This is how we're taught to think, healthcare as profitable.
The Economics of Greed - 002 - the American Healthcare Industry - My Story
2/18/2025-2/21/2025
Last year, I incurred quite a lot of medical expenses. This is the story, the numbers behind it, and my opinion on the American Healthcare system. .
The Injury
We had camped in my truck on our way up to Aspen, Colorado back in July, sleeping on a queen size futon on a custom frame I’d built to fit over the wheel wells in the bed of the truck. When we got back, I didn’t take the frame out, which made the bed of the truck about eight inches taller than usual. So, during one of the next Burnout shows, I loaded all of my drums into my truck the way I always do, all nonchalantly and just kinda using the muscle memory and brute force I’ve always used. No problem loading up and heading to the venue, but loading back up after the show, something happened, and I made a Ric Flair noise. I shrugged it off, as is my wont.
The next morning was rough. I could hardly get out of bed, which is incredibly unlike me. As a nearly lifelong proletarian, I have always “worked through the pain,” but it just wasn’t going to work this time.
I am incredibly blessed to have very basic, high deductible insurance that I’m provided at no cost to me through my progressive employer, which is absolutely unheard of and usually costs people with children several hundred a month out of their paychecks, which is criminal in the first place. I’m incredibly grateful for it. I went to the doctor. The first visit was $45. And then it just goes up from there, like a really dramatic curve upward. See the breakdown below.
So, basically I had scheduled a physical on 9/11, just a plain old physical, during which I talked about some long-term hip pain, which I’ll get into later. They prescribed physical therapy (PT), which I scheduled for the next pay period when I’d be able to more easily afford it. At the time, we were extremely house poor, having just spent our life savings on buying a house (yay). The injury then happened on 9/18/24, but the PT was already scheduled, so I just “took it easy,” which is hell for me. We had already planned a quick beach trip for that weekend, and we went, but I could hardly enjoy it because of the pain I was still in, and because there were a ton of jellyfish in the water.
I went to PT on 9/24/24 and told them that I needed to talk about my back rather than my hip, that I had suffered the injury and was pretty jacked up. From what they could tell, I was probably having pretty serious disc issues and needed X-rays etc. I paid them $130.
So I got the order from my doc for the x-rays, paid the $84.74 for those, then another $45 to my doc for him to read me the x-ray results, which then triggered an order for an MRI at $345.38, and I also did another $190 in PT within that week. I then had to wait another pay period to pay specialist price of $90 for a nurse practitioner to read me the results of the MRI, which were that I was not in danger, but that I would have to basically do stretches and PT for the rest of my existence, but at least I didn’t need surgery, for which I was thankful.
In the end, I decided to not go to the last six PT appointments and just go forward on my own, which was the right choice, financially and physically. It’s ridiculous that one would even have to choose between imaging and PT, but there I was, and I made my choice. After all of that, I spent $1,064.97, including that last remaining balance for the PT provider because the insurance decided it wasn’t going to pay for part of that care.
The Backstory
I basically destroyed my body for twenty five years for the dreams of other men. That’s my construction career distilled into a single sentence, and I’ve talked about my career and shown the lovely things I was able to build over those years in this blog. My memories of that time are all very bittersweet, but I was brutal to my body, working hard, fast, and for many, many long hours, and it resulted in a lot of arthritis in a lot of places, including my bad right hip, that thankfully don’t hurt too terribly yet at 45 years of age.
Essentially, I was a fool and did this to myself, despite having a degree in English that could’ve led me to other interesting places, including a year I did teach middle school English Language Arts, but that’s another story full of corruption and neglect.
Most of those years I didn’t even have health insurance, as is the case with most blue collar workers in South Texas. I even worked as foreman for a municipal golf association maintenance crew that was basically created by the city of San Antonio so they wouldn’t have to pay municipal benefits. I came in as most of the city employees were going out. This was fifteen years ago, about the middle of my career in the field of landscape construction and maintenance.
In 2009 when I was working at that very municipal golf course, I was in a motorcycle wreck that I’ve written about before, where I broke my tibia, fibula, and suffered a compression fracture of my L1 vertebrae. In one of the most glaringly disgusting examples of the American healthcare system, the medics in the ambulance asked which hospital I wanted to be taken to, and I said the nearest one, which was part of our Baptist Hospital System. I didn’t have insurance, but I had just gotten into a major motorcycle wreck, so it seemed logical to me.
Well, they did x-rays of my back and ankle at the Baptist hospital, and after they learned I didn’t have insurance, they patched me up “well enough” with some crutches for my wrapped ankle and nothing for my fractured spine and sent me to University Hospital, where I had to wait in the ER waiting room for over 24 hours, then get on their proprietary payment plan, which isn’t insurance, called CareLink, most ironically. I then sat in a recliner in a complete torso brace and with my ankle in a cast for two months at home.
I was back on a mower and spray rig eight weeks later because I couldn’t afford to take the time off, definitely not fully healed, and I re-taught myself to walk on that broken ankle very poorly and still suffer occasional severe pain. No Aflac, no benefits of any kind. Also, because I didn’t “milk the system,” the insurance settlement from the guy that hit me didn’t provide very much at all, and so it paid the bills I’d accrued, and a few luxuries I don’t even have anymore. I left my job at the golf course, then went to finish my English degree in two years at Incarnate Word while working on their grounds crew part time with no benefits.
So the moral of the story is this, most people can’t afford healthcare at all. If I didn’t have the job I do now, I’d be in a major financial crisis, and the fact that I could pay for all this is frankly somewhat a miracle with all the modern costs of home ownership and everything that entails.
All I did was lift a drum incorrectly, and it cost me over a thousand dollars in two months. All of the work I did all those years before led to a variety of physical issues that I’ll be trying to mitigate for the rest of my life, and it led to me figuring that I would just always be able to power through everything, which isn’t really the case now that I’m a middle-aged man working from home.
The System
So, did I really need to pay for all those follow-up appointments? Was it really necessary for me to take the extra step of an x-ray before getting an MRI? Should I have to pay full-price for imaging despite having health insurance? The obvious answer is hell no.
The current system is designed to maintain us in a state of existence that provides for itself, not for us. Is there a point to curing people when your shareholders want your profit report ever increasing? The evidence is in my story, and in the steps I had to take to get actual treatment, in having to pay for each step and each follow up of each step. Refer to the table above again. Those dates are very closely packed, and I was in enough pain to consider it a financial priority.
Consider patients with chronic pain, diseases, and disorders as well. While I have no real personal experience with that beyond the manageable arthritis I gave myself and all the things going on with my aging mother, it behooves medical providers and their pharmaceutical counterparts to maintain them in like a suspended state of manageability. There’s no reward in curing people when it comes to American capitalism. That’s just logic, and it’s true.
Have you ever seen a pharmaceutical company rep going into a doctor’s office? Did you see the car in which they pulled up or drove away, or the designer clothes they were wearing? I can’t prove pharmacy kickbacks happen, but this is America, and kickbacks happen in every other industry in this country.
What Solution?
We don’t even need money anymore. I’m just going to keep repeating that until someone listens. We need a meritocracy, and we seem lightyears away from that right now in February of 2025, with our current president and his “administration” dismantling all kinds of progress, policies, and institutions, perhaps some of it rightly so, but most of it just cruel and unjustified.
While I’m sure many healthcare providers feel very rewarded through the work they do in actually curing people (which I feel CNAs and nurses are doing most of), that should be the default motive for that industry and work, not creating as many steps as possible to drive shareholder and industry profits.
The worst thing about regulation is that we need it at all to help save the majority of us from greedy, unscrupulous people who’ll stop at nothing to acquire more wealth and power. And that’s the point. We regulate because we must, not because we want to squash people’s freedoms. The current political climate has a lot of gullible people believing that regulation equals oppression, and that’s devastating at this point in humanity’s evolution.
We have the technology and the ability to move away from these kinds of profit-driven systems, whether in healthcare or housing, but alas, the two political parties in the US have amassed so much wealth and power at the expense of its citizens that they are the current major roadblock in evolving as a culture and even a species. There’s no reason that healthcare should cost so much, nor be a deciding factor in how or where one is able to live. We shouldn’t have to choose between paying household bills or getting medical treatment.
However, this is where we are until a lot of people wake the fuq up and a progressive movement really takes hold, preferably globally. Humanity is meant to change, to adapt, to live in community, and it’s going to take a lot of work to move forward with those ideals rather than the capitalist imperialism that has been preached for centuries.
