The year I broke the bank

By Kevin Courtney

A year ago last Friday, I was diagnosed with prostate cancer. Formerly blasé about my health care, I suddenly became one of the neediest guys on the planet.

I’d always passed physicals with flying colors. My bio-machinery hummed like a well-tuned luxury car.

Yes, my cholesterol numbers could have been better, but I didn’t have much to worry about. Forgive me my arrogance, but I thought of myself as a tough, if spindly, Superman.

Year after year, I paid more in health insurance premiums than I consumed in services. I didn’t gripe about it, but this disparity was duly noted. Insurance companies made a killing off me.

2008 was the year of the great turnabout. After 61 years of good health, my body failed me.

With my survival on the line, I submitted to a torrent of medical care at Queen of the Valley and UCSF medical centers.

CT scans, ultrasounds, a bone scan, a one-hour MRI, five weeks of external radiation, the insertion of radioactive-tipped rods, countless visits to specialists, blood draws at the lab. I became a professional patient who did journalism on the side.

As my treatments rolled out, the issue of money never came up. Not once. No provider ever asked for payment up front. I never had to consider whether one treatment option was more affordable than another.

I could be oblivious to cost because I carried a magical card in my wallet. I had proof of comprehensive insurance through my wife’s employer.

I remember thinking, What if I didn’t have insurance? Would my financial crisis be the equal of my medical one?

Do you have any idea what top-flight medical care for my prostate cancer cost? Remember, we’re talking about an organ no bigger than a walnut.

I’ve added it all up. The imagings, the anesthesia, the daily zappings, the reading of X-rays, the lab reports. All told, I racked up $225,000 in prostate expenses.

I’m the Quarter-Million Dollar Man.

This number is so enormous, I have trouble getting my brain around it. I’d been a frugal health care consumer all my life. Suddenly, because of a single positive biopsy, I spent like a drunken narcissist.

The biggest single bill was Queen of the Valley’s — $73,243 for “medical services” in October. UCSF came in second with a bill for $60,337 in November.

There were another 50 bills for lesser amounts. They continue to dribble in. As recently as last week, one arrived for $3,504 for services at UCSF six months ago. From a doctor I never met, at least not while conscious.

While $225,000 seems enormous, it’s a bogus number. Insurance companies contract with medical providers to pay less than standard rates. In my case, my insurer only paid $40,000. That’s 18 cents on the dollar.

Who paid the other 82 cents? Not me. My out-of-pocket for the whole thing was a little less than $2,000. That’s less than one cent on the dollar. Less to save my life than it would have cost to buy a clunky used car.

That leaves $183,000 that was billed but will never be collected.  Doctors and hospitals wrote it off, I guess.

I shouldn’t have a complaint about our health-care system. I got terrific medical care for a pittance. Lucky me.

But while I was going whole hog on medical care, millions of Americans — and thousands of Napans — have scant protection from high medical bills.

They have no insurance or policies with high deductibles. For these vulnerable citizens, a high-cost diagnosis can mean good-bye house, good-bye retirement. Some will end up with inferior care.

My insurance future is also less secure. Because of my cancer history, I’m now a higher risk. If I ever lost my employer-sponsored coverage and had to buy a policy on the open market, I would have to pay a king’s ransom.

In effect, I’m now an insurance pariah. This label is as disturbing as the quarterly PSA tests that I will take for the rest of my life.

If President Obama and Congress want to pass legislation that ensures affordable medical care to all Americans, that’s all right by me.

Kevin can be reached at 256-2217 or Napa Valley Register,  P.O. Box 150, Napa 94559 or kcourtney@napanews.com

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