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 School |
Topiary Elephant |
LPCH Giraffe |
LPCH Daffodils and Pansies |
Images Copyright 2009 by Katy Dickinson
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