Our Healthcare System Sucks

Posted by Kirby Turner on February 24, 2009

My wife and I have health insurance provided through her employer. The coverage is good, typical of what most large corporations offer. And yet even though we have health insurance we still had to pay $2634.20 in out of pocket medical expenses, and this number doesn’t even include the cost for medicines such as the $50 cream we had to buy for our little one. Oh, and did I mention that we opted to NOT pay Cobra $3000 for the 3 months of medical coverage NOT provided by the insurance company due to the fact that my wife was taking some unpaid time off to be with our new child?

During that 3 month period our out of pocket medical expenses were $322.03. The great state of Massachusetts requires all residents have health insurance, but honestly we could not afford it. Do the math, folks. To stay “legal” we were being asked to pay just over $3000 to cover $322.03 worth of medical expenses. That makes no freakin’ sense.

For those wondering, Cobra is pro-rated so we had up to 3 months to apply. The unpaid time off was only 3 months, so we decided to wait until the final day to decided whether to pay for Cobra coverage or not. If our total medical expenses during the 3 month period were more then $3000 we would apply, otherwise we would pay the expenses ourselves. Since our total medical expenses were during that time were far less we opted to not enroll into Cobra. But wait. There’s more.

As I said Massachusetts requires every resident to have health insurance. According to the official document from our insurance company that must be included with our state income tax return, we did not have health insurance for 3 months during 2008. This means we violated state law for 3 months. I’m just waiting to see what penalties we will have to pay to the state because I refused to pay $3000 to cover $322.03 worth of medical expenses.

Back to the math. So $322.03 of the $2634.20 was because of the Cobra slash unpaid time off issue. I’m okay with paying $322.02 to save $2677.97. This still leaves $2312.17 worth of medical expenses not covered by our health insurance provider during the time when we did have full coverage. What were these expenses, you ask? More than half of the expenses were related to my wife’s pregnancy and the delivery of our first child. We had to pay an additional $1577.55 out of our own pocket just to have a baby.

This leaves $734.62, which is the amount I paid to get 4 stitches near my eye from an accident. Had the accident happened a couple of hours earlier the amount would paid have been around $291.28 but the medical clinic near our house was closed at the time of the accident leaving me no choice but to go to the emergency room. And no, I couldn’t wait until the next day. I had a deep cut less than a quarter of an inch away from my eye with lots of blood coming out. Waiting was not an option.

Let’s recap the out of pocket expenses:

* $1577.55 to have a baby
* $734.62 to stitch a cut near my eye
* $322.03 pediatric visit during the unpaid time off

Grand total: $2634.20

There is a serious problem in the United States regarding healthcare. And while the government powers that be are focused on stimulus packages, corporate bail outs, and trying to improve the economy, it seems to me healthcare reform is something the U.S. government ignored for years. Don’t believe me? Watch Michael Moore’s documentary Sicko and see for yourself.

I know my situation is minor compare to the many, many others who have major medical issues. However the point I’m trying to make here is that even with health insurance a typical American family may still have to pay out of pocket medical expenses that can be a struggle to afford. Not only that, but in my own situation if the U.S. had a better healthcare system like the ones found in other countries such as Canada and France I would have been able to put the $2634.20 into the pockets of local retailers or maybe a contractor to do some work on the house thus doing my part to help stimulate the economy.

As a side note and since I did mention Canada, I have to say from personal experience that the Canadian healthcare system is awesome, really awesome. A few years back I fractured my leg on a snowboarding trip in Canada. The total cost to see the doctor, get x-rays, etc, $86 Canadian which at that time came out to about $60 U.S. dollars. Meanwhile, here in the U.S., 4 stitches and an ER visit costed me $734.62. Something is seriously wrong with our healthcare system!

Update: My wife found 2 more invoices totaling $190 bringing our out of pocket medical expenses for 2008 to a total of $2824.20.

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