Don’t ever get sick at night. A 2 hour visit to an urgent care center for some medicine may cost you $7,000.00
Around mid-2017, my son was throwing up in the middle of the night multiple times. This was around 3:00 AM. We were obviously concerned. We quickly rushed him to the closest Urgent Care center that was open at that time in Houston. We gave our insurance card, Blue Cross Blue Shield, to the lady up front and asked her what we’d owe? We met our deductible but how much will all this cost? She took our insurance BCBS PPO from my wife’s employer and said “There is no deductible for you. Just 150.00 copay for the ER and nothing else. Bring him in.” I paid the copay. I have a Master’s in Health Services Administration and worked within the Health Care Industry, so I have a good understanding of our health care system and how insurance works. “Good understanding” is a relative term since our healthcare system is a complete mess.
They gave him a saline solution IV and some medicine to drink for the nausea. He sat there for 2 hours with the saline IV and then went home. He was fine afterwards. They said he probably caught a bug which made him nauseous.
A few weeks later we got a bill. Why? The woman up front said that we only owed 150.00 for the emergency room copay and nothing more.
So, what is the bill?
The bill is: $7,000.00 (seven fucking thousand). This is for a basic trip to the Urgent Care Center. 2 hours to get some medicine to drink and saline drop for nausea. If it was during the day, it would have been a 30.00 visit to a doctor.
I checked the insurance. Copay is indeed 150.00 for ER / Urgent care visits. EOB shows $7,000.00 from the clinic. The insurance adjustable amount (this is the insurance contracted rate) is: $135.00. So, if you have insurance they can only charge 135.00 but if you don’t have insurance, you pay $7,000.00 .
By the way, you have to love a system that rewards people who have the means of paying for insurance by providing a lower contracted rate to patients who can afford insurance but punishing those with less money who can’t afford insurance by charging them the standard U&C (Usual and Customary Charges) which are the standard charges if you don’t have insurance. The U&C are always significantly higher. Because as we all know, the poorer you are, the “more money you can pay.
Turns out apparently our insurance BCBS is OUT OF NETWORK with this particular emergency center. Of course, I did not know this at the time and the woman up front didn’t tell me. When I asked about our insurance, she mistakenly said ” You just need to pay 150.00 with your insurance.” By the way, there is no accountability when the healthcare provider gives you the wrong info.
As someone who has worked within the healthcare field, let me give you some info. Most of the healthcare administrators working on your healthcare plan have absolutely no freaking idea of what they are doing. The administrators, providers, insurance agents. They are mostly lost. Each points the finger at the other. Billing mistakes are rampant. (https://khn.org/morning-breakout/studies-find-high-rates-of-errors-in-medical-billing/)
Costs are highly inflated. Files are mishandled. False information is regularly provided from insurance companies to providers. From providers to patients. And in the end, you foot the bill. They screw up. You pay. I know because I sat at the other end of the table as a provider.
Now, I’m sure somewhere in the middle of keeping my child from throwing up, holding him, listening to the doctor give instructions, somebody slipped me a 50-page stack of documents under my arms to quickly sign with page 46 being sure to having a small fine print covering their legal ass making me responsible for all charges in case the idiot up front provides us with the wrong info, neglects to verify the insurance properly, or mishandles the billing.
Only in our fucked up health care system are WE responsible for THEIR mistakes. They can play around with numbers, give false info, screw things up and make us pay for their fuck ups. Now I’ve never in my life had so much as a bounced check, missed bill payment, yet alone unpaid medical bill. But here I was, hit with a seven-thousand-dollar bill for a 2-hour trip to an urgent care center so my son could get some medicine for his tummy when he was throwing up because the front office neglected to mention they weren’t an in-network facility. Only in the U.S. does a 2-hour visit for some oral medication end up costing this much.
I’d like to know, what is an American family to do at 3:00 AM when your child is suffering? Start looking up emergency facilities nearby and hope that they are “in-network?” And if none are, then go bankrupt or don’t get treatment? Hope that the person working up front is truthful when disclosing info? Hope that if your child is in need of medical attention, you happen to be close to an open emergency room that is “in-network” at the time? Make sure you are, because the office staff won’t tell you. Better yet, just don’t get sick. You probably can’t afford it anyway.
Keep in mind that this is something that many families face every day in America. Having to choose between medical treatment and bankruptcy. And the only thing that stands in their way is a 1 to 2-hour trip on a fateful night when their child has a tummy ache and needs some medicine.
I decided not to pay this bill. I’ve never had any collections and have near perfect credit. Having this go to collections probably wouldn’t destroy us but would bring our credit down. But out of principle, I refused to pay.
I admit though, I did start worrying. What if it goes to collection? What if we get sued? And if we get sued, what if they garnish wages? Collections can sue you over medical bills. I’ve never been delinquent in anything, but I absolutely would never pay this bill even if I had 1 million dollars.
We are a middle-class family. We’re not rich by any means. But we’re not poor either. Yet we had to struggle with this. So what if you are really struggling. What if you are barely making ends meet? What if you work at Walmart? Are you just not allowed to get sick at all?
We were very lucky because while it took some work and back and forth writing, we’ve managed to get the bill greatly reduced this time by a significant amount. By chance, one of the practicing doctors was affiliated with my wife’s work and the company was able to pull some strings. Many aren’t so lucky.
Now first off, had I not paid the bill, we would have gone to collections for the first time in our lives. I used to be one of those people who scoffed at others who were in collections. After all, if you can’t pay your bills, don’t buy shit you can’t afford. And while, that still is a good rule of thumb to follow, people have different situations that they end up in. We don’t always know their story.
One such situation is owing money on medical bills you can’t afford. You can be an exemplary model citizen when it comes to paying bills. Then imagine one night, your child is sick and suddenly you owe thousands that you can’t pay. And if you are one of those families who is barely scrapping by, your livelihood is now gone. You now must decide: A) Do I buy food? B) Do I save my child’s life with the surgery he suddenly needs? or C) Heat my home this winter? Considering all are important, meet Mr. Bill collector. Now watch the rest of America shun you, shame you, and treat you like you are some irresponsible piece of shit deadbeat trash. If you are a person of color, it’s even worse. Because now, you are a walking stereotype. It’s your fault. Nobody else’s. After all “This is America. The greatest country in the world!”
Now apply for a mortgage and get turned down because now you are a bad risk to lenders. Why? You bought to much on credit? You can’t responsibly pay your bills? No.
Because you had the audacity to have a sick child in a system that has decided to trample on the most vulnerable, sickest, and oldest population in America. That’s why. This is the America we live in. And the America we are proud of. The America we keep holding on to so dearly. While Europe continues to either laugh at us, pity us, or fear us, we refuse to join the rest of the civilized industrialized nations in providing all of our citizens with an affordable universal health care system. But we have absolutely no problem providing the wealthiest citizens with one of the largest tax cuts in modern U.S. history.
Why do we refuse to make obvious logical decisions in our best interest? All in the name of false Freedom. Anything else, would be “un-American.”
I’ll refer you to one of the first blogs I wrote when I started writing which is very related to this about how people continue to misuse the word freedom while voting away their liberty and rights. Why? All in the name of this false “freedom” that they know nothing about.
And you know what the real travesty is? These are the very same people who not only shun those who are victims of this system, but also continue to support this system and continue to vote their rights away. Continue to vote against their interests. Continue to support those in power who endlessly spit on those people who continue to vote for them.
I posted the blog I wrote regarding “the misuse of the word freedom” in the link above on Facebook? You know what kind of responses I got?
Does anyone out there feel the same? Are at your breaking point? I don’t need a “like.” I certainly don’t need “thoughts and prayers” as they do absolutely jack shit. But if you live in the U.S. and you want your country back, what is needed is the following:
- Your anger. Anger is a powerful motivator that leads to action. It all starts with anger. At what point do you decide if you’ve had enough?
- Share the message. You don’t have to necessarily share this post. But share your message with those who will listen. Currently, it seems that the U.S. suffers from a ‘me-first” super individualistic culture of incredible greed. This greed is so immensely powerful that even those getting trampled on are willing to be trampled on just on mere principle due to some warped concept of individuality and freedom. Even if this freedom is an illusion. This is taking Laissez- Faire to an extreme. Before anything is done, our culture needs to change.
3. Tear down our system piece by piece and build a new one. And this piece by piece starts in your local district. Replace those in power with those who have the determination to do what is necessary to ensure that the United States joins the rest of the civilized western nations in ensuring its citizens with basic human needs, healthcare and civil rights.
4. We don’t need armchair activists. Stop “liking” and start “doing” .
To quote Gil Scott,
“The Revolution Will Not Be Televised”