Apparently my earwax is worth $146.
Back in March, I was watching TV at home battling a head cold when suddenly it felt like someone poured a whole bottle of water into my ear then was punching me repeatedly in the side of the head. I went to bed and figured I’d sleep on the opposite side of my head to see if my ear would drain and I’d feel better. If not, I told myself I’d do something I rarely do — go to the doctor.
The next morning I woke up and still felt terrible. So before heading to work (I don’t do sick days unless I’m literally on the edge of the death), I stopped in at the clinic.
“Yeah, I think I’ve got an ear infection because I’m 5 years old again,” I told the RN who was checking on me.
She peeked in my ear. “Yup, that’s infected,” she said. Then after looking in my other ear, “You’ve got a lot of wax buildup in here. Do you use Q-tips?”
“Nope,” I said. “I hear you’re not supposed to. And doctors always tell me my ears are waxy, so it’s like, how am I supposed to deal with it?”
She rattled off a few suggestions then offered, “We can remove some of that, which may relieve some of the pressure and help you hear better.”
“Sure,” I said.
Stupid me. I should have known that what sounded like an innocent offer of help was actually me agreeing to a costly medical procedure.
The nurse came back in with a little plastic sticky thing and poked around in each of my ears for about 5-10 seconds, pulling out some nasty clumps of brownish wax. (She was right, though, it did feel like someone had pulled two corks out of my ears).
Three months later when the bill for the visit showed up, it read “Removal impacted cerumen” — $146. That was on top of my $120 office visit.
After insurance discounts, my bill was $118.38 to go into the office to confirm my own self-diagnosis. Then people wonder why I never go to the doctor.
And, once again, it reinforced my belief that a main problem with American health care isn’t with insurance companies and the cost of insurance. The problem is that there is absolutely no transparency in pricing and no price controls in place.
Your medical provider can literally charge you whatever they want for the services and the best part is you almost always have no idea what the price is until the bill shows up at your house weeks later after your insurance company has already combed through it.
The office could have billed me $300 for the earwax thing or $500 or $10,000 and I had no way of knowing or stopping it.
And that’s why you run into crazy medical bill stories all the time. NPR has an ongoing series with Kaiser Health News called “Bill of the Month,” where they highlight those stories.
Here’s one local connection — in April they featured a $143,000 bill for a girl who got bitten by a snake while camping in Illinois. That kid just happened to be the daughter of Shipshewana native and former Miss Indiana Shelli Yoder, who now lives in Bloomington.
I got some fun reactions on my Twitter account a few weeks ago after I tweeted about seeing an old invoice at the Luckey Hospital Museum for a birth and 10-day hospital stay in the 1930s that was $85.
When my wife gave birth in January, a regular, non C-section birth with a three-day stay, the bottom line bill was $36,000. But hey, the cost of bread and milk has probably inflated 42,253% too, right?
After insurance, our cost was about a tenth of that bill. But if an uninsured person walked in, you’d expect they’d be able to pay $36,000?
The health care system is super complex, yes, but right now it functions in a way no other business does. There’s little competition and no transparency.
Imagine if you took your car into the mechanic and said, “Hey, I need a new alternator,” and the mechanic said, “Sure, I’ll fix it and bill you later.” He doesn’t give you an estimate. He just fixes it. Beyond that, he’s maybe the only, or one of like two mechanics in town. But if you call the other mechanic, he won’t give you a price either. The other shop could be more or less expensive, but you’d have no way of knowing.
Insurance is its own beast, but you can’t drive down insurance costs if you don’t drive down procedure costs. And you can’t drive down procedure costs if there’s no mechanism to regulate what is being charged.
Yes, the government doesn’t regulate the cost of auto work, but the market regulates the cost of auto work through competition, transparency and word-of-mouth of customers about who is good and fair and who is not.
In health care, not so much.
Which is why it was super dumb of me to think that someone was going to spend five seconds picking some wax out of my ears as a courtesy.
Ear wax is big business. I had no idea I was walking around stuffed up with $146 of waxy gold in my ears.
Which is exactly the problem.