Hit with $7,146 for two hospital bills, a family sought health care in Mexico
RACHEL MARTIN, HOST:
Do you happen to have $1,000 at the ready for an unexpected expense? According to a recent survey, about half of all U.S. adults do not. What about $7,000? That is the medical debt one family racked up in our Bill of the Month story today. Dr. Elisabeth Rosenthal is editor in chief at our partner Kaiser Health News, and she's here to tell us about it. Welcome, Elisabeth.
ELISABETH ROSENTHAL: Good to be here.
MARTIN: OK, who are we meeting today?
ROSENTHAL: Today we meet the Fierro family of Yuma, Ariz. That's dad Jesus, mom Claudia and their two teenage sons.
MARTIN: OK, reporter Stephanie O'Neill is going to take it from here. She spoke to the Fierros and heard how they found themselves with this huge debt and how that affected their plans for medical care.
STEPHANIE O'NEILL, BYLINE: These days, the Fierro family of Yuma, Ariz., is healthy, and that's a welcome relief from a recent string of medical mishaps that hit the family of four starting in December 2020. It was just before the vaccine became widely available that Jesus Fierro Sr. came down with a bad case of COVID-19.
JESUS FIERRO SR: I started with a cough at work, a little itchy cough. And by the next day, I just - I was already with a full-blown fever.
O'NEILL: A few days later, his blood oxygen level plummeted, causing his wife Claudia good reason to worry. Normal oxygen saturation runs between 95 to 100%.
JESUS FIERRO SR: I was in the low 80s, high 70s - 78, 79. So she took me to the hospital 'cause she said I was talking to myself.
O'NEILL: Jesus spent 18 days at the local hospital with pneumonia. And while most insurers back then agreed to waive bills for COVID treatment, his did not. The nearly $4,000 bill, he says, has been especially hard to pay since COVID caused him to lose months of work.
JESUS FIERRO SR: I was in the hospital all of December, and then I didn't go back to work till March, mid-March, something like that.
O'NEILL: Then in June, Claudia fainted at a local restaurant. An ambulance took her to the same hospital that treated Jesus' COVID, where they kept her overnight.
JESUS FIERRO SR: And they really couldn't figure out what was wrong and just said that she's low on magnesium. That's what they pretty much told me.
O'NEILL: That visit left the family with yet another bill. Their share? More than $3,000, which they have yet to pay. And then just weeks later, one of their two sons, 17-year-old Jesus Jr. needed urgent care.
JESUS FIERRO JR: I'm a really big fan of boxing, and sometimes I get, like, into the mood - like, punch, punch, jab, jab. And I was doing that. I feel something shift in my right shoulder, and I just dropped to the floor.
O'NEILL: It was a painful shoulder dislocation, and he yelled for his dad.
JESUS FIERRO SR: I was trying to see if I could pop it back in there, but he just started screaming. And I better not (laughter). I'll probably make it worse, trying to play doctor.
O'NEILL: Instead, Jesus asked his son if he could handle the one-hour drive into Mexicali, Mexico, where a doctor visit costs less than an American fast-food meal.
JESUS FIERRO SR: 'Cause I go, I'm looking at another bill. I mean, if you can't handle it, then we'll go to the hospital. If you think you can handle going to Mexicali, we'll go to Mexicali.
O'NEILL: The bill? Less than $10. Jesus Fierro says he gave the doctor cash and was done with it. Unfortunately, though, the same can't be said for his COVID bill, which he's still paying. And as for his wife's bill, the hospital sent it to collections.
For NPR News, I'm Stephanie O'Neill.
MARTIN: All right. So they are paying Jesus Sr.'s bill off slowly. Claudia's bill is in collections. But Jesus Jr.'s bill is done, right? Five dollars - over and done with. And all they had to do was go to Mexico.
ROSENTHAL: Right. They live close enough to the border that that's an option for them. And Jesus actually works in Mexico, so it's familiar to him. But this is an American family who can't afford to use the health insurance they have in the country where they live. They're what economists would call functionally uninsured.
MARTIN: Functionally uninsured - tell me more about that.
ROSENTHAL: Well, most people with insurance still have to pay a share of their medical bills in the form of deductibles, co-insurance - that kind of thing. For the Fierros, their health plan says their share - call it an out-of-pocket maximum - can be $8,500 a year, right? A lot of money. So Jesus has a good job as a manager in a factory, but he can't afford to pay $8,500 a year on health care. That's on top of the $1,000 a month he already pays for insurance premiums. So the Fierros, like so many Americans, they have insurance, but it doesn't protect them from unsupportable debt.
MARTIN: And the other interesting thing here is that Jesus Sr. was in the hospital for 18 days - right? - and terribly sick with COVID. Claudia, though, only had a fainting spell, which is scary but not nearly as serious. So why did they end up owing similar bills?
ROSENTHAL: Oh, gosh, that has to do with the various and oft-inconsistent ways that the patient's share is calculated. Remember - emergency rooms are almost always an extraordinarily expensive place for care, which helps explain why Claudia's bill was so high. Also, unfortunately for the Fierros, you know, your insurance out-of-pocket payments reset each January 1. So his illness was in 2020, while hers was in 2021. So it was kind of a double-whammy for them.
MARTIN: Where are things now for the Fierros?
ROSENTHAL: They're going to try to apply for financial assistance for Claudia's bills, but, you know, that remains to be seen whether they'll get it.
MARTIN: So, Elisabeth, is it ever advised for Americans to leave the country for medical care?
ROSENTHAL: Well, you know, we hear from a number of people who do it to get an affordable price on a medicine they need or to have an elective procedure done. But it really is an indictment of our system that this is a reasonable option.
MARTIN: Dr. Elisabeth Rosenthal of Kaiser Health News. Thank you so much.
ROSENTHAL: Thanks for having me.
MARTIN: And if you have confusing or outrageous medical bills, please go to NPR's Shots blog and tell us all about it.
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