cost? No one comes close to the U.S. on that list. We lead the pack in total health care expenditures per capita; double that of our nearest rival, Canada.

In 2010, the U.S. was ranked dead last in healthcare quality-verses-cost by a Commonwealth Fund report. “Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system,” the report stated.

In 2009, the nonpartisan Institute of Medicine issued a 450-page report on the problems with our healthcare system. Nearly a third of all spending – $750 billion in 2009 – is wasted, the study found.

I can spew numbers ’til I’m blue in the face – for which a battery of needless and expensive tests would be eagerly ordered up by any hospital in the country. But what really drives the point home is honest-to-goodness real-life examples. I have two, and we’re printing another this week as our feature story.

In 2004, I spent one night in St. John’s for an attack of diverticulitis. One night, no surgery. The bill was in excess of $14,000. I had no insurance. I could have stayed at the Four Seasons for a week for less than that. It took me until last year to pay it off. During that time the billing system at SJMC changed twice. The company that the billing was outsourced to when I checked in lost all my records (an all-too common occurrence across the nation), but one thing the hospital was certain about: the $14,000.

I broke my hand last summer. I opted for a non-surgical approach to save money. (I’m still not insured.) The total bill for a plastic removable cast and x-rays to see if I was healing properly: nearly $1,500. I could have had a heart transplant in Pakistan for that amount. No, really. And on top of it, I was billed from five different sources.

The outpost clinic that initially saw me, the radiology department at SJMC, the technician that read the x-ray, the company that made me a temp cast, the orthopedist that ordered x-rays every two weeks for two months, and the person who had to read those x-rays.

I paid every bill immediately as it was incurred and still received a notice just last week that I was being sent to collection for $30.02 for yet another radiologist I had never heard of. The next time I get sick or injured, I’m booking a flight to Thailand. Turn to page 6.

About Jake Nichols

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