An $8,000 hospital bill added to my already growing debt

The clock read 9:30pm and in front of me was dozens of notes, PowerPoint slides, and practice exams to review before 8am. The all-too-familiar finals week all-nighter beckoned, and though I’ve had my fair share of experiences with studying until the sun rose, I decided to forgo the typical mug of coffee and take some over-the-counter caffeine pills instead. My friend proclaimed that they would help more than any energy drink would. I laid out all my exam materials, popped in a couple caffeine pills, and strapped myself in for a wild night of allopatric speciation and coadaptation. A wild night did ensue, but there was no evolutionary biology involved.

Around 11:30pm, what could only be described as the worst headache of my life, detracted me from my desk and led me to the bathroom floor. I decided something needed to be done. Student services at the university health system were closed, so that only left me with the ER as an option. An ER visit was outside the coverage of my standard student health insurance provided with tuition and I didn’t have a personal health insurance plan. I was wary of any costs that I might incur in the ER. Instead of an ambulance, my best friend, Eric, drove me to the hospital.

My face remained scrunched and my head continued to pound as Eric and I sat in the waiting room. When we were finally admitted, I listed my symptoms: “headache like I’ve never felt before,” vomiting, and bright light intolerance. The resident physician suggested meningitis or a brain aneurysm. He needed to run some tests to check the possibilities. It was 3am when I called my mom, telling her that I was in the hospital, asking her what I should do knowing we didn’t have insurance. She yelled, “Let them do whatever they need to do!” Knowing mothers are worriers, I asked the doctor what the pitfalls of not getting the tests were. He simply said, “Worst case scenario is that you die.” My friend said without reluctance, “Dude, don’t die.”

I was carted off for a CT scan. Afterwards, the resident physician outlined the steps of a spinal tap and explained how the results could help determine whether aneurysm was in the picture. He missed his target three times; I was lucky enough to have a 7-inch needle jammed into my back multiple times! After I jerked and shrieked as some sort of spinal nerve was struck, the attending physician stepped in and completed the diagnostic procedure on his first try. My friend stepped out after the first needle puncture. He mentioned later that he got a little sick seeing the needle thrusting in and out. The lumbar puncture experience was terrible, but not as terrible as the bill that was to come later.

My eyes bulged at the $8,000 amount due at the bottom of the bill. Multiple service items with astounding amounts were listed. I knew hospitals had to be reimbursed for their services, but I had no idea that a simple IV saline hookup would cost me hundreds of dollars! Had I known gold was flowing into my veins, I might have declined the second IV bag as the first one ran empty. I also didn’t know that a simple CT scan and diagnostic procedure would cost thousands.

What started out as a possible brain aneurysm, turned out to be a bad migraine. The migraines continued as any movement more than 20 yards during the next week would cause me to get sick and vomit. Had I known I was going to owe $8,000 for one night in the ER, I would have waited until the next morning when I could have visited the student university health department, free of charge. I ended up doing that a couple days after my ER visit anyways and that’s where they figured out what the ER folk couldn’t. They gave me a prescription for some vasopressin to help with my migraines and sent me on my merry way. The drugs helped and my migraines haven’t returned since. What didn’t help was the $8,000 bill that was added to my already growing debt from student loans.

Sammy Ta was a contestant, 2013 Costs of Care Essay Contest.

An $8,000 hospital bill added to my already growing debt

This post originally appeared on the Costs of Care Blog. Costs of Care is a 501c3 nonprofit that is transforming American health care delivery by empowering patients and their caregivers to deflate medical bills. Follow us on Twitter @costsofcare.

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  • John C. Key MD

    The charges, always, are breathtaking and probably unjustified. But the workup itself seems entirely appropriate given your symptoms

    • querywoman

      Dr. John, you are another doc who comes across as compassionate across the electric waves. And you agree that the workup was justified!

  • Patient Kit

    I’m sorry that you had to learn the hard way that the ER is not free. But I’m happy to hear that your headache wasn’t a symptom of anything more serious. I’ve talked to a fair amount of healthy young people who, for some reason, are convinced that ER care is free for all. It’s why they think they don’t need health insurance or a regular doctor. They say that if anything ever happens to them (and many believe nothing serious will ever happen to them), they can always just go to the ER. In reality, the ER is the most expensive place to get medical care. Not saying that you thought it was free, but I’ve talked to many who do. And, of course, if you really think something as serious as a stroke or anyeurism may be happening, you should definitely go to the ER.

    • SteveCaley

      The patient’s story called up my personal “Holy S**t ! ” list. I have seen very very bad things not look so bad. 28 year old mother of two or three, came in with the worst headache of her life. The fact that I remember it after fifteen years tells you that what happens next was not at all routine.

      • Patient Kit

        I can only imagine. Bad things happen all the time, including to young people. We had a 31-yr old drop dead of a heart attack while running in a marathon here in Brooklyn last week. I think we all experience things that we never forget. For example, years ago, I was walking down the street one evening when a guy “fell” out of a fourth floor window right in front of me. I’ll never forget the sounds of him hitting the concrete. I stayed with him until an ambulance and the police arrived (even though part of me knew it was likely a drug deal gone bad and I probably should have hightailed it out of there.. I have a personal list of things like that, but I’m sure all docs have long lists of patients they’ll never forget. You see a lot.

  • SteveCaley

    Caffeine precipitating migraines is a first-time for me. the $8,000 question is – have you ever had migraines or unusual headaches before? If this is a new-onset first-time migraine, it sounds like it was necessary workup – young men DO pop berry aneurysms and die. Hypertensive crisis comes to mind. These are very bad things, and merit ER treatment.
    In all aspects of this case, a primary-care physician who knows the patient is a FAR better than no primary-care physician. I’d probably send a solitary migraneur to the ER with a story like this; but it’s an important understanding that the cheapest and most effective test is talking with a physician who knows you.
    PS: I give out my telephone number – the cell – to all my patients. If I can wave off an ER call, it makes me happy. That’s what real medicine USED to be.

    • Patient Kit

      Anytime I’ve ever had a migraine, caffiene is the magic ingredient that shoos the headache, especially if I take it as soon as first vision symptoms appear pre-headache. Usually, one strong cup of coffee does the trick. I never had them that bad though and haven’t had one in a long time. I totally agree that the best care for any of us comes from a doctor who knows us well.

      • querywoman

        Caffeine, and I drink Diet Coke, not coffee, used to help my nasty premenstrual migraines some.
        Once I had a PMS headache so bad that I went to the ER and got a shot.
        I’ll never forget the day I went to the ER with a headache.
        Texas executed Betty Lou Beets that day.
        I called my mother after the ER. She said, “Didja hear about Betty Lou Beets? They fried her!”
        I said, “They shot her up with drugs in the arm. I don’t really believe in the death penalty, but…”
        Mama cut me off, “I think she got what she deserved!”

    • Patient Kit

      PS — I wish you were my doctor!

    • querywoman

      I am glad you give out your cell. I never call my own doctors after hours. I control my diabetes well, also my skin disease. If I am sicker than normal, and I can’t treat it myself, I call 911.
      If I have a really serious skin lesion, like something rupturing in my armpit, and I had surgery on an abcess there once, I take myself, no need to call 911, to the ER, and ask for an IV. Past experience taught me that.
      A person who is not chronically ill, not well-maintained on medicines as I am, really should go to the ER.

  • Suzi Q 38

    I would go down to the financial department and ask to speak with a supervisor. Tell them you have no money. Ask them if they can reduce the total charges. I would not pay a cent until they agree to reduce the charges. If they do it for others, they can do it for you, too. You have no assets (home, business, etc.) for them to file for. Maybe they would appreciate the honesty and attempt to settle this amicably. If not, they can wait a few years.

    If you would have had insurance, the insurance company would have paid far less. See if you can pay what the insurance company pays.

    Go to your school’s health center and get signed up for insurance.
    The student insurance is fairly reasonable, and may cover ER visits in the future.

    You did the right thing. Nothing is more important than your life.
    That being said, insurance is very important these days.

  • Karen Ronk

    Since I am well aware of the absurdity and capriciousness of medical bills, I took something else from this story. The growing trend of young people (and older people as well) taking these “energy” drinks and pills to stay awake or function. I wonder what kind of long term health effects we will see from this and how many ER visits have resulted already.

    • Patient Kit

      For as long as I can remember, going back to my school days (and I’m in my fifties now), students have been taking something to keep them awake through all-nighters. This is nothing new. Energy drinks are just the latest version. In fact, many of us took much worse than caffeine.

  • Josy Coke

    CT or MRI of the brain was reasonable for “worst headache of your life” with no history of migraines. The student health didn’t have to do that, because it was already done and they had the results. I’m not so sure about the lumbar puncture…

  • Markus

    The workup certainly sounds appropriate. Procedures do cost a lot in the United States compared to other first world countries for a large number of complex reasons and the payment system often does require more out-of-pocket than in other places; we all know these facts.
    I wonder whether the LP might be contributing to the long duration of a headache where the patient feels that any movement makes things worse. This patient had three unsuccessful sticks before a more experienced operator got in. Post-spinal headache is a real entity.

  • Patient Kit

    I did say in my response to him that I was not saying that he thought the ER was free. Clearly, he expected to pay something but something reasonable. But it did make me think of all the kids I have talked to who did think the ER is free and who used that mispercepfion as a reason to feel like they don’t need a regular primary care doc. If I went off on a tangent, I think it was a related tangent. And I agree that ER charges are out of control.

  • querywoman

    Hospital bills to the uninsured are vastly inflated. Insurance pays much less. My last two hospitalizations for pneumonia, Medicare paid 10% of the alleged full rate.
    If you don’t have insurance and are low income, and student grants and loans are not considered income, there is probably some program to help you.
    Ask at the hospital. I don’t know if your state has Medicaid for uninsured low income adults.
    Most medical bills are uncollectible, unsecured state. In most states, your paycheck can be garnished 10%. If you don’t have a paycheck, they can’t garnish it.

    But even if you have garnishable income or resources, and a lot of this depends on your state, you should talk to the hospital before they go that far.
    I am in Texas, the debtor’s paradise, where a paycheck can only be garnished for child support, income tax, and student loans. Child support is the most important debt.

  • Patient Kit

    It’s not just his accessibility to his patients. It’s the compassion and humanity that I hear in his posts in spite of the certainty that he has to be under the same pressures as everyone else. Personally, I need to know that we can retain our compassion and humanity for each other, no matter what. Dr Caley gives me that hope when I read his posts.

    • SteveCaley

      (blush)

      • Patient Kit

        I let my own docs know when I appreciate them too. I tell my GYN oncologist that I trust him with my life and I tell the residents who get to work with him that they are very lucky ducks. You guys do like to know you’re appreciated, right? ;-)

        • querywoman

          I have been hated by many docs in the past, but much loved by my current crop.
          My dermatologist and endocrinologist adore me, and I adore them. We can’t start praising each other enough.

    • querywoman

      Yes, I agree with your online opinion of Dr. Steve.

  • querywoman

    Hospitals have been sued for charging an uninsured vastly more than an insured.

  • querywoman

    If you are REALLY worried about your health, the best decision is to get medical care promptly. Worry about the cost later.
    I was really ill one and half years, with serious pneumonia, and was in the hospital eight days.
    All I could do was lie in the hospital and let other people care for me. I could not worry about cost. I wasn’t mobile.

  • querywoman

    Yeah, I think you made a reasonable guess about going to student clinic that sick!

  • querywoman

    I have a friend who goes to the ER with psych problems when he was young. He does it on and off now.
    He’s educate, a licensed attorney, and rich now.
    He said he learned when he was young and didn’t have insurance, that if he told them he was going to kill himself if he didn’t get medicine, they would take him seriously and admit him.
    One of my relatives was repeatedly ill and had to wait forever.
    He went to the ER with a bad tooth once. He told them he was in so much pain that he wanted to kill himself. They stuck him in the psych ward.
    He said he learned how to get taken seriously.