If you have read my blog since January, you may know that my 16-year-old son Paul has recently developed chronic and debilitating headaches and dizziness.  Despite the capable and dedicated care of Pediatricians, Neurologists, Neurosurgeons, Pain Specialists, Psychologists and Psychiatrists, Occupational and Physical Therapists, and Nurse practitioners, Paul’s situation is stable but not improving. We continue to work with the Pain Management Clinic at Lucile Packard Children’s Hospital (LPCH). Paul is still attending the Hospital School at LPCH, so he will not have to repeat his Junior Year in High School. Thanks for your prayers and good wishes – they have been been a great support and blessing to our family.

This blog entry is about the financial side of this experience. I am not pointing my Finger of Blame at one organization or another as being Bad. I think that in general America’s medical care is excellent. But I am presenting a specific example of how very broken the financial side of America’s health system is.

When Paul first went into the hospital, we did not consider the financial side. We approved the recommended treatments and stayed focused on supporting Paul and each other. Over the months, this situation has evolved from a crisis into a new schedule: six sets of pills a day, drop off and pick up at doctors’ offices – hospital – school, walks and stretches and massage, time in the sun, and of course regular homework and chores. Almost every day, we receive medical bills or insurance Explanations of Benefits.

Explanations of Benefits are cryptic and offer a very narrow view of a small set of medical charges. The first bill which gave us any overview of what our medical adventure cost was the hospital bill for Paul’s brain surgery, for $163,613.70.

Statement Date: 03/02/2009
Service Date(s): 02/05/2009 – 02/09/2009
Total Charges $163,613.70
Patient Payments $0.00
Insurance Payments -$25,921.32
Insurance Adjustments -$136,324.50
Other Adjustments $0.00
Balance Due Upon Receipt $1,367.88

When I reviewed the statement, I was equally amazed at the total price and the 83% insurance adjustment. I know if I did not have a good job which includes health insurance, I would not be eligible for either the $25,921.32 insurance payment or the $136,324.50 discount. I would have to pay $163,613.70. Please understand, with my husband still looking for work, I am quite happy to pay only $1,367.88 for Paul’s brain surgery. However, I know there are growing numbers of people who have no job and little or no health insurance such as mine. It feels very wrong that the privileged pay the least.

Paul-Hospital SchoolPaul at LCPH Hospital School, Palo Alto CA<br /> photo: copyright 2009 Katy Dickinson Topiary ElephantLPCH Topiary Elephant, Palo Alto CA<br /> photo: copyright 2009 Katy Dickinson LPCH GiraffeLPCH Topiary Giraffe, Palo Alto CA<br /> photo: copyright 2009 Katy Dickinson LPCH Daffodils and PansiesLPCH Daffodils and Pansies, Palo Alto CA<br /> photo: copyright 2009 John Plocher

Images Copyright 2009 by Katy Dickinson


Filed under Home & Family, News & Reviews

3 responses to “$163,613

  1. Charles Soto

    You’ve picked up on exactly why our current system is both bad from a socialist angle, AND represents rather poor capitalism, as well. You see, in a purely capitalistic system, your son would have received care if, and only if, you could pay the providers. Then again, providers would compete with each other to provide the care. It probably would arrive at a "market rate" for those services.
    However, because a couple of centuries ago, modern societies determined that "public health" was actually a good thing, we essentially can’t "let poor people just die already," so we have safety nets. So, pure capitalism fails, and you get this bizarre reality. By the same token, pure socialism fails because there is not a national health care system that averages out risks, costs, etc. We have the worst of both worlds! And I don’t mean care – I’ve made the Dell Children’s Medical Center one of my "must give" charities. It’s just that they’re squeezed by the same inadequacies as the beneficiaries of their services. I guarantee you the health providers would much prefer a sane system.
    I wish the best for your family! Encourage your son to go into medicine. Mine wants to be a physician since his hospital visit (as brief and thankfully non-lifechanging as it was). Even with the screwed up system we have, I’d be very proud and I’m sure he would be very rewarded playing a part.

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