“What’s the primary goal with regard to your stay here?” she asked.
“That it be as cheap as possible,” I replied, my spirits sinking. I knew how impossible that was.
She looked at me intently.
“Sir, we want you to focus on getting well. Please don’t think about the cost; that can all be worked out once you’re healthy again.”
So many times, I’d heard myself say these very words when a patient expressed concern about treatment expenses.
But now I realized the truth: No one involved in my care actually knew the cost of any of the treatments they were suggesting.
Despite the evidence I’d found online, it was hard to stand up to an army of MDs telling you that you need surgery. Although I feared that my insurance coverage wouldn’t come through, I resigned myself to going under the knife.
At 5 p.m., my nurse informed me that emergency surgeries had preempted all the anesthesiologists and that my procedure would happen as soon as anesthesia was available.
“Don’t worry,” she said reassuringly. “Appendectomies don’t get canceled.”
My phone rang. It was another supervisor from work.
“How do you feel?” he asked.
“The pain is 5 out of 10,” I said. “A little less than this morning.”
“Andrew, get out of there. We’ll schedule you for an appendectomy as an outpatient procedure tomorrow. You’ll save a lot of money.”
Seconds after hanging up, I pulled out my IV. I walked out of my room and down to the nursing station.
“I’m signing out against medical advice,” I told my nurse.
She looked shocked. “Sir, please don’t do this. You could die.”
“I’m not going to die,” I said. “If I need to, I’ll come back.”
I texted my supervisor, asking him to call in prescriptions for the antibiotics used in the studies. That night, I started taking them.
The next morning, my pain was down to a 3. I declined outpatient surgery.
Over the weekend I lay low, and on Monday I worked a full day. On Tuesday night, I attended my regular yoga class with no problem.
On Wednesday, I got word that my insurance would apply retroactively from the first of the month.
Then the bills started to arrive. The full tab for an ER visit, a CT scan, a dose of IV antibiotics and hospital admission came to more than $30,000 — and that was without an appendectomy.
Two weeks later, I finished my oral antibiotics. Total cost: less than $50.
It’s now six months later. I haven’t missed a day of work, and I feel great.
Had I known that my insurance was active, I certainly would have had that appendectomy. In retrospect, I’m thankful that I didn’t know. A 77 percent success rate may not be acceptable to an American surgeon, but it was good enough for a guy without insurance. Now if I need an appendectomy, I know it will be covered by insurance.
It’s easy to tell a worried patient, “Let’s worry about the cost once you’re healthy,” but having been that patient myself, if only for a day, I know how thoroughly the fear of medical bills can obliterate any concern about health or healing.
Nowadays, when someone asks me how much a treatment costs, I no longer get annoyed. I go and find out.
This is an edited version of a story that originally appeared in “Pulse — voices from the heart of medicine,” an online magazine of stories and poems from patients and health-care professionals.