Hospital Room Ruminations

This morning, my wife of twenty-odd years (well, not all of them were odd; some were actually pretty normal*) had a hysterectomy.  Under the synergetic influences of morphine and phenergan, she is sleeping, leaving me alone with my thoughts and my laptop, not to mention a very numb butt (boy, are the chairs uncomfortable here!).  And I’m wondering:  how many of the Presidential candidates have ever had to worry about their medical bills or even accessing health care?

  About three months ago, my wife went for her annual OB/GYN visit and had a Pap smear done.  The results came back suspicious, prompting her doctor to recommend a colposcopy and biopsy.  The biopsy, in turn, indicated the presence of precancerous cervical tissue.  Based on its localized nature, her OB/GYN recommended the Loop Electrosurgical Excision Procedure (LEEP) to remove the precancerous tissue.  This was done in the doctor’s office and the removed tissue was sent off to the pathology lab (For the guys:  Given the LEEP uses an electrified piece of wire, the resulting smoke coming from between your wife’s legs is an unnerving spectacle, to say the least!).

  Unfortunately, the pathology report which came back confirmed the presence of stage 2 cervical cancer in the removed tissue.  This was quite a surprise to the OB/GYN, not to mention me and Mrs. BK, as the initial biopsy did not indicate cancer.  Although her OB/GYN was quite confident all suspect tissue had been removed by the LEEP, he recommended removal of her cervix (and uterus) as soon as possible to eliminate the possibility of cervical/uterine cancer.

  I consider myself fortunate to have good health insurance; it is one of the benefits provided by my employer, a DoD contractor, in return for me occasionally showing up for work.  For this, I pay about $265/month (my employer pays the rest), which gets me and my family an 85/15 policy with a $350 individual deductible.  I also get to divert some of my pay pre-tax to a flexible spending account.  Because my benefits open-enrollment took place this past November, my wife decided to postpone her surgery until 2008, so I could increase my pre-tax contributions to my "flex" account to help pay the out-of-pocket expenses. [Side note:  Is this what conservatives mean by being "smart" consumers and "managing" health care costs; i.e., putting off critical medical procedures until you have the money to pay for them?].  Having a rough idea as to what we were facing (more on that in a second), I increased my flex spending contributions to the maximum allowed by my employer.

  The total out-of-pocket expenses for this surgery will be considerable.  The estimated cost provided to us by my wife’s OB-GYN was $3000.  This meant an up-front $450 (my 15% portion) payment last week to her OB/GYN.  Because her surgery was only a few hours ago, I haven’t seen the bill for the hospital (nor the anesthesiologist, the pharmacy, the pathology lab or any of the other seemingly hundreds of charges associated with any surgical procedure).  The estimate provided by the hospital business office back in November to my wife back gave a price tag of nearly $30,000, a figure which seems high for a vaginal hysterectomy with no complications (which, fortunately, there have been none).  If this holds true or if the cumulative costs add up to that amount, this means I will be paying another $4500 or so out-of-pocket (15% of $30,000), for a grand total of nearly $5K.  This doesn’t even include the 2007 out-of-pocket costs associated with this particular medical adventure as I haven’t seen all the bills from the various medical providers and the explanation of benefits from my medical insurance provider.  This is on top of the other medical costs for 2007 which included two emergency room visits (youngest son’s dislocated patella while playing soccer and oldest son’s severe abdominal pain which was diagnosed as constipation from Hell), wisdom teeth extraction for two sons and various minor doctor visits.  As of the end of December 31, 2007, the total out-of-pocket expenses for the Big Kahuna family was about $4K.

 As I said earlier, I am fortunate.  I have a good-paying job which provides me with health insurance, leave time and a method of diverting a portion of my pre-tax salary for health care expenses.  Nevertheless, I am concerned.  With one son in college, the other one college-bound in a couple of years and my career uncertain after 2010 (the program I'm working on will end then), I have to ponder how I would cope with these expenses were it not for my fortunate circumstances.  It could be worse:  my brother is the sole employee of his plumbing business.  He pays over $800/month for health insurance with a high deductible, has no leave and no pre-tax diversion for health care (that I’m aware of).  If he can’t work, he can’t pay his insurance or the copays/deductibles.  I've seen my brother work himself nearly to death trying to keep them above water financially, which has become even more problematic with the housing slump.  Even with the insurance, paying the out-of-pocket expenses for their health care has kept them hovering near bankruptcy for nearly two years.  As with the Big Kahunas, my brother has delayed medical treatment because of financial reasons.

  Our current Presidential aspirants have, for the most part, never had to worry about these things from a personal perspective, either due to their personal wealth or their employment with the federal government.  Those who are either current or former senators have access to the best health care programs the American tax payers can buy.  While I don’t know the particulars of the health insurance policies afforded U.S. Senators, I’m pretty sure they haven’t had to postpone treatment due to financial considerations.  I’m also confident that should catastrophic health issues affect them (Lord forbid), they won’t have their insurance canceled nor are they likely to wind up filing for bankruptcy.  This is why I place little credence in the blather offered by most of the Presidential candidates.  While they may have to deal with serious health issues (i.e., Elizabeth Edwards or John McCain), they’ll never have to worry about paying for it.

For any of the Presidential candidates (or their campaign staff) who may read this, I am speaking directly to you:  

THERE IS SOMETHING VERY WRONG WITH A HEALTH CARE SYSTEM WHEN THE GOVERNED AREN’T AFFORDED THE SAME LEVEL OF HEALTH CARE AS THOSE WHO ARE ELECTED TO REPRESENT THEM AND WHEN THE ELECTED DON'T HAVE TO MAKE THE SAME DIFFICULT CHOICES.

[*Apologies to my favorite author, Patrick F. McManus, for stealing that line.]