A patient has just had a heart attack. The question he is faced with is: How much will it cost?

Our patient picks up the phone and calls 911. The emergency operator asks, “Which service provider would you like? We have an ambulance with well-trained paramedics that will cost you $1,800 to respond; we have the volunteer fire department that will cost you $600; and we have Archie’s Emergency Services, which will send a covered pickup truck to transport you to the hospital for only $200.”

The caller, lying on the floor grasping his chest, yells, “Send the ambulance! Now!”

Before our patient enters the emergency room, the hospital administrator greets him at the entrance. “Sir, which service do you prefer? We have our Trauma Care, which will cost you $25,000; our Emergency Care, which will cost you $10,000; or, you can have a seat in our waiting room.”

“For God’s sake, I’m having a heart attack. Save my life!”

“So, you want Trauma Care. Good choice, sir.”

After emergency services have been completed, the administrator stands next to the patient’s bed. “Sir, it is the opinion of the doctors that you will need a pacemaker.” She takes out a price sheet and places it in our patient’s hand.

Our patient looks over the price sheet. “Why is the pacemaker from Archie’s Medical Devices only $400?”

“Those are recycled pacemakers, sir, taken from cadavers.”

“My God, who would want one of those?”

“There are some people who can’t afford anything else,” the administrator replies.

“Well, what’s the difference between the $2,000 device and the $18,000 device?”

“The $18,000 device comes with a lifetime warranty. It usually isn’t covered by insurance.”

“How do I know if it is covered by my insurance?”

“You will have to call your insurance company to determine that.”

“When do you need to know my choice?”

“Well, you need the operation sooner rather than later.” She pulls out another sheet of paper. “These are the prices for the procedure to install the device.”

Our patient looks over the sheet. “What’s the difference between the $5,000 procedure and the $100,000 procedure?”

“The $100,000 procedure is performed by one of the best physicians in the country. His success rate is more than 90 percent.”

“And the $5,000 procedure?”

“That is performed by medical students from the university.”

“Which is covered by my insurance company?”

“I’m sorry, sir, you’ll have to call your insurance company to determine that.”

After spending two hours on hold with the insurance company’s call center in India, our patient finds out that there is a coverage sheet to help him determine out-of-pocket costs for each procedure. He can access it on the website.

Our patient screams into the phone, “I’m in the hospital!”

Two months later, our patient is recovering at home with his new pacemaker. He has missed several months of paychecks from his job. Thank goodness for free-market medical care, he thinks, as he dumps that day’s newly arrived pile of medical bills into the garbage. Reading them would cause undue stress that could lead to another heart attack.

 

Richard Crose lives in Bloomington.