The High Cost of Health

By Anonymous / Spring 2020

I could not feel my hands, my legs, let alone my fingers and my head was extremely heavy. I had all the swelling over my entire body, and everything I saw was vague. My eyes started searching around the room naturally and saw a broken motorcycle helmet. Meanwhile, the helmet aroused my memory and when all the fragment of memory assembled, I remembered that I was hit by a car when I was riding my motorcycle and thrown a few feet away from my motorcycle. Then, I was sent to the hospital and had a surgery on my arm. I had no idea how many X-rays I had during the hospitalization. However, the hospital staff asked for my insurance card right away. After all the treatment, I asked how much I need to pay, and the only answer I received was that you were going to be fine, and your insurance would pay for it. While recovering at home, I received countless bills and the amounts are ridiculously high. It was obvious that there should be something wrong with my bills, so I consulted my insurance and I knew that the hospital charged me over hundred thousand for the surgery fee. At that moment, I was shocked, and I thought they wanted to take my arm back. In fact, my insurance already covered 90% of it. However, I still need to pay for the rest. Immediately, I requested an itemized bill. I found out that there were so many nonsense charges on my bill, such as occupational-rehab, mentality counseling and I have never experienced those service during the hospitalization. In addition, the amount of emergency hospital service on the bill is much higher than the price they listed out on their website. Thus, I communicated and explained my situation as I really couldn’t afford the bill, especially during this Covid-19 pandemic as we have to spend more expense on the face masks, hand sanitizers and all other medical supplies. Eventually, they adjusted the amount and ruled out all the unfair charges on my bills and gave me some discounts. Moreover, they offered me a payment plan as well, so I can pay for it by month until I pay off the balance. Based on my experience, after comparing to other hospital, it is obvious that the amount of the bills we get absolutely depend on the providers and the price varies wildly.

My story is the lucky one. Having a student medical insurance is the key for helping me to pay for the hospital bill but so many American can’t pay for the bills and result with a negative credit history on their credit report. The negative credit will crash your future. It makes you no chance to finance a car, house or even to have a credit card as no one would loan you money or trust you that you will pay them back based on your bad credit record. Many people often ask this question” are we supposed to pay for the medical service? There is no denying the fact that we are responsible to pay for the medical service, but we should only pay for the reasonable price. Furthermore, we have to look at the other side of the coin that is how this imperfect system affects our society and our lives, especially during this pandemic.

COVID-19 has been crushing the U.S. We have 97,048 deaths in Covid-19 (CDC). COVID-19 has brought a lot of harms in our daily life. However, could you imagine that what if you were infect by COVID-19.A coronavirus patient was having the treatment in New York City and unfortunately, he died but his last words are “Who is going to pay for it” (Elasser). This example makes us to have a reason to believe that American will think of the cost of the hospital before they have treatments. It stops people visiting the hospital even though they suspect they have coronavirus. According to a survey by Nicole Lyn Pesce, “1 in 7 American wouldn’t seek coronavirus treatment because it probably cost too much”. This is also a main reason why we are having the community spread now. Thus, if we look deeper, why we should be afraid to visit the hospital. According to WHO, health is a fundamental human right. However, it seems like we are losing our basic human right now. There is no doubt that the U.S medical system is making people confused and affording higher medical expenses.

Why is the medical care so expensive? Let’s explore some important reasons for why it is so expensive. First, the hospitals need to have the higher administration fee. The U.S. healthcare system is extremely complex, with separate rules, funding, enrollment dates, and out-of-pocket costs for employer-based insurance, private insurance from healthcare.gov, Medicaid, and Medicare, in all its many pieces(6 Reasons Healthcare Is So Expensive). Therefore, the administration fee will increase. However, this is no harm for the providers because as profit providers, they can forward the cost to the patients easily, such as adding up the hospitalized fee and service fee. Secondly, it can be said with certainly that hospitals are the profit center. According to the 6 Reasons Healthcare Is So Expensive in the U.S, “Hospital care accounts for 33% of the nation’s healthcare costs”. For example, a typical angioplasty to open a blocked blood vessel, for example, costs $6,390 in the Netherlands, $7,370 in Switzerland, and $32,230 in the United States (6 Reasons Healthcare Is So Expensive). We all recognized that these are the reasons why the medical expenses are expensive. However, in order to tackle the problem, we must investigate the root cause.

If we look deeper from the above reasons of the expensive medical care, we can see that the government’s policies have the major impact to the medical system. It is well-known that the United States follows the market economy which advocates less intervention to market and let the market follows the market forced. Thus, the medical providers have their right to charge as much as they want based on the market and profit. It seems like the government acquiesces their behaviors. Also, the government keeps cutting of the tax for the wealthy, so it affects the resources allocation, such as the wealth transfer. As the government decreases the funding for the hospitals and making them to go private. Why are they having those policies? As the government believe in the ideology of Neoliberalism can give people freedom and create the fair environments.

This covid-19 is a trigger to expose the failure of the Neoliberalism in medical system. Neoliberalism is generally associated with policies like cutting trade tariffs and barriers (Birch).

Under this free market, the employers have their right to lay off the employees even during this pandemic as the company is always profit over people. Besides, we can see that the lower working class will lose their job and can’t even afford the cost for the medical masks and hand sanitizers. There is no doubt that if they were tested by positive Covid-19, they would not be able to afford the bill. The large bills are holding the people back in doing the Covid-19 test as they don’t know who will pay for the bill. This is putting the society in danger as we all know that the Covid-19 can be transmitted to people easily and have the incubation. Moreover, the government hasn’t regulated the medical system as they think under the free market, the invisible hand will push the price to the balance level. Unfortunately, working more and gaining are not appearing on those lower-class workers. For instance,  the lower-class workers work more but the employers will take all the profits. Under Neoliberal principle, the lower classes are suffering, and the wealth classes are taking all the benefits. In the light of this reason, the social mobility is decreasing, but we all know that the lower classes are the driving force to society progress. Hence, the lower classes don’t have any bargaining power as they can lose their job easily. Let the free market to control and take over everything are making a vicious circle in the society, and the lower classes will never have chance to move upward in the society, let alone paying for the health insurance and the medical bills.

From the above illustration, we can infer that some ideological obstacles are preventing us, as a society, from solving this problem. The main ideological obstacle is the contradiction for the government’s policies. The government tax policies have not been friendly to the poor people. For instance, the sales tax is a regressive tax, so if you have a higher income, the tax rate decreases. Another example is Amazon paid no tax in 2018, but they had 11.2B profit. It really doesn’t make sense. The contradiction is that on the one hand,  the government is supposed to use the tax to do the wealth transfer and improve the public service , but on the other hand, they keep cutting off the tax for the wealthy.  In addition, “If you hand public service to private companies, either you create a private monopoly, which can use its dominance to extract wealth and shape the system to serve its own needs”( Twohig).  This is the privatization , and the government is definitely using ideology to create the medical system they want. Without  funding support from the government,  the hospitals will put the profit to be the priority as they need to bear all the costs on their own. In order to maximize the profit, they have to minimize the cost, so they will suppress the wage of their workers and charge their customer as much as possible. Without the intervention of the government and under the ideology of Neoliberalism, the hospitals have their right to set up the price they want. The U.S government believes that the Neoliberalism can provide freedom to the people regardless wealthy or poor people. The wealthy may find this to be truth in this, but the fact is that all the people should have human right and Libra should not tilt to the wealthy. The Neoliberalism also instills the conception that the people have the personal responsibility, so “it is all on you if you succeed or fail”( Twohig).  There is no denying that we do have our responsibility in success or failure, but the government also needs to take their responsibility. However, the truth is that the government is trying to avoid their responsibility and let the market force to decide all the allocation of the resources. The reason is that they have seen the market and economic growth is driven by the ideology of Neoliberalism and changing the society, such as having more billionaires in the United States. The decision they made is that sacrificing lower class people in exchange for the bloom economy. Covid-19 demonstrates that lower classes workers need more help from the government and the medical system needs to be reformed, or the people will spend their whole lives to pay for their medical bills. We have to face the truth that the world hasn’t been fair since we were born, such as some people can inherit a huge fortune from their parents without even working. The equality is supposed to have a fair environment for everyone. In doing so, the allocation of the resources is getting more and more crucial. What I am seeing in 2020 now is that the gap between wealthy and poor people is getting bigger. Especially through Covid-19, we can see social welfare has not been enough for poor people. For instance, lower classes’ jobs and health are insecure.

In my opinions, the government should play a key role in solving this problem. Given the above, we know that Neoliberalism forces the hospitals to be “a thing oriented” over “a person oriented”. First, the government can raise up the tax for the wealthy and support the medical system. This move can make the private hospitals go public again as the government will share the costs and support their operation. After, the hospitals go public, the government have more control on their service, charge and the profit. Second, the medical system should be as simple as possible, such as cutting off the health insurance, being a single payer system and going with the public health system instead. “Taiwan’s health insurance lets everyone not be afraid to go to the hospital. If you suspect you have coronavirus, you won’t have to worry that you can’t afford the hospital visit to get tested” (Gaffney). Taiwanese are not afraid to go to take the covid-19 test because “Visitors can expect to pay roughly 10-20% of the costs for care themselves, with the remainder being made up by the government”(Expats Guide). Needless to say, Taiwan’s public healthcare system is giving enough protection and confidence for their citizens, and it is also why Taiwan has the lower confirmed cases. Let’s see what the difference is between the Healthcare system between Taiwan and America.  According to Scott,  he points out  that “The Taiwanese health care system is built on the belief that everyone deserves health care”, America health care system is built on the belief of profit. Thus, we can see the power of the single-payer system.

Is it all on the government? The answer is obvious, and it is “No”.  The profit hospitals should take the first step in helping the medical system. They should stop overpricing their service. Being a profit company, the hospitals should bear the corporate social responsibility, and this is unshakable duty. When they start putting people over profit, the medical system will become organized, such as transparent price list and fair charge for the service. Based on my personal experience, the average costs for my arm fracture surgery should be around $25,000-$30,000 in the market, but the hospital charged my health insurance over $100,000 and after my insurance paid 90% of the fee, I still need to pay 10% of that. You may be wondering 10% is not that bad, but what if they charge your insurance more, such as $1,000,000, then you need to pay $100,000. The hospitals should stop scamming their customers. When it comes to robust profits, where those profit goes? Most of the profits go to the management classes’ salary, rather than medical equipment. We have no power to set up the price as they do, so this is the responsibility that they should take for the society.

Individually, we should have the citizenship responsibilities. Some people are avoiding paying for tax, but they still want to have the public service. As an individual, we should stop being selfish as well. Let’s try to imagine that if all the people avoid paying tax but require the government to pay for their healthcare and all other service. Before we ask the government to pay for our healthcare, we should ask ourselves that if we are ready to pay more tax or not. According to Mark,  Europeans express that “ they prefer to pay higher taxes and get government health care for every resident in return”. Also, we should bot abuse the public service. For example, under Covid-19, we should do our best for quarantine. We have right to use the public service, but we don’t have right to abuse it. If we want the society to be shifted from “ a thing oriented” to “ a person oriented”. Then, we should do our job as well instead of relying and complaining the government all the time. There is no free meal in the world.

We are all human being. We will get sick or even a surgery sometimes. My story is a good example that accident can’t be predicted. You will never know that when the accident and disease will come to you. No one expects the Covid-19 will sweeping across the United States and making over 100,000 deaths. Recently, some patients were received a Covid-19 bill which exceeded $800,000(Live). In order to solve the imperfect medical system, we need government, people and hospitals to collaborate on this mission. Sometimes, the government needs our voice to remind them to do better, then we should voice out instead of silent. As the saying goes, “ The silence of the good people is more dangerous than the brutality of the bad people”(Martin Luther King, Jr). If we pay higher tax, but the government will cover the health care for our whole life. The advantages far outweigh the disadvantages. We are human and we will get old and die one day, so don’t try to predict what the next pandemic will come. We don’t predict, but we prevent instead. We all know that we only have one arm and our arms are costly.

Works Cited

Birch, Kean. “What Exactly Is Neoliberalism?” The Conversation, 11 Dec. 2019.

CDC. “Cases in the U.S.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 7 May 2020.

Elassar, Alaa. “A Nurse Revealed the Tragic Last Words of His Coronavirus Patient: 'Who's Going to Pay for It?'.” CNN, Cable News Network, 11 Apr. 2020.

“Expats Guide to Taiwan Health Care.” Expatriate Healthcare, 19 Feb. 2018.

Gaffney, Adam. “America's Extreme Neoliberal Healthcare System Is Putting the Country at Risk Adam Gaffney.” The Guardian, Guardian News and Media, 21 Mar. 2020.

Live, Help Hope. “Amid Shock of Sky-High COVID-19 Medical Costs, National Nonprofit Pledges Help and Hope.” GlobeNewswire News Room, "GlobeNewswire", 10 June 2020.

Pesce, Nicole Lyn. “1 In 7 Americans Wouldn't Seek Coronavirus Treatment Because It Probably Costs Too Much.” MarketWatch, MarketWatch, 29 Apr. 2020.

“6 Reasons Healthcare Is So Expensive in the U.S.” Investopedia, Investopedia, 1 June 2020.

Scott, Dylan. “Taiwan's Single-Payer Success Story - and Its Lessons for America.” Vox, Vox, 13 Jan. 2020.

Thoma, Mark. “Economist's View.” Economist's View: Health Care Costs and the Tax Burden in the US and Europe.

Twohig, Niall. “WCWP100 Lecture 14 and 15 notes”