Doctor, I can’t afford this
Jin Kim | Monday, April 29, 2019
If you’ve ever had a loved one lying in a hospital bed, clinging to their dear life, you know that the last thing on your mind is the medical bill. Because when you see them lying lifeless and unconscious, wrapped in tubes and bandages, surrounded by buzzing machines and frantic nurses, the only thing on your mind is wishing for their full recovery — not worrying about how much that recovery might cost.
So when the nurse comes over to tell you that there is a surgery that might just save their life, that if you sign these payment slips they might just get better, you don’t question it. You don’t ask how much it is or if there is a “cheaper” option or if you can have some time to “think” about it. No, you sign those waivers without question, without hesitation, because life is priceless.
But one day, you come home from work and look in your mailbox and find that life does have a price. And it’s ridiculously expensive. As you open and begin to read the medical bill, trying to make sense of all the cryptic numbers and nonsense fees, you’re surprised by how much you’re being charged: The monthly premium to the insurance company is much higher than what you expected, the out-of-pocket deductible is out of this world and, of course, minimum payment is due by the end of the week. The question is no longer, “Will your loved one survive?” but rather, “Can you pay for it?”
For many of us, seeing a bill like that in the mail may not be a big deal. After all, if your family can afford to send you to a school like Notre Dame, a school that costs over 70 grand a year to attend, what’s a few extra hundred dollars a month?
But imagine, for a second, if you were from a slightly different family. Imagine if both adults in your family worked full-time, minimum-wage jobs, and their paychecks barely keep the lights on, pay the bills and put food on the table. Imagine if you were from a family that has no savings to rely on, no emergency funds to tap into, no piggy bank to break when times are tough. How, then, must it feel to see a bill like this in the mail?
Because to these people, this isn’t just another bill. No, to these people, a bill like that is the difference between staying afloat and sinking in debt. It’s the difference between whether they’ll keep the house or lose it. So when they see a bill like that their mind starts racing — it’s racing to see how much cash they have on hand, racing to see far they can stretch last Friday’s paycheck, racing to determine whether they’ll go broke tomorrow, the day after, or next week.
When I was in grade school, I had a friend — we’ll call him Jimmy — and Jimmy and I were very close. We lived on the same street, we went to the same school, we were in the same class and we were just so alike in every way. Even our birthdays were a week apart. In short, if you knew Jimmy, you knew me because I was him, and he was me.
When we were 10, Jimmy’s father was unexpectedly diagnosed with late-stage liver cancer, and the prognosis was really bad. Now, Jimmy’s family never had much, but his parents worked hard to make sure their three kids always had enough. To this day, I still consider Jimmy’s parents to be the most hardworking people I’ve ever met. But even for this hardworking family, the cancer diagnosis would prove to be too much.
After Jimmy’s father was hospitalized, the medical bills started piling up. The family was forced to sell everything they had of value — the furniture, their car, the family heirlooms — and at one point, it got so bad that Jimmy and his siblings had dinner at our place every night. One day, Jimmy’s mother decided she couldn’t do it anymore. She sold the house, moved her kids to a cheaper neighborhood, moved their schools and moved her husband to a hospital whose treatments she could afford. It goes without saying that this treatment wasn’t the best treatment available, but tell that to a mother working to feed three kids and pay the bills.
After Jimmy moved away, staying in touch grew harder and harder. What normally took a minute walk to get to his house took an hour bus ride. Moreover, his new home was in a bad neighborhood, and my parents were reluctant to take me there. Eventually, the distance had a toll on our friendship, and we moved on. It was only years later that I heard from a friend of a friend that Jimmy’s father didn’t make it — he passed away not long after we grew out of touch.
I don’t know if Jimmy still remembers me. We had great memories, but they were all so long ago. But let me tell you something: I never forgot Jimmy. I never forgot his family. I never forgot his hardworking parents or his loving brothers and sisters. And I never forgot how happy the family was, content with what little they had. But most importantly, I never forgot that America, in all her greatness, failed to protect this wonderful family from going down the drain because of the medical bills — that it wasn’t the cancer in and of itself,that broke this family, but rather the cost of treating it.
Because Jimmy’s family never even had a chance. For a lower-middle class family in America, with both adults working full-time, minimum-wage jobs, all you need is one major car accident, one major heart attack or cancer diagnosis, and you’re done for. There is no hope for you. The bills come after you, you sink in debt and your options are to either file for bankruptcy and start all over or die trying to pay off your debt. That’s the choice that these people have to make.
My friends, this is the reality that ordinary Americans contend with every day. As much as our politicians like to incite us and divide us with thorny issues like immigration and transgender rights, the fact is that none of these issues affect the day-to-day of ordinary Americans. An asylum seeker hopping over the southern border is not what keeps the mortgage unpaid; a transgender boy or girl walking into the bathroom of their choice is not what turns the power off. Rather, it is that as healthcare costs continue to soar, Americans are struggling to pay for them. That is what keeps Americans up at night. That is what leaves bills left unpaid, what turns fresh food into fast food, what turns a car ride into a bus ride and a bus ride into a long walk, what turns a savings account into a bounced check.
We call ourselves the greatest nation in the world. I truly believe this is so. But we cannot be proud of this title if we fail families like Jimmy’s. If year after year, administration after administration, we fail to provide basic, affordable healthcare solutions for people like Jimmy’s family, we can no longer claim to be the greatest nation in the world. Because what is a nation, if it cannot care for its own citizens? What is a nation, if it fails to protect its most vulnerable people?
My friends, I’m going to say what is uncomfortable to hear but what must be said: Our healthcare system is broken beyond repair. Every day, deductibles and premiums climb higher and higher while insurers drop out of exchanges intended to help the most vulnerable members of our community. Americans are given the choice to either enroll in a plan that charges thousands of dollars in deductibles, or not enroll, pay a fine and risk not having insurance for when they need it most. It is the Catch-22 of the 21st century. Meanwhile, our country is getting sicker and older, placing unprecedented strain on a healthcare system that is already weakened by lawsuits filed by questionable political interests.
This is our Titanic moment. We are all aboard the same sinking ship: the hull of Obamacare is torn in, the stern of Medicare is shattered and the water is rushing in. The longer we wait, the greater our danger. If we are to live, if America and her values are to live, we must jump ship. We must find something new. We must fight for comprehensive, structural reform to the system.
For those of you who wish to remain behind, I wish you the best. But before you make that choice, let me tell you the facts so you can make an informed decision: In the five years since Obamacare was passed, deductibles went up by an average of 67% and premiums went up by an average of 24%. This means that the same treatment that cost you $1,500 then, costs you $2,500 now. The same insurance plan costing you $500 a month then, costs you $620 now. Taken yearly, that’s a difference of thousands of dollars. And if you compound that over several years, because we all know most illnesses require several years of treatment, you’re looking at tens of thousands of dollars in medical expenses that people can’t pay for.
It’s no surprise, then, that the Consumer Financial Protection Bureau (CFPB) found in 2017 that medical bills are the most common reason consumers are contacted by collection agencies. One-in-five Americans have at least one medical bill on their credit history; one-in-five Americans have at least one medical bill that is overdue. And did I mention that two-thirds of all bankruptcies last year were for medical reasons?
But if you agree with me that we need to change the system, then we must act swiftly. The burden of hefty medical bills on Americans has long reached the tipping point, and we have no time to waste. To be sure, there is a long fight ahead. Our politicians are either reluctant to move forward with something new, or they support something irresponsible that would easily make this country bankrupt. Meanwhile, the corporate giants that seek to benefit from the status quo will work to keep things in the way that they are. But we have no choice: We either die on this sinking ship, or we jump ship to fight for a chance to live.
So let’s fight. Let’s fight for a better healthcare system. A system that works for America. Let’s fight for lower prescription drug prices, more affordable healthcare solutions, more accessible healthcare solutions. Let’s fight for more transparency in the system, so we know exactly what we’re being charged for and why. Let’s fight for our health. Let’s fight for the health of your family, for the health of my family, for the health of Jimmy’s family, for the health of America’s families. Let’s fight to make America feel better again.
Jin Kim studies computer science and economics at Notre Dame. He is from New York City, New York, but his home-under-the-dome is Keenan Hall. He can be reached at [email protected]
The views expressed in this column are those of the author and not necessarily those of The Observer.