Chapter 8
Review- By Holly Rosenberger
Even for those who can afford most care may find themselves impoverished by a catastrophic medical expenditure.
Debates that Have Structed Health Care System Change
The American health care system is approaching a breaking point. I know I am at my breaking point. Chapter 8 from the required text discusses the issues with health care being a private good or a public good. The number one issue that we all have in health care is who bares the costs?
Most of this chapter, was very interesting to me because I am living it on a personal level. On October 5th, I got a terrible call from my babysitter. My son was on the trampoline with his big sisters, and she said he came in being carried by the oldest and was screaming bloody murder. They could not get him to calm down and he kept saying his leg hurt. I knew from just listening to him on the phone something was broken. I came home from work, only to pick him up and drive right to the children’s ED here in Greenville. He was so upset and frantic they could not pinpoint where he was hurt. He got some medicine to help with pain and relax. He then had 4 different sets of x-rays on his leg from his toes to his hip. Once we got the x-rays read, he did break his leg right under his knee. He got the leg splinted in a soft cast because it would swell too much to have a real hard cast. We would follow up with orthopedic doctors in 2 weeks. We spent just under 4 hours in ED and were so thankful for the care we
received. Not once did I expect to get the shock of the bills after this visit. Let me preface and say that I have state insurance and pay for the highest amount they offer. I pay about 4,000 a year for health insurance. So far, I have received $3,200 worth of bills for this one hospital visit for less than 4 hours. I have paid the hospital for the x-rays, for the nurses, for the material for the splint, for the “consult” of the ortho Doctor who they had come look at his leg. I have paid Vidant Ortho for the PA who put the splint on. I have paid Eastern Radiology to read the x-rays that the hospital has taken. I have paid an ECU hospital bill for the attending physician who was working that day. I have paid ECU Ortho for the follow up appointment in two weeks to put the cast on, and those x-rays. We had to come back after the hard cast on and take that cast off and do another x-ray to be to be told he needs it back on. Then the last appoint 14 weeks later to take it off and then 3 weeks later to make sure it is healing well after he starts to walk again. $3200 AFTER insurance. The biggest thing that I had to pay was $350 charge for the MATERIALS for the splint. Has anyone had a splint/ soft cast before? It is soft bandages, put in water that hardens. I just can’t see how the hospital is labeled no for profit- when they are charging $350 for cloth. The hospital took the x-rays- but they can’t read them. They must send to another facility to reach them and then get to charge me $30 EACH x-ray to review them. A level 1 trauma hospital can’t read their own x-rays. This is where I think government capping should be mandated.
According to the text, this discussion has a lot to do with the private vs public healthcare system. Do we have an efficient system, and thus creating an efficient market for healthcare. In the United States, an emergency room visit costs $2,200 on average, according to the most prominent insurance carrier in the U.S., UnitedHealthcare. Sometimes, a visit to the emergency room can exceed these prices since the actual price you pay out of pocket will depend on your condition and the diagnostic tests and treatments you undergo.
North Carolina alone averages in the middle of the 50 states with an average visit of $1,589.00. The lowest being Maryland with average visit of $623.00 and the highest average being Florida with $3,102.00. The text also states that the national healthcare expenditure per household illustrates an even bigger problem. In 2017, the per household cost of health insurance was 29,000, compared to the medium average household income of 60,336 a year. 2 They are saying the average for per house to rent was $12,276 and own a house $ 18,696 on average a year. How do people have to pay more for health insurance, then their own house mortgage. And the worst part is that insurance doesn’t even cover things until after you hit your deductible and mx out of pocket expense, so you are spending even more than that!
The text states that healthcare is not universal, it is not a predictable need. We can’t judge when and how much we need yearly. The need for medical care is a probability, an expensive probability. The answer is not universal, but the United States has not found a better answer yet either.
- (U.S Census Bureau, 2018a, 2018b)
- Goldsteen, R. L., Goldsteen, K., & Goldsteen, B. (2021). “Debates that have Structed Healt care Systems Change” . In Jonas’ introduction to the U.S. health care system (pp. 84–84). essay, Springer Publishing Company, LLC.