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Learning About High Costs of Health Care in Emergency After Daughter's Playground Accident

Late last year my daughter, a fourth grader, was on the playground at school during recess when she fell from the top of the monkey bars. It was a bad fall, and it appeared she hit her head. The school immediately called emergency services and my cell phone. They told me they thought she was OK, but they also said she was strapped to a gurney and on her way to the emergency room.  

Her teacher, Mrs. Heilman, rode with her in the ambulance and held her hand the entire way. How cool is that? The principal of Moyer Elementary, Mr. Haskamp, followed the ambulance to the hospital and the Fort Thomas Independent Schools Superintendent, Gene Kirschner, personally called me to make sure we had everything we needed.  

After a quick ambulance ride to St. Elizabeth hospital, which is about a half mile away from her school, they began checking her out and taking x-rays. The doctor and nurses were terrific. The school was terrific. It turned out, she was fine. She was bruised, she was scared, but she walked out of the hospital.  

Thank God.  

This column isn’t about the educators, the response by the emergency responders, or the doctors. I still get choked up thinking about how wonderful everyone was. What this column is about is what came after: The bill.  

(Cue the scary music – “dun dun dun”)

My company has excellent insurance, as well as a Health Reimbursement Arrangement (HRA), but I almost never use it. I had no idea what something like this would cost.   When I started receiving bills, I honestly thought they were mistakes. I didn’t receive a single bill. I got multiple bills. One from the emergency room. One from the doctors. One from the ambulance service. One from the radiology department.  

It was all confusing and seemed expensive.  

All told, the bills totaled up to over $2,200.  

Excluding the educators, this emergency pulled away at least a half-dozen professionals for 15-30 minutes each. When you factor in equipment costs and administrative fees, I’m sure it adds up pretty quick. But it was, to say the least, much more costly than I would have ever guessed.    

But it wasn’t just the cost. Navigating the waters of “how to pay” is terribly confusing and was a challenge, even for the insurance experts I asked to help me.  

Did you know that most fire departments in the area bill you directly for an ambulance run? I didn’t know that. Honestly, I thought that was a service we received by paying taxes.  

Between the school’s insurance and my company’s insurance, the total out of pocket came to just shy of $600. Not as bad as $2,200, but not terribly good either. Of course, the $1,600 the insurance companies paid impacts our expenses next year when we figure out our rates.

So, the question is, knowing the expense and hassle involved, would I still want the school to call emergency services if the same thing happens again in the future? With liability concerns, would the school even have a choice? The doctor told me he was 95% sure she was fine, but with malpractice liability issues, did he really have a choice to not do the x-rays?   

When you receive other services, you typically get quotes. But my experience was, in an emergency that involves someone’s life, you don’t shop around for the best deal. 

Look, this could have been a lot worse. I realize that even with a major unforeseen expense, we were very lucky.  Compared to other families out there that have had long term illnesses, enormous health care bills and serious heartaches, believe me, I’m not complaining.

But this brief glimpse into the world of health care was eye opening. Our experience was one of terrific quality, but at a very high cost. 

I can’t even imagine how difficult and expensive the system must be for the thousands in our area that have chronic conditions requiring chemotherapy or a transplant.

Whether you hate the Affordable Care Act (ACA) or not, without the current Medicaid system in place, it is clear that hundreds of thousands of Kentuckians couldn’t get care for their families. None of the health or insurance officials I’ve spoken with disagree with that assessment. Heck, the middle class is struggling to survive the current costs of health care, so you can forget about the working poor being able to do it. Not without help.

Trying to be objective about the ACA, I think it is safe to say that it hasn’t gone far enough in controlling costs. Let me say that again: IT HASN’T GONE FAR ENOUGH IN CONTROLLING COSTS. We continue to have a serious problem with the cost of health care in our country. 

Malpractice reform, additional oversight, patient-centered medical homes, Accountable Care Organizations built around hospitals, and community health policies that focus on healthier living are all ways to help reduce costs. I’m all for those conversations.   

Without completely starting over as some have recently suggested, both the left and the right could give a little to improve the situation. Kentucky is arguably the unhealthiest state in the union and, in general, it seems our elected leaders have been choosing idealism over pragmatism. That needs to change.

I don’t have all the answers, but I sure have some questions. I’m sure many of you do as well. We need to be asking those questions and encouraging thoughtful discussions that will lead to some solutions. 

Regardless of what happens, I remain convinced we need to value education and health in our community if we want a better quality of life and a thriving economy. 

After all, in today’s world you can’t have liberty and the pursuit of happiness, if you don’t have an education and your health.

Brent Cooper is the president of C-Forward, a Covington-based IT firm. He resides with his family in Ft. Thomas.