Let’s all be outraged for a minute, shall we?
How, how, how are we going to fix the health care system? How can small business owners, families… ANYONE deal with the cost of health care? How can a simple sinus infection cost ~$300 to address?
I have a sinus infection. No big deal, right? It’s going around right now. But I’ve had it for more than a week, and it’s getting worse, not better. I’m starting to lose income because all I want to do is sleep. I’m grumpy. I’m whiny. And I have to run 13 miles tomorrow. I cannot afford to be sick.
So, yesterday I broke down and went to an urgent care clinic. I’ve had a lot of sinus infections, and usually I wait and wait and wait then go to the doctor only to have him give me antibiotics that make me feel better in 24 hours. So this time I decided to go a little earlier than usual to avoid the extra days of misery.
As a small business owner, I struggle with the costs of health insurance. I secured what amounts to coverage for catastrophic events, paying about $175 a month for a $5,000 deductible and a Health Savings Account, which I also pay into every month. Right now I have about $1,000 in it, so I figured I could spend a little to feel better. That’s what it’s there for, right?
I told the doctor I thought I needed antibiotics, and he went into the long explanation of why doctors no longer automatically prescribe antibiotics. Most of these colds are viral. Most of the time antibiotics will do no good. When we overprescribe antibiotics, it can contribute to the creation of antibiotic-resistant “super bugs” that are increasingly hard to treat.
I know all this, and I feel guilty that I was asking for an antibiotic. But I felt like I understood my symptoms very well and needed more help.
The doctor said one way to tell if an infection was bacterial was to get an x-ray of my sinuses — I think he said something about a snot-to-fluid ratio, but I’m not sure. All I heard was CHA-CHING! How much was an x-ray?
As the nurse was leading me down the hallway to the other department, I asked how much x-rays were. I started to get this panicky feeling in my chest — the visit to the clinic was likely to be $150. X-rays… maybe another $100? So $250 for the doctor to tell me to take two aspirin and pay on the way out?
For the first time in my life, I stood up to ask more questions about a medical test. I’ve had dozens of sinus infections — this was the first x-ray anyone had ordered. And I just couldn’t afford to wipe out a quarter of my health savings for a cold.
So I asked to speak to the doctor again first, and I started to cry (remember I was sick — and whiny). “All these expenses come out of pocket,” I said. “If your gut tells you this is viral, and you’re going to tell me there’s nothing that can be done, no problem… I’d prefer to just go home now without the x-ray.”
Long story medium, he did other tests and determined I needed antibiotics and other meds. Or maybe he was just giving into my whining. I don’t know. The prescriptions cost $125. The visit is going to be about $175, I think. That’s $300 for a sinus infection, and about 1/3 of my savings.
My stupid little sinus infection that I never should have seen a doctor for is so very, very minor. What if something big happened? What if I had kids? What if I couldn’t get health insurance or couldn’t afford to put money away? In fact, I was just thinking of slowing down my contributions to my HSA because I thought I had enough money stashed away. Now I know that even a small problem can wipe that account out.
I get scared, friends. I worry for people who can’t afford coverage. I imagine moms in a doctor’s office, knowing they’re facing medical bills they’ll have trouble paying when their kids are sick. Boyfriend D.J., who’s a bankruptcy lawyer, says medical problems are one of the factors that regularly seek people to ask for his help. What are we going to do?
I have no answers. But I have tons of questions.



Beth on 06 Mar 2009 at 10:21 am #
Here’s what I’m telling myself after my sinus infection incident:
Beth, repeat after me: “I will not run to the doctor when I have the sniffles.”
SOndra on 06 Mar 2009 at 7:34 pm #
Bingo, that is how health care works. I struggle with these same issues. I want to know if you like HSA plan, I wanted to start mine in Jan. hummm, I haven’t done it yet. Maybe that’s your next blog idea….procrastination. Tell me when you feel better
Dr Kadiyali M Srivatsa on 07 Mar 2009 at 3:27 am #
“Easier said than done”, I have worked as a doctor for more than 25years and know most doctors use their common sense less. You cannot differentiate bacterial from viral infection based by X Ray, what a load of rubbish, this doctor must give up medicine. You must know bacteria are living one cell organism. They release toxins which will make you feel hot and cold. Very high temperature is likely to be viral. Doctors have undermined the confiedence of people and I am ashamed of myself for not doing enough to educate people.
I have published a website listing common symptoms to educate people. I am sure you find this useful and help you reduce visiting doctors. Soon I am planning to publish a programme that will help people like you & parents of young children.
Andrea on 10 Mar 2009 at 1:46 pm #
I can’t help but notice that you were correct, you needed something for the infection. And you did something important…you asked questions and got information and were direct with your medical professional about your needs. Kudos to you, girl.
The larger issue of medical insurance is HUGE!!! I’m getting the bills in for my November surgery, and every day I am grateful my employer provides excellent medical coverage. I would like to point out that this surgery was unavoidable. Nothing I could have done to take care of myself would have prevented it. Total bills to date (before “contracted discounts”) are about $50,000. I’m grateful it’s only been about $2,000 out of pocket for me. If I didn’t have the health coverage I do, I would have been asking you for DJ’s business card! I’m lucky to have good coverage…and I have thanked my boss for maintaining the quality of our insurance in spite of current economic challenges. The sad reality is I’m in the minority where this is concerned.
LisaNewton on 11 Mar 2009 at 5:19 pm #
I know how this goes. A friend of mine pays more than you do for similar coverage. She’s reluctant to go to the doctor for just the reasons you outlined.
Just as Andrea said, it’s “HUGE!!!”
Craig on 13 Mar 2009 at 10:20 am #
I have no answers.
Every time I say anything about how the health care industry needs to be regulated or reigned in, someone else points at me and yells, “Socialist!”
Now I shut up — and pay up.
sarah on 16 Apr 2009 at 7:54 am #
Just had a sinus infection. My internist is hard to get into, so I went to an urgent care center at a CVS pharmacy (Walgreens and other drug stores are begining to get into the clinic biz). Negative is that they only treat limited conditions and are typically staffed by a nurse practitioner (overseen by an MD offsite). Although controversial because of this structure, the clinic really fit my need. I was able to get in and out with a prescription for an antiobiotic in about 20 min. (she basically looked in my nose and ears, felt around my face to identify areas of tenderness, asked symptoms, etc.) Cost was just my $20 copay (they even handled processing with my insurer). Those without insurance would have paid $62 (Minute Clinics have a straightforward pricing list). Obviously, doesn’t solve the big issues. But hopefully other healthcare providers start aiming more frequently for similar convenience and direct pricing.