I like being outside. Like most boys growing up, I spent a fair amount of time playing in dirt. As a kid if I wasn’t in our sandbox or the open field a couple of blocks away I was probably getting grass stains from soccer or sliding into second base on some local baseball diamond. Winter meant skiing, still does actually. It was no surprise then when I decided to take up rock climbing. Rock climbing is basically playing in the dirt for older kids I believe.
By June of 2003, I had been climbing regularly for several years. We spent hours and hours climbing at the Black Cliffs during spring, summer, and fall months. On multiple occasions we even tried climbing in the dark, that proved incredible difficult. Climbing was new, challenging, and exciting. Even the gear was fun to purchase; I’m what some might call unique. The only down side to climbing was the falling aspect. Unfortunately, I forgot that one aspect of climbing that June.
My friends got my off the cliff and to the emergency room in great time! I’m pretty sure search and rescue could not have gotten me to the hospital any faster than they did and since I did not have insurance at the time, I did not want to call 911 and find out.
Now, being polite and in shock, I was going to wait my turn at the check in desk once at the hospital. There was some lady checking in already when I walked through the front door that night at 7pm or so. To this day I still have no idea what was wrong with that lady, all I know is that as soon as the check-in girl saw me she deemed me a higher priority. I’m pretty sure I was in a wheel chair and on my way back to a room before the lady that was checking in had sat back down. It’s amazing how quickly one can get service when you show up bleeding profusely from your head and your left arm is sticking 3 inches up in the wrong direction.
Once they got me into the E.R. bed, the on call doctor and nurses immediately put a C-Collar on me and began giving the “you could have a serious neck injury” lecture to me. I must have got that lecture half a dozen times that night. Considering I had walked into the E.R. under my own power, was still coherent, and had no numbing, besides my broken arm, I was pretty sure I had avoided a neck injury that night so I didn’t pay attention to the lectures much. Also, the E.R. doctors sent me to a have a CAT scan of my spleen before my neck, that didn’t help their cause.
At this point it was time to deal with the cut on the top of my head. The nurse on duty began the procedure to put six staples in my head. For those of you that have never experienced this, the nurse pulls out of a drawer a stapler that looks like it could be from any office or school supply closet. This stapler was in a plastic package that they opened and put on a surgical tray with a bunch of towels and bandages. I’m pretty sure it was the nurse who then pinched the skin on the top of my head together and then stapled it. By the looks of it this was a pretty simple procedure that required minimal effort considering my other injury.
After determining that I didn’t need immediate surgery or was in any type of life threatening situation, the plan was to send me home that night and then come back some time the next day for surgery on my left wrist. However, the E.R. could not get my pain under control with all the morphine so around midnight they admitted me. To this day I wish I were a better writer so I could better describe how much pain I was in. All I can say is that I was experiencing the oddest mixture of adrenaline, fear, pain, panic, shock, and drugginess ever.
Sometime during the night my vitals tanked. Turns out my body is not a fan of morphine, I’m ok with that! At this point though getting any sleep was next to impossible because multiple groups of doctors and nurses were going in and out of my room almost consistently. Truth be told, I was actually relieved not to be able to sleep because at this point every time I closed my eyes I relived the fall.
My surgeon, Dr. Lamey, came to my room about 6:30am to introduce himself and give me a run down of the surgery. At that moment I was scheduled for surgery at 5pm that night if I remember right but there was a hope that I could get in earlier. As any hospital patient knows, hurry up and wait is the mantra. This day turned into the best and worse day of my life. It was the worse day because just lying in the hospital bed waiting for surgery made the pain even worse. It was the best day of my life because the surgery brought me so much relief.
My local hospital was experiencing a nurse shortage at the time. This was more than evident by the 900-year-old nurse I had during the day. She and I didn’t click. My main grip was that she would inject morphine like it was a race against time. That crap burns when injected to quickly. It was so bad that I tried to hold out as long as I could with the pain because the night nurses were much nicer and didn’t burn my veins when they injected the morphine.
As one can imagine, I was not in the mood to have anyone touch me at this point. That meant that I was still in my blood soaked climbing gear when they wheeled me into surgery. Dr. Lamey is an incredibly nice and generous doctor but I can still remember him screaming at the techs for bringing me into the operating room still covered in blood and dirt. After getting me cleaned up and surgically ready, Dr. Lamey did his thing successfully. I was now the proud parent of 10 screws and a plate (As a side note, this was the first and only bone I have ever broke. I’m a big fan of if you are going to do something, do it right!).
Due to the seriousness of the break, Dr. Lamey put me in a soft and hard cast. Basically, nothing was going to get through to my healing arm. Since he had done this, Dr. Lamey never ordered ice because there was no point even though we have all been taught that we should ice swollen joints. The casts were just to thick at that point to have ice do any good. This did not stop the hospital from trying to ice it though. Turns out there was a reason they wanted to push icing, they tried charging me $8.00 per ice bag. When I say ice bag I mean a basic plastic bag that we all use to get our apples at a grocery store with ice machine quality ice. I ended up eating most of the ice because they said I wasn’t able to eat a pizza yet.
I fell on a Tuesday evening, the surgery was on Wednesday, and I was going to be discharged on Thursday. Before I could be discharged though, I had to walk around the entire 6th floor without help. I did it, just not very quickly of course. Turns out I had become a local hospital celebrity because as I was walking around other nurses and doctors that I had never meet where talking about my fall I discovered. Everyone was impressed that I was still alive. Better lucky than good I like to say.
As my family and I waited for the discharge papers to be finalized and for them to find a wheel chair big enough for me, the 900-year-old nurse came in and told use that so far my bill was around $900.00. Although I was technically in their care for 3 days, the first and third days were only partial days. The $900.00 seemed reasonable considering that I had needed surgery and the length of my stay. We fully understood that the bill was going to be higher than that when everything was finally added up. What we weren’t prepared for was the final number.
I don’t have a copy of the final bill but working off memory, my hospital bill came to roughly $10,000 for what was roughly 41 hours of care. This did not include the surgeon or anesthesiologist’s bill either. The surgeon’s bill was roughly $2,000.00 and the anesthesiologist was something like $1,200.00. My fall now had a price tag of around $13,200.00 and as I said earlier, I did not have any insurance at this time.
Since I have been criticized for this in the past, there was no doubt that the hospital was going to get paid. My family and I were not looking for freebies or handouts. All we wanted was to be charged a fair price, just like everyone else would expect. I don’t know how much clearer I can be on this!
As I mentioned earlier, there was something like $80.00 worth of charges for “ice bags” on the bill despite my doctor not ordering it. I was charged $400 for a “set-up” fee for the stapler. There was another $800 for a consultation charge between the E.R. doctor and attending whom I never meet. The actual stapling procedure was something like $600.00. After the surgery, my doctor ordered Percocet, as needed, every 4 to 6 hours but I was being charged $25.00 per pill regardless if I took it or not. My parents bought a full prescription of Percocet for something like $30.00 at the hospitals pharmacy just to let you know.
These charges seemed excessive so I started to ask questions. Big mistake. As soon as I started to question a charge the billing department became incredibly rude and snotty towards me. All I wanted was justification for these charges. Like I said, the hospital was going to get paid but I wasn’t just going to blindly write them a check without more information.
At this point I started searching the Internet for payment options or programs that might help. I even explored medical bankruptcy because I figured I could recover from something like that on my credit rating and that was more appealing than paying excessive hospital charges. It was during this research that I discovered that hospitals couldn’t charge interest on bills, which means I didn’t have to cave under their pressure to pay full price.
Through research and asking my friends, I came across The Hospital Survey and Construction Act (or the Hill–Burton Act) of 1946. The bill’s sponsors were Senator Harold Burton of Ohio and Senator Lister Hill of Alabama. My basic understanding of the bill was that hospitals were given grants and funds for unused hospital beds based on some government formula. The idea was that hospitals could then offer cheaper or free care to people without insurance because they were receiving these grants. I found some address that I could request a copy of all hospitals in my area that were receiving Hill-Burton Act funds. So, I sent a request for a list with the hope that my hospital would be on it.
In the meantime, I had a meeting with the billing manager in order to explain my situation. At no time had his representatives suggest I look into programs like the Hill-Burton Act or medicare/medicaide. It was either pay now or be treated like a second-class citizen. This was going to be the main topic of our meeting.
As soon as I mentioned the Hill-Burton Act, the billing manager alerted me to the option of having my account audited by a nurse who worked in the billing department. I had not come across this option in my research nor had been told about this option from any hospital employee. This was something I was more than willing to take advantage of.
As I mentioned earlier, I’m a big fan of the phrase “better lucky than good”. Within minutes after meeting this nurse/biller, she said I reminded her of one of her grandkids. As we all know there is no one better to have on ones side than a grandparent. Our meeting was relaxed, comfortable, and not at all confrontational, as I had expected. We ended up going through every single charge on my bill from the time I entered the E.R. to the time that I was discharged. I plead my case based on my memory and what my parents had witnessed while at the hospital and she explained the hospitals costs. By the time the meeting concluded, my bill was roughly $7,000.00 which was what my dad had figured his insurance would have been charged if it was him that had fell that night instead of me.
The hospital then got a check for the total bill. Like I said, they were going to get paid for their services.
This experience taught me 3 things. First, I was incredibly lucky to be born into my family who had 2 successful parents who could afford to help me out financially. Many people are not as lucky which means they are either avoiding needed care or are filing for medical bankruptcy. In our country, denying someone access to quality care because they were not lucky enough to be born into a financially stable family does not seem right or fair. Second, with our health care system so large and so profit motivated, we have to be our own advocates. We have to stand up for ourselves! Yes, I realize health care has endless resources and ability to make our lives miserable but all it takes is one nurse/biller who knows how the system works and we as patients can achieve a small victory. Finally, I don’t think its fair or right to blame the uninsured for our high health care costs. The uninsured are the ones that are truly paying full price for medicine, not the insured. If it weren’t for my willingness to be my own advocate, I as an uninsured patient, would have had to pay roughly 30% more than someone who fell with insurance. Our healthcare system is now to complex and profit-centered to blame just one group for high prices. We need wholesale change before we can get a system that charges a fair and competitive price for healthcare. This debate will not be won on a bumper sticker.