Andy Neary recounts a serious multi-vehicle crash on I-43 near Oshkosh, Wisconsin. Although his physical injuries were relatively limited—a shattered pinky (two pins, about one month in a cast) and a chipped tooth—the billed medical costs were high: $27,000 for the surgery and follow-up (including eight physical therapy visits). He uses this anecdote to argue the U.S. health-care system has perverse incentives (fee-for-service, insurer negotiated-fees, broker commissions) that drive up costs.
Questions this video answers
$27,000
A shattered pinky (also a chipped tooth)
Two pins surgically inserted, about one month in a cast, and eight physical therapy visits
Southbound on I-43 near Oshkosh, Wisconsin
We walked out of the back of the body shop and into the yard to look for the remains of my Toyota Highlander that was amongst the other's car wrecks that day. And as we got near my automobile, the owner of the body shop stopped, looked at me and said, hey, man, I'm sorry about the looks back there. We just assumed the driver of this vehicle was dead.
I replay 4-19-A lot in my head, and I'm still blown away by how lucky I was to walk away. Traveling southbound on I43 near Oshkosh, Wisconsin, I came upon stalled traffic. And as I started to slow down, I hit a patch of ice and I started to slide. And the semi behind me hit that same patch of ice and he started to jackknife. So I looked in my rear view mirror and I could see the trailer of his semi start to swing at me like a baseball bat. And the last thing I remember hearing were three loud bangs, semi hitting me, me hitting a construction wall to my left, and then hitting a second semi in the right lane. And when I came to, about an hour later, I was being moved from a backboard onto a hospital bed. There were about six EMTs, nurses rushing around the room, hooking me up to monitor, sticking electrodes all over my chest. It was like a scene out of er. It was pure chaos.
For a shattered pinky.
Hold on. I chipped my tooth, too. Now, this dramatic story does not end here, folks. You see, my pinky required two pins to be surgically put into it. The surgery itself took probably less than an hour, and my hand was in a cast for about a month. After the cast came off, I needed eight visits to the physical therapist, all for the low cost of $27,000. How did two pins, a cast, and eight visits to a physical therapist cost $27,000? Now, fortunately, I had health insurance, so my financial responsibility was not that much. But this blows my mind. And I know there are folks in this room and employees on your health plan that have experienced the same type of shock. Folks, we have a health care problem. You guys remember back in the 1980s when Ronald Reagan coined the phrase trickle down economics? The problem in health care has its own trickle down effect. And here's how it works. We've got providers who, by and large, get paid a fee for service. So they get paid on volume. The more they do, the more they make. They then work with insurance companies and they agree to their negotiated fee contracts. Bigger the contract, bigger the profit to the insurance company. So you could say the larger the charge. The larger the discount looks, the larger the insurance company makes. They then pay brokers commissions, bonuses and kickbacks to place your business with them. How do you win.
