Making Health Care More Affordable

By Miah Newman, RN

Looking at health care I see so many ways we can improve.  With the costs rising and deductibles killing the budgets of families in need of medical care, we are changing who has access to care.  Working people carry insurances with high deductibles.  After the birth of my twins, I realized the costs of having them was over $10,000 out of my pocket over the course of 9 months because it spanned two fiscal years.  How are people handling this and what can we do to help make things more affordable and still meet the needs of Americans?

One woman, age 22, mother of two, was homeless and placed in a hotel in a Boston suburb.  Miles from family and friends who could give support, she calls 911 in the middle of the night for an ear infection.  After a 1500-dollar trip in an ambulance and an expensive emergency room visit, the baby improved after Motrin and was sent home with a script for an antibiotic.  They did not, however, have transportation home.  The hospital paid for a taxi to return the mother and child to the hotel.  Had there been an on call service offered this mother, she may have made a phone call, perhaps to a pharmacy that could have done a delivery or she may have had the Motrin at home to try and then followed up with a PCP in the morning.  What might have been a sixty-dollar trip to the PCP and a five-dollar copay turned into a three-thousand-dollar night.  Due to her lack of a job, the bills go to both the hospital and the government.

Another patient with a lump in her neck visits the PCP.  Due to the high cost of her deductibles she refuses a CT Scan.   The scan costs $100 copay, plus the first $750 of her deductible which she does not have as she works as a housekeeper in a local public university.  She declines her test which later becomes an infection.  The infection turns to sepsis requiring a four day stay in an ICU followed by another week in the hospital and the patient’s near death.  18,000 dollars in health care costs because she declined a standard test she could not afford.  Had the abscess been caught and not left to observe, this patient would not have become septic and nearly lost her life.

Health care is quickly turning into something for the really rich and the really poor.  The poor are given excellent insurance without deductibles or copays while the rich do not blink when they are charged 850 dollars for a CT Scan.  This leaves middle class Americans to struggle.  Parents need to decide between medical treatments and paying the bills.  If there could be equality, and more help desks for people to help them make a medical decision, we may actually save money.  People will be more proactive and not reactive and will have guidance through their health care.   If underinsured people had access to better coverage they may not avoid care, but actually seek it.  The insurance companies believe in high copays because they think people will think twice before testing.  This backfires because necessary testing is not always done which only leads to bigger costs overall.  If doctors are fined for ordering testing that is unnecessary or their contracts with the insurance companies state they are to operate with integrity, we should see improvements.

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Miah Newman was a contestant in the 2015 Costs of Care Essay Contest.

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