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[Part One] Setting the Scene: The Rising Cost of Medical Care

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This is part one of a two-part series on medical funding and the current state of health care.

The landscape of health care is already on a slippery slope. But what may be most terrifying is the fact that no one—insured or uninsured—is exempt from the steep costs of medical care.

Skyrocketing health care costs are leaving people across the country feeling squeezed, and even with insurance, Americans are unable to pay what they owe after receiving treatment.

Health care has been, and continues to be, a hot topic, and the rising costs of care are making things even more controversial. In a recent Gallup poll regarding the health care system, 55 percent of respondents said they worry a great deal about the affordability and availability of care.

Health Facts & Figures

An article by The Atlantic described the insured-uninsured conundrum this way, “Just because a person is insured, it doesn’t mean he or she can actually afford their doctor, hospital, pharmaceutical, and other medical bills.”

In fact, there are roughly 44 million people in the United States right now without health insurance, and another 38 million with inadequate health care coverage. It’s not the availability of care that’s the issue—it’s being able to pay for it. After receiving care, people are crippled by the cost.

With nearly one-third of Americans feeling unable to rely on medical care (let alone being able to afford it), a lot of people have started to take matters into their own hands. Fewer and fewer people today seek preventative care or schedule routine appointments. Without routine check-ups, diseases, conditions, and the severity of diagnoses escalates. By the time medical care is received, the cost of care has virtually spiraled out of control.

Expecting the Unexpected

An unexpected visit to the emergency room can be detrimental to a household budget.

Sarah Kliff, Senior Correspondent at Vox.com, is one of the country’s leading health policy journalists. To make sense of the unpredictable and costly reality of medical expenses, Kliff focused on one thing for a whole year: reviewing patient bills from their emergency room visits. Her laser focus on the ER stemmed from the fact that millions of people visit the emergency room each year, making the ER one of the more frequent ways individuals interact with the health care system. She sifted through 1,182 medical bills, and her conclusion was this: medical prices are unpredictable…and they’re skyrocketing.

Initially, Kliff was most interested in the facility fee. What did it cost to simply walk through the doors of an emergency room? Depending on the hospital and how severe a patient’s case was, she found an ER facility fee could range from as much as $533.00 per visit to as high as $3,000.00.

Of course, no one expects to end up in the ER. And, in general, Kliff found these patients paid the visit for pretty typical ER circumstances, like car accidents, pain from a heart attack, a ruptured appendix. In one visit from Kliff’s research, a girl had eaten a coin.

But what Kliff also found is that, like the facility fee, the cost of care varied from ER to ER. For instance, in many cases, before a doctor could determine the course of care for a woman, he or she would order a pregnancy test. In one ER in Texas, a pregnancy test cost $236.00. In Illinois, $147.00. In Georgia, $465.00. For perspective, a pregnancy test on Amazon costs about $7.00.

In another example, bacitracin cost an ER patient in Tennessee $1.00, while a patient in Seattle was charged $76.00 for the exact same tube of this common antibiotic ointment.

Since prices aren’t public, patients aren’t aware of the cost and it isn’t until weeks or months later when the medical bill arrives in the mail that they realize how much they owe.

What Happens When Working Families Can’t Afford Care?

Even working and insured families are having a hard time keeping up with the cost of health care. And actually, the cost burden of insured premiums are growing faster than income.

In 2018, Kaiser Health News profiled a family earning $100,000.00 a year. They didn’t experience any major health issues that year and were insured through an employer-sponsored insurance program. Still, they managed to rack up $12,000.00 in medical debt. The cost of getting sick, even minorly so, is high.

The Federal Reserve Board’s annual report on the Economic Well-Being of U.S. Households found that 44 percent of Americans could not come up with $400.00 in an emergency without turning to credit cards, family and friends, or selling off possessions. In the world of medical bills, $400.00 is a drop in the bucket—in most instances, $400.00 wouldn’t even cover the facility fee upon arriving to the ER, or the pregnancy test if you’re a woman living in Georgia.

Despite the reality of the situation, there are solutions to these crippling costs. Including:

  • Transparent pricing, where health care consumers are empowered to make informed decisions about their care based on cost. Not all, or even most, medical facilities offer transparent pricing, but the rise in consumer concerns is setting the foundation for it to become more popular, hopefully even the norm someday.
  • More urgent care centers. The rising cost of ER visits is one of the primary reasons there have been more urgent centers being built. Simply put, they are a lower cost alternative to hospital visits.

Coming Up Next: Why Medical Funding Matters

Amidst the rising costs of health care, medical funding is more important now than ever before. Stay tuned for the next edition of this multi-piece spotlight where I’ll answer:

  • What is medical funding?
  • Why is medical funding becoming a necessary part of personal injury lawsuits?
  • What are the benefits—to attorneys and plaintiffs—of having one company provide medical funding?

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