The Family that Pays Together

One Family's Quest to Meet their Deductible

One of the certainties that I am now firmly entrenched in middle age is my ever increasing familiarity with our healthcare system. Granted, system is a generous word for what I have encountered so far. I doubt a madman could have created a more convoluted and confusing system of offices and facilities, referrals and specialists, deductibles and co-insurance, cryptic codes and mysterious charges. If our system doesn’t heal us, it will likely drive us to madness—so in that regard, despite all the major advancements in medical technology, we might as well be downing swigs of mercury like folks did in the olden days.

If there is any design to our system, or any designing principle to our system, it seems to be to extract the most money possible from patients who are in too much pain to object to the absurdity of what they’re about to be billed. Take, for instance, my most recent foray into the dizzying land of healthcare—kidney stones. An x-ray taken at the hospital, when I was in the throes of abdominal discomfort which I ranked as a red-angry face on the smiley-face chart at the emergency room (I couldn’t get a timely appointment at my primary care physician), cost me $497. An x-ray taken at the same hospital, on the same x-ray machine, of the same kidneys, but this time ordered six weeks later by a urologist as a precursor to an office visit, was $111. Why one set of x-ray costs roughly $400 dollars more is beyond my capability to understand.

I suppose I can’t complain too much because this year I had the foresight to select the “high option” insurance plan. The “high option” means that I pay a little more per month and, if we meet our deductible, the insurance company pays a higher rate of co-insurance.

In the past, we have never met our deductible, so I suppose it’s been a good deal for the insurance company. Not this year. Not to be outdone by dear old dad, Thomas fractured his arm last week on the playground at kindergarten. We haven’t got all the bills yet for this accident, in part because the earliest appointment available at our local orthopedic clinic was a full week after the accident actually happened, which meant Thomas had to dangle his limp fractured arm in a sling for a week before he finally got his blue protective cast.

The good news, I suppose, is I also had the foresight to opt into the supplemental “accident plan” offered by my employer (I’m a sucker for insurance I don’t understand). As best I can tell now, the accident plan—and I suppose all insurance—is just a form of gambling, except there is really no winning, but merely a limiting of loss. I pay $20 a month extra for the accident plan. On the roulette wheel of accidents you can choose from, arm fractures provide a $1000 payout, which is even better than lacerations and dislocations. Rest assured, the $1000 will be going straight back to healthcare providers—and be counted toward our health insurance deductible.

All this is to say, I’m pretty sure we’re going to meet our deductible this year for the first time as a family, an achievement we could do without. All the people—the doctors, the nurses, the radiologists—have been great, at least once you can actually get an appointment to see them. Half the battle seems to be getting in to see the right people when you need them. Unfortunately, despite all the wonderful advancements in medical technology, the system itself seems like an overloaded, convoluted, inefficient, and expensive mess. Surely, there has got to be a better system, one that doesn’t require people to gamble with their health.