The Brokenness of American Healthcare

After over two decades of perfect health, I’ve spent the last five years navigating a devastatingly broken system. From outlandish insurance premiums and confusing deductible requirements, to lackluster care and unfair loopholes, I am not happy. I’ve been frustrated but patient as I make strides towards a clear diagnosis and a resolution of symptoms. In five years, I’ve spent over $67,000 on medical care. Between insurance premiums, the annual max out-of-pocket and out of network care, over 25% of my gross income pays for healthcare. This does not even account for lifestyle changes to promote better health, such as converting to organic food and home products.

While the above numbers are quite outrageous, I had come to accept and build my habits around the broken healthcare system cash cow. However, my emotions recently came to a head when an old acquaintance made a series of poor decisions and then magically landed himself a “get out of jail free” card. I don’t get worked up over anything, but I have been livid for the last month.

The individual above is a white, middle-class, middle-aged male whose income hovers around the happiness plateau. He owns a home, has a good job and does pretty well for himself. And yet I am responsible for paying his medical bills.

So, here’s the thing. This guy feels that insurance premiums are too expensive–and I don’t disagree–and thus has opted out of medical insurance since booted off his parents plan in his early twenties. For twenty years, he was generally healthy and paid out-of-pocket whenever he needed to see a doctor. No harm done. When he contracted MRSA last year, he self-treated with bentonite clay and colloidal silver and, somehow, it worked. Rather than take the health scare as a sign to consider medical insurance, it only solidified his sense of invincibility.

Earlier this year, this man went through a mid-life crisis that involved sleeping with a series of strangers. Somewhere along the way, he contracted gonorrhea. Because he didn’t have insurance and wasn’t willing to spend $100 to see a doctor or be tested, he opted to self-treat the infection for two months before visiting an urgent care. By the time he sought care, he was septic. He was rushed to the emergency room and spent three weeks in the intensive care unit, racking up over $500,000 in medical bills.

Initially, he panicked, certain that collections would take away his paid-off home. He worried that he’d be forced to declare bankruptcy and start over. He tried to laugh off the fact that a series of poor decisions was going to cost him everything. I felt bad for him, but also couldn’t help but hope this would be the wake up call he needed. For years, people have insisted he at least sign up for catastrophic insurance. Maybe it would finally click.

But things quickly took an unexpected turn. While in the hospital, the man flirted with the nurses and quickly won their pity. When he revealed that he was a professor, the nurses told him that they’d see what they could do about the bills. They helped him apply to the state-funded health care program, which is generally reserved for those with disabilities or living below the poverty level ($17,000 annual income). The able-bodied, middle-class man with a steady income was immediately approved. And, with that ruling, his $500,000 in medical debt was immediately passed on to the taxpayers of the state of Arizona. On top of that, we’ll be paying for his healthcare premiums and care for at least the next twelve months. For every hour I work and every dollar I earn, a portion is paying for this man’s stupidity.

What possible loophole could he have snaked through? Several people close to me have been diagnosed with cancer while unemployed and they were denied state healthcare, sometimes more than once. I am confused and infuriated, and not just at this one case. The fact that this acquaintance was able to pass the consequences of a potentially devastating decision onto state taxpayers makes me wonder how easy it is for others to do the same.

I will gladly provide funding to disabled persons, low-income individuals, single-parent households, the elderly or anyone else for whom medical insurance is unattainable or an unreasonable burden. I have so much compassion for those who are doing the best that they can manage under their given circumstances. I have–I’ve learned–no tolerance for those who game the system and steal funding away from those who are unable to provide for themselves. By saving his house, this man is indirectly delaying a cancer patient’s treatment and preventing a house-bound diabetic from collecting a life-preserving prescription.

A few weeks ago, I didn’t understand why I was so upset at this situation. It felt unreasonably selfish. He cheated the system and I’m better than that. He didn’t hurt anyone and I wasn’t directly impacted, so what’s the big flipping deal? Yet, the more deeply I thought about it, the more clear it became that this wasn’t about me. This was about my loved one who was denied state health insurance after surviving a brain infection and developing a seizure disorder. This was about my family member who developed cancer and was denied state health insurance, which delayed a medically-necessary amputation. This is about a dear friend who was lost to an aggressive cancer while state health insurance was busy deciding to deny them benefits, twice. It seems incredibly unjust. Those who clearly need assistance don’t receive anything, while those who don’t qualify for assistance are given handouts on a silver platter.

I’m not sure where the problem lies. Medical insurance is expensive, medical costs are rising at an unsustainable pace, the issuing of state-funded care seem unjustly inconsistent, and everyone seems to be getting sicker. Is the state-sponsored health insurance program corrupt? Are there glaring loopholes that unscrupulous folks can slip through? It the increasing corporatization of medicine leading to the increased costs? Are people forgoing insurance and routine doctor’s visits due to the cost, ultimately raising the bill long-term? I think all of the issues are intertwined, feeding off of one another.

I started listening to a new podcast this week, which was recommended by a friend in the medical field. An Arm and a Leg is “a podcast about the cost of health care. Revealing and surprising stories, conversations and hacks to get us less scared and confused about the mess we’re in.” Only a few episodes in, I already feel less alone. Medical care is getting more expensive, the quality seems to be going down, and all the nuances are seemingly-impossible to tease apart. The podcast is hosted by a journalist who is investigating the topic as he tries to secure decent healthcare for his family as a self-employed person. He shows first-hand that the task is far more challenging than it should be.

While the ideas brewing in my head around this topic over the last few weeks have been more of an angry rant, I wanted to end this on a positive note and I think this podcast might be a good start. For years I’ve been complacently (though begrudgingly) paying my medical bills as they roll in, blaming a thoroughly broken system on the high costs. However, seeing a person who shouldn’t have qualified for state-sponsored insurance and debt forgiveness really made me question the structure and the ethics of the existing system. Quite frankly, I’m happy that someone has taken on the daunting task of dissecting what’s truly going on with the American healthcare system and I hoping that the dissemination of such knowledge will (eventually) lead to some fundamental change.