Last week I almost killed my wife. It was the middle of the night and E poked me awake (grounds for murder in itself) to tell me that she wasn’t feeling well and there was an agonising pain in her stomach. I made a few sympathetic noises, gestured towards some painkillers and went back to sleep. An hour later she budged me awake again to say that she thought she should go to the emergency room. “Are you sure?” I asked. The idea of rousing our sleeping toddler and Uber-ing to a Philadelphia hospital at 3am seemed a little extreme. “It’s probably just gas or something,” I said. “See how it is in the morning!”
The next morning it was worse. My wife went to ER where she was told that her appendix had cruelly turned on her and she needed an appendectomy. The appendix may look like a tiny, harmless worm but it can become deadly very quickly. One minute it’s just quietly hanging out in your gut; the next, it’s rupturing and you’re at risk of dying of a horrible infection. It’s kind of humbling really: a 10cm (4in) tube that everyone used to think was a completely useless vestigial organ (now scientists think it might be used as a sort of safe house for helpful bacteria) can kill you unless you get medical help fast.
I am not just feeling humbled, by the way. I am feeling extremely contrite. It is harrowing to think that if my wife’s appendix had been a little further along in the going-bad process, my advice that she postpone a trip to the ER could have had very serious repercussions. She could be dead, basically. And I’d have spent the rest of my life replaying the moment I told her it was probably just gas.
Why didn’t I just take E to the hospital in the middle of the night? Well, in my defence, it’s not just because I’m lazy and like my sleep, it’s because I try to avoid hospitals at all costs. That’s partly because of some very bad hospital experiences (the time a botched routine operation in the UK almost killed my mum, for example) and partly because, even though we have health insurance, medical care in the US can still be incredibly expensive. When you have to worry about medical costs then you’re more likely to take a wait-and-see approach: one recent survey found that almost four in 10 US adults say they have delayed or gone without medical care in the past year due to cost.
So how much did it cost to get E’s appendix out? We’re still waiting to find out. One of the great joys of for-profit healthcare is that there are no fixed prices and the bill is always a surprise. A medical facility on one side of town might charge tens of thousands more for the same procedure as a facility on the other side of town. And if you see a provider that isn’t in your insurance network? Then you could find yourself on the hook for the entire bill, which could be more than $40,000 for an appendectomy. Even if your doctors are all within your insurance network, your insurer might try to wriggle out of paying. One of my friends got charged $13,000 to have her appendix out in New York because her insurance company said it was an “elective” procedure. She eventually got them to cover most of that but it took several hours of arguing on the phone. Not something anyone wants to be doing after a big operation.
E is back home and doing very well now. She got brilliant care throughout but, nevertheless, the whole ordeal was a reminder of how cruel the US healthcare system is. When your loved one is sick, you should never have to worry about whether a particular doctor is within your insurance network; you should never have to worry about how much everything will cost. Still, while bashing the inhumane US healthcare system is one of my favourite themes, that really isn’t the point here. The point is that I hope my foolishness serves as a lesson: don’t ever delay getting medical help if something doesn’t feel right. Always trust your gut.
Arwa Mahdawi is a Guardian columnist
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