Bills, bills, bills

I've been wanting to write a piece about the financial aspects of illness for a while, but I wasn't sure how to frame it. I didn't want to seem like a whiner, after all we have so many blessings in our lives. And I didn't want to get too political. But the financial part of illness can't be ignored, so I figured I would just lay it on the line. I just ran some end-of-year reports in preparation for tax season, and even though I keep really close tabs on our finances (10 year budget, anyone?), I was still SHOCKED at the amount we've spent on medical bills. In 2011, we personally spent about $17,000 out of pocket. According to the insurance company, the total amount billed by doctors and facilities was $1,077,309.82 (yes, as in 1 MILLION dollars). My "responsibility" was listed as $31,966.64. Some of those bills were written off by docs, which is why our portion was more like $17,000. I know sharing this might be an "overshare", but it's reality. I really don't think people know how much it truly costs to be sick in America.

Anyone who has ever had to deal with a chronic or major illness knows that a HUGE amount of stress comes from the financial fallout associated with medical bills. Growing up, I always took healthcare for granted. My parents weren't super hypochondriacs, dragging us to the doctor every other week for every sniffle and bruise, but they took us if needed. We never saw bills or knew about medical insurance premiums. Even in college, there was always the nurse on campus for minor prescriptions - sinus infections and whatnot - and I was on my parents' insurance for everything else. I remember visiting my ex-boyfriend in North Dakota one holiday and having to go to the emergency room for a bladder infection. Who knows how much that little visit cost my dad, but it was never mentioned. My parents were wonderful about making sure I knew that I needed to go to the doctor when I was ill and not worry about the money. After all, some things were more important.

Mike and I have struggled over the years between layoffs and changes in salary, but we try to live by the solid principal of not spending more than we earn. We've paid off so many things together, and before I got ill, we were not carrying any debt. We had used Dave Ramsay's ideas to pay down as much as we could and tried to live within our means. And then I got sick. The bills started slowly at first, and they were manageable. We were able to keep up with everything and didn't have to carry any debt for several months. Then I got my bill for my first kidney biopsy. After that, the bills started streaming in regularly. I started to understand that gnawing feeling you get when you flip through the mail, hoping and praying that there aren't any new bills. I paid what I could and set up payment plans for the rest. Finally, after my second hospitalization, I hit my out of pocket max and everything was covered at 100%. While that was such a huge relief, we continued paying on our installments on the big bills and knew that a couple months down the road, the insurance year would reset and we'd be back at square one.

Each year, we debate which medical plan is the best option for us. It's always a struggle to determine what kind of coverage we need, but I have learned so much more about insurance over the years. I know that I personally would like to have as much money in my paycheck as possible, even if I have to pay a higher deductible, because once a premium is paid, it can never be returned. If I got the best coverage, I would see nearly 1/3 of my paycheck disappear each month. I just don't think I can stomach that. I also have learned that hospitals and doctors actually do understand the financial crisis we have in our health care system. Every person I've talked to has been so incredibly understanding. When I tell them that I can afford to pay them $25 or $50 a month, they always assure me that there's no problem with that. Most doctors offices and hospitals don't charge interest, so payment plans are an infinitely better option than putting it all on a credit card. I learned that lesson the hard way at the beginning of this adventure.

Politics aside, I have always felt that a country has a duty to uphold health care for its citizens. Going through the things we've been through these last few years - unemployment, major medical issues, applying for grants and federal aid - have all shifted my social lens even more. Once I start dialysis, I'll qualify for medicare because the costs of dialysis are so great that private insurance companies would find ways to prohibit coverage. Being on this end of things - asking for help when it's the last thing you want to do, swallowing your pride and realizing when you've gotten in over your head, and knowing that nothing - no amount of careful budgeting or planning - could have prepared you for the incredible amount of money that being sick costs, really reinforces my belief that a country must stand up and support its citizens. I'm blessed with a solid job, an understanding and flexible work environment, supportive family and friends, and a hard-working talented spouse. Together we have been able to weather the storm relatively well, but I also think of how different things might be now if I had lost my job or was unable to work, losing insurance and income. It truly happens so easily and quickly.

I think the thing that bothers me the most is that money - one of the most common sources of stress - is the first thing on the mind of many people who are chronically ill. While their energy should be focused on healing and recouping, too much stress is felt from the constant influx of bills. I wish there was a waiting period of sorts where medical billing could be delayed until the patient had recovered. I remember sitting in the hospital with my computer paying bills and balancing our accounts, crying from stress over money and bills when I should have been resting and trying to get better. I know the doctors need to be paid so they can earn their livings too, and I don't really know how to solve the problems. All I know is how it feels and how we're managing. We take things one day at a time, slowing chipping away at the bills and hoping that - one day - they will slow down.