A writer and editorial note about this entry:
I wrote the bulk of this post back in early September 2024, about seven months after the events I describe here actually happened. I did not complete the post to my satisfaction, so it was not published at that time.
Recently, on December 4th 2024, the news broke of the murder of United Healthcare CEO, Brian Thompson, while Mr. Thompson was attending an investors meeting in Manhattan in New York City. The murder clearly was a targeted one. As of this posting, law enforcement in Pennsylvania have a suspect, Luigi Mangionne, in custody after a worker in a McDonald’s restaurant reported him to police because Mr. Mangionne looked very similar to images the employee had seen posted about the suspect.
I will say here that I am saddened and appalled at the reaction of many, particularly in social media, over the glee that was expressed over Mr. Thompson’s murder. You might be someone who is upset over the treatment you get from insurance companies, but does that justify murdering someone? If you are someone who thinks the answer to that question is yes, then I would say that you have some serious self examination to do.
Now, about that night in the hospital….
One evening, back at the end of January 2024, I had worked a 48-hour long weekend, as part of rotational duty that is required of each member of my work team. It was the first time I did this, and it definitely threw me for a loop for some days afterwards as far as my sleep patterns go.
Two or three days later, was working the evening hours at my job when, at roughly 6:00 pm, I started to feel a slight shortness of breath. I started gasping a bit and got it back. As the evening went on, I started experiencing these episodes of shortness of breath more and more frequently, and having to work that much harder to feel as though I was getting enough oxygen in me. I was scheduled to work until roughly 11:30 pm that night, but by 9:00 pm I was practically done in. I was at a point to where I could not concentrate on my job. I decided to call my team manager to tell him what I was going through, and also informed a senior colleague who happened to be on duty. I then got into my vehicle and took off to get medical help. I tried passing by a clinic that I knew was nearby, but it didn’t appear open. I then decided to drive to Memorial Hermann at Gessner and I-10 to get treatment.
Once I reached the hospital, I saw the emergency room was open and headed there. I signed in, gave them information, and then waited. After a relatively short time, I was called in by the doctor on duty. After running some tests and what not, I was eventually moved into a nearby adjacent room. Over the next 7-8 hours, I was run through an MRI, a CAT scan, chest X-rays, a metabolic panel, and a number of other treatments. I was dehydrated, so they rehydrated me. I also have high blood pressure.
Eventually after 4-5 hours, the night doctor on duty gave me an inhalant mist. I was hooked up to a machine and given a mask like plastic device to cover my nose and mouth with. I was then told to breathe through it for about 10-15 minutes. That helped significantly. I was still wheezing while breathing, but I was once again feeling as though I was getting a lung full of air when I breathed in. The hospital staff kept me around for another two hours or so before I was released. I was written a prescription for drug medication, given a small machine with a number of doses of the inhalant to use if and when necessary, and was asked to line up a visit to a doctor which I did some weeks later.
As I drove home at 5:00 am or so in the morning, I couldn’t help but wonder about one obvious thing – namely, how much was this visit to the hospital going to end up costing me? Given that I’ve followed the news and politics for much of my life, I knew full well that American health care over the past several decades has become very expensive. Given that the medical personnel had administered a number of tests on me on some expensive equipment, I had a thought that my time in the hospital was perhaps $1,000 per hour. That would amount, I thought, to a bill of some $8,000, all for what turned out to be a fairly serious, but temporary breathing episode.
Then came the hospital bill….
In the days and weeks that followed my breathing episode, I utilized the breathing mist until the wheezing noises I occasionally had went away. At that point, I was confident that I was over whatever had caused the episode to occur. As for the tests themselves, they largely came back negative. I never really did find out what had caused my breathing problem to come and go as it had.
Notices began to show up about costs, but I was continually told in these notices that they were not hospital bills. Rather, they were simply the goings on back and forth between my health insurer and the hospital. At first I saw a bill of $14,755, but not knowing anything concrete meant that I figured the insurer was going to try to bargain that all down. After two months, I did get a bill from a radiology group for $1,600. I expected to have to pay at least a chunk of money out of pocket, so I went ahead and paid the bill.
Several more months went by before I finally got a notice from Memorial Hermann. This time it was a bill. The bill still listed the price at $14,755, and noted that my insurance had paid $5,119 of the bill. I still owed the hospital $9,636. So there you are – one night in the hospital for some breathing trouble and I ended up with a total hospital bill of $16,355.
I was floored by the result. I talked to several people, including my manager at my job, who inquired if I had taken company health insurance? He said that if I had, the out of pocket costs would have been capped at $5,000. I said no, as I had worked as a contractor for a number of years and I had purchased a health indemnity plan from an insurer because I did not want to have health insurance which was tied to whether I was employed or not.
How did America get to here with health care and where to go?
I know the answer to the first part of this question (how did America get here?), versus what to do in the future. I work in a hotly competitive industry with falling prices for my company’s products and services. The sales and account representatives have to bid for projects against several competitors all the time. Even worse, the world expects that the prices for my company’s products and services will continue to fall. That means we live on the margin. My company has to constantly come out with new updates to current products and whole new products every several years or we will go out of business. It means that every day, every single employee of my company has to show up, ready for battle. And, it also means that none of us are particularly getting rich.
In contrast, I tend to see health care as being loaded with lots of government created barriers to entry and cartel-like behavior – you have to be licensed in order to be a doctor or a registered nurse, for example. Health care is very heavily regulated, not to mention that a ton of laws have been passed at the federal level over the past 60 years or more. Since Medicaid is a federal program, but administered by the local branch managers in America otherwise known as state governments, there are a slew of state statutes that have been passed for Medicaid, including fraud. In Texas, the Legislature has over a dozen chapters of statutory law that pertain to various issues having to do with Medicaid (see chapters 532-544 of the Texas Government Code).
Having said all of this, I’m also aware that there is quite a bit of cross-subsidization of health care costs. Something tells me that part of what happened that night was that not only did I pay the full freight for my own health care, the massive out of pocket bill I got stuck with likely paid for several other people’s health care as well given that operating emergency rooms are likely a money losing spigot for most hospitals. For all you Lefties out there shrieking about equal outcomes equity, let’s just say that I learned out of all this is that equal outcomes equity doesn’t stop with people’s paychecks.
It also doesn’t help that very few health care providers post or produce the prices for their services. One of the few that does is the Surgery Center of Oklahoma. One of the most important elements to making markets function and work is for perspective buyers to know how much a seller’s prices are for the seller’s goods and services. Pricing conveys important information to buyers about the good or service, conveying to the buyer whether they think the good or service is worth buying. The same issue goes for insurance in the United States. Since most Americans get their health insurance from an employer, most Americans probably have little idea of what the overall cost of their health insurance plans are. In my case, had I known that some of the procedures I ended up paying for were that much, maybe I would have simply asked for the inhalant first, which was likely been the least expensive option, and which turned out to be the one thing that actually did help with my condition.
Throw in vast sums of taxpayer money into this swampy mix and health care in America becomes exactly what I described above – a massively expensive mess, heavily regulated, with arguably wrong incentives all over the place. To give you an idea of how some of these incentives work, recently I was out socially when a large, heavy set man fell flat on his face. There were several of us nearby, and we all reacted quickly. We got him to where he was face up, found that he was breathing, and one person called 911 EMS for assistance. Fortunately the man was okay, albeit he had extremely high blood pressure. The Houston Fire Department medics who arrived tried to push him to have them take him to the hospital, but he flatly refused. Why? Well, it’s likely that despite his condition, he didn’t want to have to pay for the EMS ride, nor did he likely want to have what happened to me and get stuck with a pile of expensive medical bills.
So there you have it. It’s been 60 years since Medicare and Medicaid were passed into law. It’s also been decades since employers were given tax breaks for offering health insurance to employees, which means this health care mess didn’t happen overnight. Nor will any change that would make healthcare becoming any cheaper happen overnight either. The only thing I would suggest is to try to not get sick in the first place and to stay away from the healthcare system for as long as you can. Going anywhere within a mile of the healthcare system is asking for nothing but trouble.