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Can Anyone Spot Me Fifty-One Cents?

August 10, 2006

So, we are among the insured. Thank God.

What can I say about health insurance? It certainly takes a load off of our troubled minds, and makes us grateful for the law of large numbers. I was absolutely shocked when The Wife called the insurance representative from the car to tell them that a.) we just had two children, and b.) one of them was in the ICU for the forseeable future. Their biggest concern was to find out how to spell their names. Literally, no questions asked.

Still, insurance represents one of the biggest evils in our world today, right? Globalization, and corporatization, and hyper-commercialism, and faceless bureaucracy, and the commodification of compassion, and the further marginalization of the poor, and the long, slow death of quality health care. We’re constantly jumping through hoops, chasing down ‘case managers’ of dubious existence, working angles, arguing about prenatal charges, finding forms, and making phone calls. If it weren’t for our amazing pediatrician and his willingness to bury himself in paperwork, we’d probably be defeated by now. It just seems so very wrong that so many health care options are ruled by the question ‘will insurance cover that?’.

And yet, we’re thankful for everything we get, thankful that the bill above (which represents our initial nearly two months at Children’s Hospital, and doesn’t include the $23,000 delivery and NICU admission at GW, or the subsequent month at HSC, or the care we’re currently receiving, or the next five surgeries, two heart catheterizations, and related expenses) represents the fact that we have access to such great care in the first place. Thankful that, for the most part, our expenses will consist primarily of co-pays, and not the sum total cost.

Along the way, it is fascinating to see how these things work. Take surgery, for example. The six-hour procedure that saved our son’s life? About $6500. That’s for the room, and one of the world’s best cardiothoracic surgeons and his team of 3-4 surgeons, and all of the other staff and support people and equipment and laundry. Plus the folks who clean the room afterward, and the ice to induce hypothermia. Sure, anesthesia was another two grand, but that day seems like a pretty good value to me.

And the cost of nursing care…money well spent. We’ve met some amazing nurses, and we recognize that we owe much of Will’s recovery to these specialists. But at close to a thousand bucks a day, I can personally attest to the fact that there’s quite a mark up here. The nurses I know don’t bring home nearly that amount per day.

It’s also interesting to see that insurance alone can offer accountability to hospitals. If the hospital — in their estimation– charges too much for something, insurance will simply say ‘no’. We got one list of charges that totalled about twenty G’s, to which the insurance provider said to the hospital, “you’ll get nothing, and like it”. They even split hairs over comparatively little things like portable chest x-rays (which our son got about once a day while he was inpatient). The hospital charges something like thirty bucks to have a radiology tech push the camera down the hall and into the unit, position it, shoot the film, and take ‘er back. Seems fair, right? Well, not to our insurance company. They insist on only paying sixteen bucks for each and every one. And what’s the hospital going to do about it?

So insurance is our friend, our nemesis, and our diversion. We’d be in a heap of debt without it.

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5 Responses to “Can Anyone Spot Me Fifty-One Cents?”

  1. [REDACTED] says:

    Sure, I think I’ve got two quarters laying around here somewhere…

  2. Anonymous says:

    Truer words were never typed. We hit close to 1 million with Jack by the end of his first year! I saved the EOBs just to every now and then pull them out and say, Wow.

  3. WMS says:

    yikes! That wonderful “friend, nemesis, diversion” dilemma is one reason Hillary couldn’t push health care reform.

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