Ouch!

Originally posted to MySpace, July 19, 2009

 

I have a bad back. I injured it in 1995 while living in Germany. At first it caused only acute pain. As time went by, the pain became chronic and eventually got so bad that I went to the doctor. An MRI of my spine in 2002 revealed the trouble: I had two bulging discs. Though not severe, they did prove to be a real pain in the butt—I mean back. A major flare-up in 2006 prompted me to visit my doctor again, have more scans done, and seek out a back specialist. He was shocked at how herniated the discs were, but he remained confident that it was treatable. The two cortisone treatments he gave me proved worthless. I never returned for a third.

Thanks to the nature of the German medical system, all these visits to the doctor and radiologist never cost me a dime, except for the quarterly ten-euro fee for visits to the doctor. I never had a deductible. I never had a co-payment. For the lion’s share of medical treatment under the German system, you pay your monthly insurance “contribution”, and you’re done. Anyone who has a job is required to pick a health insurance company. If you have a job, you will have insurance. Period. Your employer pays more than half of those expenses. Your premiums are deducted automatically from your gross pay each month.

Should you lose your job and go on unemployment benefits, you remain insured. How? The unemployment tax that funds Germany’s Federal Employment Agency also covers the cost of insuring the jobless. Germany has recognized that illness does not take a vacation simply because you are out of work.

In July 2009, I aggravated my herniated discs such that I needed to make a trip to the emergency room in Amarillo—without health insurance. Since I could not get into a car without shooting pain, I called an ambulance. The only good thing about the ride is that it eliminated the need to spend who knows how long in the waiting room. The bill for taking this overpriced taxi ride turned out to be nearly $1,300!!! Ouch! I just needed a comfortable ride to the hospital. I didn’t want to make a down payment on a medevac helicopter!!

In the hour I spent at the hospital, a technician took my temperature and hooked me up to a heart monitor. Never saw him again. I then saw a nurse practitioner about 20 minutes later, and she just gave me two shots: a pain killer and a muscle relaxant.

Shortly thereafter, I got to see a lady from the business office, who pleasantly informed me that, because I wasn’t insured, I would need to make a down payment of 100 bucks. Should I be able to carry out “prompt payment”, I would be granted a 50% discount on the expenses for that visit, excluding the doctor’s bill. She estimated the total cost to be about $700. The final bill actually turned out to be over $1,100! Let me write that out: one THOUSAND, one hundred dollars. For TWO SHOTS??!!

Then there was the bill from the physician, who was not even a full-fledged doctor. For her services, the nurse practitioner charged me 638 bucks!!! You have got to be kidding! I know it takes a long time to get through medical school, but it is not the patient’s responsibility to pay back the doctor’s student loans! For that price, she might as well have shoved a dildo up my butt, because I certainly got screwed!

Can you imagine how up in arms translation customers would be if they had to pay $600 to see the sentence “I would like a cup of coffee” rendered in a foreign language like Spanish or German?

So, a 15-minute ambulance ride plus 2 shots in the ER comes to a grand total of $3,076.92. Can someone explain to me just what the hell makes medical care in the U.S. so friggin’ expensive??

My girlfriend (now wife) spent the 2008 Christmas holidays with me in Germany. During that time, she developed a blood clot in her leg. Prior to her visit, one had already been discovered in the same leg. It was in a varicose vein and not serious. However, the doctor gave her a list of warning signs to look out for. Should she notice one of them, she was told to go to a doctor immediately. When one of them did appear, it was Christmas Day, and she was on vacation in Germany.

It was a potentially dangerous situation, and she was waaaaay out of her health care network. What kind of expense would she incur without any form of traveler’s health insurance? Our main concern was her health. We would straighten out the bills later. So, we went to the ER in Augsburg, the only place that was open at 11:30 PM on December 25.

We explained the situation, and the receptionist took her personal data and credit card information. That was the end of the administrative process. Strangely, several other people had also decided to spend part of their Christmas holidays at the hospital, so we had something of a wait, while the understaffed emergency room did its best to get around to everyone. Fortunately, the doctor spoke enough English to discuss the situation with her and explain what would need to be done. How many American doctors are able to converse with their patients in, say, Spanish?

An hour later, they wheeled her into the radiologist, who was even more proficient at English. The sonogram revealed a new blood clot: this time a deep vein thrombosis in the same leg. Something more serious than she already had. After some additional waiting time, the doctor explained she would need to go on blood thinners. Since ER’s around the world are limited as to the treatments they can provide, she was given an injection. We got a spare injection to take home with us. I was to give it to her the next day. We were also told to go to the emergency clinic in Augsburg the next day, Dec. 26 (also a holiday in Germany), to get a prescription for further blood thinners in the form of hypodermic syringes, already prepared and disposable.

Evidently, Christmas is a popular time for people—children in particular—to hurt themselves. The clinic was packed. The only people who were not there en masse were doctors. We had a two-hour wait for a five-minute conversation with the doc so we could get the prescription written. We also had to pay out-of-pocket expenses to the tune of roughly 25 euros.

Luckily, one of the few pharmacies open that day was along the route home, so we were able to get the prescription filled. Since the pharmacy didn’t have the exact medication prescribed, they had to find a substitute. The pharmacist had to confirm the switch with the doctor at the clinic. In the end, she got permission over the phone to use a different product. In my 18 years of living abroad, I had never had such friendly and helpful service. The box of 10 shots (one a day, to get her through the rest of her vacation) cost less than 100 euros.

When my girlfriend returned to the US, she saw her doctor about getting put on an oral anticoagulant. Since the Coumadin wouldn’t take effect for a while, she needed more pre-measured injections to take concurrently. She got a prescription for roughly ten. Her insurance covered the cost, but when she looked at the receipt, she nearly suffered a heart attack. Essentially the same product she had bought in Germany would have cost her ONE THOUSAND dollars ($1,000) in the States.

There is no other way to put it people, but that is MESSED UP!! There is no excuse for a set of plastic tubes and metal needles filled with a clear liquid costing more money than some people earn in an entire month. The only explanation is that pharmaceutical companies charge outrageous prices simply because people need what they make. “If you don’t care to pay that much, then go ahead and die. We’ll find someone dumb enough to take out a second mortgage on their home just so they can get their medicine.” In my book, that attitude is tantamount to extortion. The American public is being held hostage by its drug makers. The question now is: which terrorists are worse, those in the Middle East or the ones right here at home?