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If you’re uninsured, don’t get sick

Kelly Dilworth

A few years ago, I had a nagging pain that felt like a runner’s stitch on the right side of my stomach. It didn’t hurt much, but it wouldn’t go away. Feeling nauseous and tired, I decided to stop by an urgent care center after work just in case.

Several hours later, I was wheeled in to an operating room at my local hospital for emergency surgery. It turned out I had acute appendicitis and if I had waited any longer, I would have been doubling over in pain.

The surgery was quick and uncomplicated. I was out of the hospital in a few days. However, as the medical bills drifted in for the next few months, I was astonished. The total cost for that routine but medically necessary procedure was more than I made in a year.

Luckily, I had health insurance through my employer and only paid a small fraction (meaning, several thousand dollars) out of pocket. But then just a little over a month after the surgery, I lost my job at a company that was too tiny for me to qualify for COBRA and was forced to scramble for bare-bones insurance to make due.

Suddenly, the timing of when I got sick felt much more poignant. If I had gotten appendicitis when I was unemployed, I would have been stuck with medical bills so high that there’s no way I would have been able to pay them on my own.

Medical debt is one of the leading causes of bankruptcy, according to a study released in 2009 by the American Journal of Medicine. And it’s no wonder.

Now, a new study published this week in the Archives of Internal Medicine has found that the bills Americans get stuck with for routine procedures such as appendectomies vary widely across hospitals — and even between patients.

According to the study:

  • Charges for a routine appendectomy at hospitals in California range from $1,529 to a whopping $183,000, depending on the hospital.
  • The median charge for an appendectomy in California is $33,611, which is more than a lot of people make in a year.
  • Older patients, those with Medicaid and the uninsured were stuck with the highest hospital charges.

The authors of the study concluded that hospital costs are so complex and unpredictable, it’s nearly impossible for consumers to figure out how much they’ll have to pay for a procedure.

“We talk about ‘consumer-driven health care’ and how patients should ‘shop’ for care,” said lead author Renee Y. Hsia in a news release. “But right now, our system isn’t set up at all for allowing patients to act as consumers. It is nearly impossible — even for me, as someone who studies this — to predict what someone’s hospital bill will be.”

For me, the study also drives home another point. Healthcare costs have become so obscenely high these days that unless someone is fabulously wealthy or has an ultra-secure job with killer benefits, they’re just a run of bad luck away from financial catastrophe.

It’s hard to imagine being uninsured and getting stuck with a $183,000 bill for a short stay in the hospital. However, far too many people know exactly what that feels like.

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