A few posts ago I spoke generally about the 7-8 months following my surgery. Too many wound care appointments to count; therapy; and working through a variety of traumas.
As I reviewed that post, I realized that there was a very real and measurable trauma that I haven’t addressed yet. We can look at the physical and emotional traumas and they are very real, but no one really talks about the financial trauma that our health care system causes millions of Americans every day.
I have health insurance. Truth be told, I have pretty good health insurance. Through the affordable health care act I no longer have to worry about pre-existing conditions. With the rebate provided by the Federal Government I able basically able to afford this “Silver Level” health care plan. So, what does that mean in actual numbers?
By using about 80% of the rebate applied to my monthly premiums, I paid about $230 per month in 2023 for insurance. That means that without that rebate I would be paying almost $700 per month for that same plan. This “silver” plan had a maximum “out-of-pocket” of about $8,000.00. By about July of 2023 I had already exceeded that out-of-pocket number, so every appointment with my therapist was covered in full. Every wound care appointment was covered in full. Any other medical appointments I had… covered in full. That’s all a blessing in one way.
On the other hand, I spent about $2,700.00 on premiums last year to incur another $8,000.00 in medical debt. I don’t make a lot of money. Without major debt (my car is paid for, no school debt, no big credit card debt…) I can lived pretty comfortably by lower middle class standards. My living room set is about 28 years old, but it works, and I’d rather travel than have nice furniture. I don’t save much… I know I should, but I don’t… travel means too much to me.
So, no. I don’t budget for $8,000.00 in medical debt. These bills keep coming.
Then, I received the bill for the “rental” of my wound vac machine. This machine was supposed to be covered. I was not supposed to be discharged from the hospital without that prior clearance. Yet, alas, every month I receive yet another bill for about $3,500.00 for that “rental.”
Every time I open one of these bills, I hear my surgeon’s voice, “This was preventable.” This is the voice - the one sentence - that made me file my initial letter of grievance with the ER Department that “cared” for me those first three visits. Was it fair that I was being billed thousands of dollars for something that was “preventable”? I needed to do something. As much work as I did to take care of myself physically and mentally; these financial reminders were causing me a different level of trauma.
I wrote a first draft of my letter for the hospital in about 20 minutes. I asked my parents to write down as much as they could remember about each of my ER visits. Again, in the interest of protecting both innocent and guilty, I will not share my letter here. But, know it was very detailed and full of facts mixed with true emotion.
The process of putting all of this information together for my grievance was an interesting one. I had to go back to look at the medical notes for each of my ER visits. This was a truth that I don’t think I was fully prepared for.
As I read through each of my visits, I quickly realized that there was SO MUCH MISSING! In my second appointment there was no mention of the contusion on my leg. In fact, not only is there zero mention of the contusion, there is a note stating that, “the patient reports no change in swelling or redness.” Please know… that is an outright lie. My mother, my best friend, and I all commented with concern about the growing contusion.
As I shared details like the one above with others, people would immediately tell me to get a lawyer; that I needed to sue them. For me, this was about a lawsuit. I had misplaced faith in an already broken healthcare system. I think I actually believed that they might take some level of responsibility for their actions, or lack thereof. Not only was I wrong… they’re lack of documentation is essentially was saved them.
The final decision from their third party was that they did nothing wrong, or outside of the “standard of care.” This decision was made even with the letter from my surgeon stating that while I would have needed surgical intervention either way, the incision and healing time would have been much less had they intervened sooner. The argument, I guess, is that they still intervened - maybe not as quickly as I would have liked, but they did.
While I did not officially consult with a lawyer; I spoke with a couple of lawyer friends to see what they thought. The overall consensus was that the lack of documentation saved them. Had they mentioned the contusion, or a possible abscess and then did nothing (which verbally, they did!) then I would have a case. But, because it wasn’t included in the notes, it becomes a he said/she said debate that I would eventually lose.
Traumatizing? You betcha! Am I angry? Yes. Will I pay those bills? Slowly, yes. Is any of this right? Not really. Will it ever be? Not likely in my lifetime.
I have been thinking a lot lately about perspective. I was dealt a pretty shitty hand in 2023. There is no question of that, but there are so many others dealing with much bigger and shittier hands. The overall debt load that I carry because of this is a result of an insanely broken system. But, I am so damn lucky to be privileged enough to be able to afford any kind of insurance. Without that insurance my medical debt would be approaching $100,000.
Perspective… this broken system is fucking people all over our country and it shocks me that more people aren’t fighting in the streets to change this. I am a middle class, middle aged, white woman. The amount of privilege that comes with those titles is immense, and even I am being screwed over by this so-called health care system.
This is just another aspect of what I went through in the past year. We can talk about the literal scars, or the mental health issues and find compassion and find the answers to work through and heal. But this… the financial burden that health care puts on all of us who are middle class or lower… how do we heal from this one?
I could of course, talk about fighting for change, voting, etc. but we all know that already… I don’t mean to end this on such a sad note, but let’s be honest. I don’t see this system changing in my lifetime, and I just hope that I come up with a way to accept there are things I can vote for but still have zero control over.
Oddly enough, even with all of this, I still feel an immense amount of gratitude for each and every one of you who have read these posts and commented on them. Your words of encouragement and admiration have confirmed I am doing the right thing by sharing this journey.
I have a certain amount of hope that this will encourage everyone to realize that they need to be the biggest advocate they can for themselves. This means that if you want something noted in your medical records, you need to ask that doctor or nurse or PA to physically make the note while you’re in the room. Find your worth and fight for yourself, because the sad truth is, our medical system will not do it without our demanding it.