THE BLOG

Beverly Hills Adjacent Medical Bills

05/17/2010 05:12 am ET | Updated May 25, 2011

As the mother of a kid with chronic health condition, I'm deeply invested in health care reform.

Just one night in our lives provides an example of the failures of our health care system, the connection between jobs and health care, and game of chicken we're playing with our future.

In less than a 24 hour period, we managed to rack up a $22,000 bill at what turns out to be the most expensive place to spend the night in Los Angeles. How did we run through that kind of dough on a night that included not one meal, massage, face lift or bottle of Veuve Clicquot? We checked into our local hospital pediatric ward.

Our twelve year old son was experiencing severe abdominal pain. His physician, fearing a bowel obstruction, ordered an x-ray. After that x-ray didn't yield useful information and because the wait time for an appointment with a local specialist was over three weeks due to the fact that he sees Medi-Cal patients, our kid became one of the millions of Americans who on a daily basis seek pricey care at a hospital emergency room.

When we were advised our child would need to spend the night for observation, none of the staff laughed when I asked if we would get a break on the price since he wouldn't be eating or drinking. Since earlier in the day, the imaging center (which has a relationship with the hospital) refused to give us a copy of the film, he needed to have an identical x-ray to the one he'd had only three hours prior. At midnight a CT scan was ordered. Finally, in the wee hours of the morning, as my son settled into his bed, I collapsed into a contorted heap on a cot reminiscent of Papillon's prison slab. Luckily, he was able to weather this episode without surgical intervention, and we departed less than 24 hours after our arrival.

Let's do the numbers:

The room charge was 4,209 dollars. Just for perspective, you can get a private villa and full day spa vacation for less than that down the street at The Peninsula Hotel, although with sheets that had a thread count of about two, you could say it was exfoliating. The afternoon x-ray cost approximately 600 dollars, while the exact same hospital film tallied in at a whopping 1,286. The emergency room service was 4,064 dollars. The CT scan was billed at 8,928 dollars. Call me naïve, but that seems a tad pricey. We spent exactly ½ hour in there. Add in lab fees, all told, just over 22,000. Dollars. Plus the 80 dollars to the chiropractor I had to shell out after I woke up shaped up like pretzel.

The cost is only half of the frustration. Because of the Byzantine nature of the hospital's billing system we've received over a dozen invoices so lacking in transparency they might as well be written in Cyrillic. Each notice contained contrary and conflicting insurance information that required me to call in the correct information for every single charge. Our insurance company then issued reams of letters questioning each charge, followed by a slew of explanation of benefit statements, none of which seem to relate to the bills we have previously received. In fact, when I called the insurance company to trace the provenance of one particularly impenetrable bill, the adjuster admitted they hadn't called the provider either and the phone number they had on file turned out to be a random person's private cell phone!

This is not news for our family. Since our son's birth and diagnosis with VACTERL a constellation of birth defects, we've racked up over a dozen surgeries. Rarely a week goes by when I don't receive a threatening letter or two from the hospital even though they know full well the insurance company is still evaluating the claim. It is so confusing and overwhelming, that I used to pay before the insurance adjustments had been made because they'd just plain worn me down. What is news is that I can't afford to do that anymore and now lose work hours each day on hold with claims adjusters.

Our insurance will likely pony up something in the range of 5,000 dollars but if history is any teacher, our bill won't be resolved until sometime in 2011 and I wonder how the dedicated professionals who follow our son's case can stay in business. And what if we don't continue to find enough work to qualify for our employment based plan? We now fall into that category of uninsurable people with "pre-existing conditions."

Though at this point, my union's health care plan is more Pinto than Escalade, I am concerned about how the proposed Cadillac tax might affect us but I've seen how failure to embrace change can be as damaging as taking a dangerous leap of faith. Fear of changes to our earned benefits has stymied the much needed merger of the two competing Actor's Unions. The result has been less bargaining power, less work for members and consequently less money to fund health insurance which in turn gave us higher deductibles and larger co-pays. So I'm throwing caution to the wind. I'm willing to risk being taxed because even though I only live "Beverly Hills adjacent," I've got luxury-sized bills on a compact budget.