Read the longer form article below, or listen to the piece aired on NEPM HERE.
“If I made four-thousand more dollars two years ago I would be bankrupt today,” Karl Prahl explains. He’s sitting at the kitchen table of his small apartment with a cup of coffee. His dog, Leche, wags her tail by his feet.
Two years ago, after noticing a loss of sensation and motor control in his right leg, Prahl was diagnosed with a non-cancerous tumor pressing dangerously on his spinal cord.
Prahl is a poultry farmer in Easthampton, MA. His limited mobility because of the tumor, and his long recovery from spinal surgery drained his financial resources as he had to rely on friends and new employees to keep his farm functioning and his birds alive during his recovery.
What he didn’t have to deal with was overwhelming medical debt.
“I probably would have died if I was still living in Iowa,” he said matter of factly. “I wouldn’t have had insurance and when they told me the cost of an MRI, I wouldn’t have been able to cover it.”
He’s not alone.
Healthcare costs are the leading cause of bankruptcies in the US. Most people with medical debt owe over $1000. This is a particular burden when approximately 4 in 10 Americans couldn’t cover an unexpected bill over $400.
With an average visit to the ER in Massachusetts costing around $1200, anyone experiencing a medical emergency could find themselves in financial hot water literally overnight.
And medical expenses can add up remarkably quickly. The average cost of an MRI is $1325. In Prahl’s case he has needed seven. So far.
“The neurosurgeon wants me to come in for an MRI every year.” He shrugs when I ask him what he’ll do if he loses his medical coverage. “I won’t get an MRI. I couldn’t.”
For many people in the Pioneer Valley, where the average household income is well above the national average, medical debt isn’t a concern. However, that optimistic feeling is, at best, limited to groups with insurance, and at worst only a single medical emergency away.
This seems more surprising in light of the fact that the United States spends nearly double per capita on health care as other comparable countries, most with nationalized healthcare systems. For all that extra money, we have, overall, worse healthcare outcomes. Our maternal mortality rates, for example, have double since 1985, matching the pre-war maternal mortality rates of Palestine.
What, exactly, are we paying for?
Those of us without insurance will either forgo necessary care or will end up saddled with medical debt. While those of us with insurance may briefly note in amazement what our care would have cost us if we didn’t have insurance coverage.
Though the number of insured people in the US has been steadily decreasing, there are still 26 million adults without insurance. The number of underinsured is much greater, 43% of working age adults.
At the moment, at least for Prahl, everything is, if not fine currently acceptable. He has been able to receive necessary medical care. Masshealth saved his life. What might it be like if the 26 million adults in the US currently without insurance could say the same?
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