Pl read

1. Why o Why?

If you are visiting these writings for the first time, or have not read the entry "Why o Why",

may I suggest you read that first and then read the rest in numerical order?



Friday, 5 May 2017

17. Overhaul of the US healthcare system -- speak up America

The  US Congress has taken the first step to  repeal of The Patient Protection and Affordable Care Act, often shortened as the Affordable Care Act (ACA) and nicknamed Obamacare. 

The nightmarish experiences of seven years ago appear in front of my eyes. Even deep inside me, I can feel the jitters. 

So can 10's of millions of Americans who have what is  referred to as a "preexisting condition". And, I have two!  So many "what if"s. Patients without insurance have more than their medical condition to worry about. "Control the spiralling nervousness", I tell myself. But, given what happened seven years ago, it seems like a hard ask. 

Subsequent to seeing me in person and based on the results of diagnostic tests, decision was made by my doctors  to proceed with a Bone Marrow transplant, at which point we were asked to pay a deposit (since we had no medical insurance in the US) based on a detailed cost estimate. So we paid up a total of $276,950 upfront. This included about $150,000 for transplant which would cover hospitalisation for about 40 days (10 days prior to transplant and 30 days post transplant), all the labs, diagnostic investigations, doctors' visits, medicines and IV infusions, etc. It also included about $ 63,000 for 90 days visit to the hospital post discharge. 

However, to our dismay my family discovered that even before the transplant, the balance in my account was just $12,000! So, the estimate given by the hospital for the entire transplant and post discharge of 90 days was exhausted even before the transplant had taken place giving my family unbearable shock and distress. And, this is on the 7th day after admission and without any complications.  We were repeatedly told that the estimate is based on averages and if there are no complications, our spending will be much lower than the deposit paid, and that is how it should have been. 

Since the doctors that we consulted suggested that i must go ahead with the bone marrow transplant immediately without losing time we decided to go ahead with this decision even though there were questions about the finances needed for further treatment. Fortunately my colleagues at UMass came to my rescue  and worked out an arrangement whereby I was able to carry out a collaborative project long distance, and benefit from the accompanying medical insurance.

After the transplant,  from all the information we were able to gather, we inferred that the prices we had been charged by the hospital's pharmacy for medicines and the prices charged by the hospital for room rent, doctors' visit, labs and diagnostic investigations were much higher than the price paid by insurance companies. This was truly unconscionable.  I was reminded of these and other aspects of the treatment  that happened  6 years ago. 

Clearly, many sleepless nights are in store. 

A patient undergoing treatment for deadly diseases such as LA is clearly worried about whether he or she will be lucky enough to see the next day.  For an uninsured patient, the worries are compounded by the question of where the next Dollar required to continue the treatment will come from; this worry will only help hasten the end of the patient's life!

Clearly, such an outcome will reduce the overall costs of medical care in the US. After all, there is no need for any further spending on a person who is no more. 

A very clever idea indeed!


1 comment:

  1. Trumpcare vs Obamacare vs Self Insurance will make an interesting study. It might be possible to arrive at threshold values of who, at what age, with what pre-existing conditions should opt for insurance if at all. Also this might be a good opportunity for marketing medical tourism in India.

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