The Rube Goldberg Machine That Is American Healthcare

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Stephen* thought he was going blind.

Something got in his eye. Instinctively, he rubbed it, then felt excruciating pain.

From that moment on, his eye was not the same. Something was in there he thought, but neither he nor his wife could see anything.

His wife worried that he had done some damage. Stephen, who relies on his eyes for income, was more worried. Besides potentially going blind, which was frightening enough, losing his vision could have financial implications too.

Sometimes in America, going broke is more frightening than going blind.

Stephen’s wife knew you don’t mess with eyes. Having worked in an optical shop for ten years she saw what happens when you do. So she drove Stephen to the emergency room. The doctors couldn’t find any damage. What they did find though surprised Stephen and his wife.

He had pink eye.

Itchiness, apparently, is a common early symptom of conjunctivitis, aka pink eye. Definitely not an emergency. But definitely needing prescription medicine.

Like many Americans, Stephen has healthcare. Sort of. In America, having healthcare is like not having it. Healthcare for many Americans comes with individual and family deductibles so high they render “healthcare” useless for anything not life threatening.

Essentially, healthcare many Americans have is catastrophic coverage. Not practical healthcare.

So when Stephen and his wife received their emergency room visit bill, it came with a triple-whammy. The first was the bill: It was only $280.

Nothing to sneeze at, but manageable on their income.

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Stephen and his wife are not in a position to pay $700.

Naturally, Stephen called the hospital to arrange for monthly payments or other financial assistance. After less than a couple of minutes, the call took an interesting turn.

“I’m happy to take care of this for you,” Lesley, the hospital business office representative said. “Don’t worry about paying it.”

Stephen and his wife were both shocked….

“How is it you can do that?” Stephen asked. “How is it that, on the front, end you guys charge so much per month in premiums, and have such huge deductibles it makes using insurance really useless, but then, on the back-end of this process, you have the wherewithal to simply forgive $700?”

Lesley explained: “[our company] is a nonprofit organization. We have funds set aside to help people in situations just like this. Unfortunately, the system is what it is. On the “front end” as you call it, we have to adhere to the system. But we also have programs like these people like me can use, at our discretion, to help families out. It’s one of the best parts of my job to be able to do this.”

Stephen was flabbergasted.

It could be said the cost of Stephen’s treatment, while covered by a pool of funds set aside specifically for such circumstances, was actually paid by people who have the means to pay the cost of their care. Or, it’s paid by donors to the hospital. Stephen, being a republican, shivered at the idea that his treatment was contributing to the high cost of healthcare. He believes such freebies are passed onto others. And when that happens, that amount people have to pay is higher than it would otherwise be.

Stephen was conflicted. He couldn’t pay what he owed. But he also felt he should. The fact that Lesley totally waived the cost, gave him relief, but also triggered his shame. The shame he felt was less about his financial wherewithal and more about the beliefs Stephen holds, beliefs many Americans hold, about paying for things.

“Unfortunately, the system is what it is”

That’s true. And it’s not.

It is possible to have a system that cuts through all this unnecessary complication and simply offers things like education, healthcare, shelter, basic clothing and food at no cost to anyone. “Cost” aka, paying for things, is a fiction, created right alongside money, which also is a fiction.

The system we’re alluding to already is on the drawing board. There’s no reason families like Stephen’s – or any family – should have to pay for what they need.


In that future, people are supported so they can thrive.

And when we say no cost to anyone, we mean it. Humanity can have a society where no one has to pay for anything.

That’s where humanity is heading. When we arrive, it will be glorious. And when we look back we’ll wonder: how could we have been so blind?

*Not his real name.

2 thoughts on “The Rube Goldberg Machine That Is American Healthcare

    1. What makes me go “hmm” is we could have a system where NOBODY PAYS. And eventually we will. But not until we release the belief that goes “someone has to pay”

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