With health care costs spiraling out of control and Congress grappling with the best way to reform our health care system, there’s a little something they should know about my cat.
Several years ago, Smokey, an orange tabby of seemingly unlimited courage and extraordinary compassion, was stricken by kidney cancer. The veterinarian at nearby Angel Memorial Hospital in Boston – one of the best veterinary centers in the country – told me that Smokey would surely die unless he had the cancerous kidney removed.
Saving Smokey’s life would require surgery, followed by a stay in the intensive care unit with intravenous antibiotics.
My children were 7 and 10 at that time and loved Smokey very much. And Smokey had been my friend for a decade. He had literally attacked my friend’s Doberman Pinscher when it barked at me, sending the dog whimpering away.
I decided to go forward with the surgery, despite the risks and despite the veterinarian telling me the treatment would be very costly.
Smokey came through the surgery just fine, but then complications set in. He was bleeding internally, and needed several transfusions and more aggressive monitoring. And, needless to say, that meant the bill for his care would increase beyond the initial estimate.
Our health care system is broken because the consumers of health care are generally not the payers – insurance companies are. The problem isn’t that there is too little health insurance; it’s that there is too much.
I couldn’t say no. Then Smokey’s lungs began to fill with fluid, because he had received so many transfusions. The only option was to infuse several units of packed red blood cells and devote special nursing resources to Smokey, costing even more.
I was already deep into the healing journey. My children were praying for their beloved pet. So I said yes to the rising costs yet again.
In the end, Smokey survived and thrived, but only after the initial surgery, many transfusions, IV antibiotics, custom blood products flown in from Maryland, 11 days in intensive care and special nursing attention.
The bill was $7,200.
Now, that sounds like a lot to spend on a cat (and it is), but I had it and I was willing to spend it to save Smokey.
But here’s the question: Why would it cost $50,000 to $100,000 or more for the same care – surgery, antibiotics, transfusions, intensive care treatment and the rest – rendered to a human?
I believe the answer is that my cat had no health insurance. The hospital could only charge what it thought someone might actually pay. The marketplace was functioning and keeping prices at least somewhat rational.
Our health care system is broken because the consumers of health care are generally not the payers – insurance companies are. The problem isn’t that there is too little health insurance; it’s that there is too much. In a way, it would be better if insurers paid consumers directly (and somewhat less) for their documented health care needs and then let those consumers negotiate pricing with hospitals and other providers.
An expansion in the use of health savings accounts would also be in the same spirit. Competition for health care dollars controlled by consumers would ensue, and prices would plummet.
Bottom line: Smokey was saved from cancer. The fact that he ended up healthy, for a little over $7,000, proves our health care delivery system in sick.