Uninsured Americans may be a broken bone from bankruptcy


Everyone should contribute to healthcare costs, but who has $17,000 to fix their hand?

I don’t consider myself a serious cyclist. I don’t drive very fast or far. But when the weather is nice, I try to pedal instead of driving for errands. Among those runs is a 10-mile round trip to the grocery store a few times a week. During one of these short trips in early July, my bike saddle broke and I landed on the sidewalk.

After limping home and spending hours immersed in denial and ice, I finally dragged my lame right hand to the doctor. An x-ray confirmed broken metacarpals, including one with a “spiral” fracture. I tried to convince three doctors that I didn’t need to go under the knife, but all said surgery was needed for the bones to heal properly.

The outpatient procedure, cast, splints, and physical therapy reminded me how lucky I am to have access to excellent medical care in Des Moines. The bills and insurance statements that followed reminded me how lucky I am to have good health coverage.

The costs related to the surgery so far total $17,663. My insurer paid about $10,000 and I’m happy to pay my deductibles as well as the ongoing therapy co-pay. I just want my hand back.

Yet, in the midst of it all, it’s been especially painful to listen to ignorant, fully insured Washington politicians gossip about health care as if they’ve never seen a medical bill. They talk about how people should “shop around” for the best care deals. They voted for legislation that would dismantle Obamacare and remove coverage for millions of Americans.

Was I supposed to buy the lowest price in the metro area for hand surgery? Asking the doctor to use cheaper screws to hold the bones together? Should I negotiate for each finger or for the whole hand?

And what would I have done without health insurance? Maybe he didn’t have surgery and is hoping for the best. Certainly, uninsured Americans did just that. Because not being insured can mean being a broken bone from bankruptcy. Average people don’t have thousands of extra dollars to pay unexpected medical bills. Many haven’t even saved a few hundred dollars.

According 2016 Federal Reserve Survey of Household Economic Well-Being, nearly half of adults say they couldn’t cover a $400 emergency expense or that they would have to sell something or borrow money to do so. Twenty-two percent of respondents had a major medical expense that they had to pay out of pocket in the previous year. Of these, about half said they currently have debt related to this expense.

Certainly, health care providers can reduce fees for low-income patients without health insurance. But even if they owed, say, $10,000 and could eke out $100 a month, it would take more than eight years to be debt free. And hopefully they won’t run into another medical expense during this time.

Americans need health insurance. They need it to cover their bills if they are diagnosed with diabetes, high blood pressure or cancer. They need it if they want to have a baby. They need it if this baby has a heart defect. They need it if they fall off a ladder and break a leg. And this country needs a health care system in which we all help to share each other’s health care costs.

But many Washington politicians don’t seem to understand that. Instead of focusing on ensuring that residents of a wealthy country can get the care they need, they seem intent on trying to cut coverage. They talk about health care and insurance as if it were a luxury rather than a necessity.

And some have the audacity to suggest that if we all ate healthier and exercised more, we wouldn’t need to go to the doctor. Until you fell off your bike while shopping for apples at Hy-Vee.

ANDIE DOMINICA is a columnist for The Des Moines Register. Contact: adominick@dmreg.com

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