Health 1 of 4

Health Care in the US;  a personal perspective.

One thousand, one hundred and twenty seven dollars.  Three Stitches.  That is Three hundred and seventy five dollars and sixty seven cents per stitch.  In my lip, in America.

Let me tell you what happened.  I fell whilst roller skating.  Tripped or pushed.  By an American.  Face plant on the wooden floor.  Instantly I knew what had happened.  Hadn’t split my lip since my teenage years, yet the sensation was familiar.  No great pain, no tooth damage, just a tooth through the upper lip.  And quite a bit of blood.

The Emergency Department of the major teaching Hospital in this small University Town, I walk in at 9.09 pm.  Efficient staff take my details, do the necessary paperwork.  Sit and wait, I am told, you will be seen soon.  How soon I ask.  Should be within three hours at the maximum I am told.  I tell my son to go home, that I’ll return by taxi.  He presses to stay, but leaves with what I think is relief.

Looking around at the others waiting I am quite shocked. Not only do many of them appear quite ill, and/or appear in some discomfort, they are not the people I see at faculty, around the University nor around town.  I sit and ponder, trying to work out where these people come from, what their story is.   They are generally fat, many are obese, they are coloured, they are poor.  They are the cleaners, the kitchen hands, the labourers, the unemployed.  And the thing that strikes me most is that these people are here now for two reasons that would rarely apply in Australia.  Firstly it is not work time, so they can get attention without putting either their job or this weeks pay packet at risk,  and secondly they get no preventative medicine.  I imagine this is because they have no health insurance, thus do not go for regular checkups, nor do they follow up when they have had a check.

Just after 2 am a nurse takes me to a bed in the surgery and asks me to lie down.  This is the first contact in over four hours.  There are a few other beds in the surgery, all occupied.  An hour later a doctor comes, cleans up my lip, gives me a local and stitches the laceration.  A senior doctor comes by and approves the work.  This takes perhaps twenty minutes all up.  I am back home and in bed by 4 am.

The lip has healed well, I have no lasting scar.

Four weeks later I get a letter from the hospital with a bill for $780, in two parts. The first is for use of the facilities.  The second is for professional services and materials.  Good god, I think that is quite expensive.  I call a Bush Nursing service in Victoria, Australia and ask the cost of this sort of thing.  No more than a couple of hundred bucks is the laconic reply from the centre manager.  Oh well, I thought, health care in the US is reputedly expensive, and I do have insurance.

A day or two later I get another bill.  From the doctors.  $347. Now a total of $1127! I faint.  I think of asking my family to call a doctor.  I think better of that.  I am flabbergasted.  I finally telephone the hospital.  Agreement is reached to pay something less than $700 total.   (I understand that the US Health Insurance Companies never pay full fee.)

Next time I split my lip I hope it is in Australia.

Cecil Poole, May 2013