Man surgery is expensive. $22,000 for a bit under two hours of work? And even then, on a knee? How about if you're shot, or hit by a car, or struck by cancer?
For the past six years, hospital profits have soared, peaking in 2004. The reasons are partially mundane -- strong stock market creating investment income, slowing expenses, etc. But we've also seen a rapid increase in the number of invasive surgeries (with no apparent cause) and much tougher bargaining with insurers. In addition, debt collection has become much more sophisticated, with wage garnishing emerging a routine practice.
In Jason DeParle's spectacular book on welfare, American Dream, Jewell Reed, one of the welfare mothers he followed, loses her health benefits, keeps working, and is eventually hospitalized for her bleeding ulcers. The cost, which was far beyond what she could pay, was simply deducted from her paycheck into perpetuity, shrinking the wages of a woman already living on too little. In her favor, though, the automatic withholdings barely phased her. After all, everyone else had them too. "Anybody that works is gonna get their check garnished," she said. "Everybody in Milwaukee owes a hospital bill."
That's not a policy argument, of course. Hospital treatment is costly, and someone's gotta pay. But given a society that believes in a right to trauma care but lacks a comprehensive approach to paying for it, it'd take a certain naivete to be surprised by the major medical component underlying most bankruptcies and constraining the growth of low-income paychecks. Care is expensive -- check out these bills. Those with orderly finances able to pay monthly premiums are barely touched by the expense of sudden illness, but would nevertheless be best positioned to pay the actual costs. What bitter irony, then, that those unable to afford even the more diffused insurance premiums end up buried beneath the full expense of operations and treatment.
