I've just had the unpleasant (!) news that I'm going to have to pay over $3,500 up front for two medical examinations, one involving nuclear medicine (to compare the function of my kidneys) and the other a CT scan of their current physical state. Of course, it's the new year, and whereas last year I paid my entire deductible in the first half of the year (plus some charges my insurance wouldn't cover), and thus had a "free ride" for the second half of the year, we're back at square one for 2025. Very fortunately, my wife and I have been saving our shekels for this, knowing it was coming. Even so, it's a big hit, and we'll have to pay twice that before I hit my maximum deductible this year. That's bound to happen.
However, I also have to admit that despite medical costs being (seemingly) very high in this country, there are valid reasons for that. DiveMedic addresses some of them.
This woman here had a child that was born prematurely. That child spent a month in the Neonatal Intensive Care Unit (NICU). The bill came to $738,360, and the mother complains that the cost is too high. There are many in the comments that agree, and it’s filled with comments about how other countries have free healthcare, which is of course false.
The bill for that child’s care is completely reasonable. Let me explain why:
Nurses work 3, 12 hour shifts per week, and NICU nurses are frequently on 1:1 care, meaning one nurse to one patient. A 30 day stay in the NICU means that your child had the undivided attention of 5 nurses for a month. An experienced nurse, (for obvious reasons NICU nurses tend to be fairly experienced, qualified, competent, and educated) aren’t cheap. The average pay for a NICU nurse in the US is about $130,000 a year. Night shift makes even more, thanks to shift differentials.
The nurses in charge of your child’s care cost the hospital $70,000 in direct compensation, plus the costs of insurance, training, and other HR expenses. In all, just the nursing care for that month in the hospital cost that hospital about $140,000. Now add in the costs of everyone involved in that from the doctors to the lab technicians, and even the janitors.
Each of those people is highly educated, even the janitor. Yes, the janitor. To comply with Federal law, that janitor has to be instructed on CPR, stroke procedures, HIPAA compliance, Medicare and Medicaid laws, sex trafficking, recognizing child abuse, disposing of medical waste, and a host of other laws. He also needs to be background and possibly drug checked, especially to work in a pediatric wing. All of this raises the cost of hiring that janitor.
Back to the nurses. It takes 3 years of schooling to become a registered nurse. Then it takes years of experience, training, and work to specialize as a NICU nurse. In all, the average NICU nurse has been a nurse for 5 years or more and has attended far more schooling than a beginning nurse. Pediatrics is a specialty. So is neonatology, as is critical care. NICU nurses have to certify as all three. That’s why they make what they make- competence costs money.
Then there is the lab work, the cost of provider that supervises those NICU nurses (usually a nurse practitioner), lab technicians, respiratory therapists, medications, medical equipment, supplies, meals, and even the guy that empties the trash. Then there are the doctors, as well as the regulatory costs of compliance.
In total, labor costs alone for that stay were probably in the neighborhood of $300,000, so I don’t think $700k is out of line once you do the math.
That isn’t even considering what procedures may have been done- if surgery was involved, you can also add anesthesia, scrub nurses, surgical nurses, and a host of other specialties and specialized equipment.
There's more at the link.
DiveMedic acknowledges that in many countries with so-called "free" or "public" health care, these costs are never seen by the patient: but that's because they're paid by taxpayers in general. Whether the patient pays them directly or pays a wodge of extra taxes to subsidize them, she's going to pay, one way or the other. "Free" healthcare isn't.
That's why I can't complain too hard about having to pay close to five figures last year in insurance deductibles, plus pretty much the same again in costs not covered by insurance. At least I live in a country where the medical system is good enough to treat me, and advanced enough to offer the latest technology, and I don't have to wait forever to see a doctor who may or may not be competent! I can certainly understand the frustration of those who need treatment but can't afford it, but even there, many hospitals offer arrangements whereby they take the financial hit and offset it against their taxes as a charitable donation. Other generous individuals donate to help cover the cost of expensive procedures (as one reader, who wishes to remain anonymous, did for me last year - for which my eternal gratitude!). There are ways.
These two examinations, later this month, will determine whether I need further kidney procedures (up to and including losing a kidney if things don't look good). I'm hoping and praying for the best. Thereafter, as soon as the kidney situation is dealt with, I have to look at further spinal fusions near the site of my existing one. After 21 years, that area of the spine is showing the strain, and needs reinforcement. That's going to be very painful and very expensive, I suspect . . . but we'll see. Again, thanks be to God that I live in a country where such advanced care is available! I shudder to think what the fusion procedure might be if I still lived in Africa. It would probably involve baling wire and strips of rubber tire!
Peter