To the Editor:

Imagine that you go to your general practitioner and she reminds you that it’s time for a colonoscopy. You have the colonoscopy and the doctor tells you that you have colon cancer. The surgery is scheduled. You get a CAT scan to see whether there is any obvious spread to the cancer. The surgery is completed and you are home two days later, missing about 11 inches of your colon.

While you are recuperating, the bills start rolling in:

• Colonoscopy office visit, colonoscopy, pathology: $6,624

• Pre-Op CAT scan: $2,080

• Physician office visit, surgery, pathology: $10,749

• Hospital: $45,288

The total is $64,741. This happened to me. I am on Medicare and have supplemental coverage. Of the total, Medicare paid $15,027 and my supplemental insurance paid $2,391. My out-of-pocket cost was about $200.

If I were under 65 and had no insurance, I would be liable for the entire $64,741. Few families can afford this kind of a financial shock. News reports claim that almost half of households cannot afford a $400 financial surprise.

I also looked at my drug costs. A 90-day supply of my four generic prescriptions has a list price of $905. I paid $92. Again, without the price reductions negotiated by my insurance company, I would be liable for the entire $905 — or I would do without.

My point is that an increasing number of people are one medical diagnosis away from financial disaster. This should not be the case in the wealthiest country in the world. After all, every other developed country in the world has figured it out.

There are numerous ways to solve this problem. With the exception of the millions of citizens who have poor or no insurance, our current mostly private system works, although it is the most expensive in the world and provides only mediocre outcomes. 

The first, and most important issue, is to cover the approximately 80 million Americans with inadequate or no insurance. Simply expanding Medicaid would cover several hundred thousand people just in North Carolina. Most states have done this. Modifications to existing programs (e.g. ACA, Medicare, Medicaid) could probably accomplish most of the rest.

Ultimately, however, we must provide universal coverage and address the outrageous costs and mediocre outcomes of our current system. Not addressing this problem condemns millions of Americans to premature death and/or financial disaster. 

Is that who we are?

John Gladden

Franklin