Impatient patient, part 4: My $25,929.60 head injury

Impatient patient, part 4: My $25,929.60 head injury
CORBIS

One year ago today, someone clubbed me on the back of my head and took off with my purse. I suffered a “mild traumatic brain injury,” which seems like an oxymoron because the injury and the recovery didn’t feel mild.   

Nonetheless, after a $1,123 ambulance ride, a two-night $5,697.85 hospital stay and 50-plus insurance claims for treatment ranging from cognitive therapy to vestibular therapy for dizziness, my marbles appear to have returned to their proper places in my brain.

On this one-year anniversary of the attack, I am especially grateful for MinnPost.com’s health insurance coverage because without it I would be filing for bankruptcy protection. I also am thankful for Minnesota’s Crime Victims Reparations Fund, which picked up a good portion of my out-of-pocket expenses.

At times, however, I feel guilty about how much is being spent to heal me and I suspect it has something to do with reporting about health-care reform and policy while 47 million Americans remain uninsured.

I fret about how high our small staff’s premiums will go, but I know from my reporting that state law caps increases at 25 percent for small businesses with fewer than 50 employees and that the impact is supposed to be spread across the insurer’s entire small-group pool. Still, I worry that our deductibles and out-of-pocket expenses will increase.

In fact, I’ve become somewhat obsessed with trying to put a dollar sign on what this crime cost society and me. I’ve run countless Internet queries, trying to track down a multiplier. I’ve called criminologists and sociologists without success.

One dated national study [PDF] estimates that 1.4 million people suffer traumatic brain injuries in a year — 11 percent caused by assaults. According to the study, direct and indirect costs are nearly $60 billion, which breaks down to about $42,860 per person.

Adding up the bills
As of this writing, I’m estimating at least $25,929.60 in direct costs stemming from a felony assault that caused a subarachnoid hemorrhage.

Here’s how I arrived at that amount:

• Hennepin County Medical Center, which has a first-rate traumatic brain injury program, has billed my insurer for $18,132.85 in claims so far, including the hospital stay. HCMC wasn’t reimbursed the full $18,132.85 because of built-in reductions like “provider responsibility amount” and “allowed amount.” But that’s the hospital’s estimated expenses for the excellent care I received.

As someone who has written about cost-shifting in health care, I have wondered how much of my bill goes toward paying for the uninsured served by the state’s public safety-net hospital. The majority of HCMC patients receive health care through federal or state programs; I’m among the nearly 25 percent of HCMC patients covered by private insurance. 

• Hennepin Faculty Associates billed about $600 in services related to the hospital stay.   

• I submitted a $1,090.76 claim to my property insurer for a pair of prescription glasses and a pricey purse, the latter of which did not get replaced because of a $500 deductible.

• I lost about six weeks of work after the injury, and although MinnPost generously continued to pay me during that time, I plowed through all my available paid-time-off last year, exhausted much of this year’s PTO and worked extra hours to make up any difference. Neither MinnPost nor I carry short-term disability insurance. I’m estimating that MinnPost, a 2-year-old nonprofit, lost at least $4,200 in productivity from me.

• The Crime Victims Reparations unit, which “compensates victims for losses sustained due to violent crime in Minnesota,” covered the bulk of my share of the costs and nudged providers into waiving the rest. Otherwise, I would have had to fork out a $1,000 deductible and up to 20 percent of the overall bill. Much to my surprise, the unit also awarded me $1,900 for lost PTO.

Those are the easily quantifiable costs.

But I can’t help but wonder how much it cost to assess, assemble and mail copies of 50-plus claims, 50-plus explanation-of-benefits summaries from the insurer, and 50-plus more bills seeking co-payments. And who knows how many claims and denials were sent between the providers and the insurer? All I know is I have a 3-inch-thick file of paperwork. 

I also have not been able to put a dollar sign on all the time spent by my son, friends, neighbors, and present and former colleagues to deliver meals and groceries, do my laundry, clean my house and drive me to medical appointments and elsewhere when I could not drive, cook or clean because of dizziness and exhaustion. Their visits and support were priceless to me.

So, the total cost of the assault could be closer to the $42,860 figure when their generosity and other indirect expenses are factored into the equation.

Indirect costs
In my mind, indirect costs would include the following:

• The extra work my colleagues picked up during my absence and my gradual return to work, including any delays caused by the 20-minute breaks I was required to take every time my head started hurting. About eight months into the recovery, it became difficult for me to discern which was to blame for the headaches: the TBI or the 1,000-page health-reform bills.

• The hours Minneapolis police Sgt. Ron Christianson spent patrolling the area where I was attacked, talking to businesses and residents in the area, and trying to find the assailant(s), including distributing photos of the possible suspects seen on videotape from a nearby business. He also called regularly or sent detailed emails to update me.

“I’m always reminded of the robbery every time I drive by the area, which is quite often,” he wrote me last week. “It’s still an active case, and I’m still looking.”

• The time spent by a couple of good Samaritans after they found my tossed wallet and driver’s license in different locations and proceeded to search for other contents in the area before turning in the wallet to police and mailing my driver’s license to me.

• The jail, court and prison costs in the event anyone is tried and convicted. I’m not holding my breath because the “solve rate,” in general, is low for robberies.

What this crime cost my psyche is a subject for another day. I try to focus on how fortunate I am because 1) I’m alive and have resumed my life and work, and 2) my employer’s health insurance and the reparations fund paid for most of my recovery.

I occasionally wonder about the assailant’s psyche and the troubled path that brought him and his friends to a parking lot one year ago. In the matter of a few minutes, this crime netted about $30 in cash, an outdated cell phone and a nice purse. 

Casey Selix, a news editor and staff writer for MinnPost.com, can be reached at cselix[at]minnpost.com. Follow her on Twitter.


Related content

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By Casey Selix, Dec. 9, 2008

The impatient patient, Part 3: TBI yields St. Nick in cyberspace
By Casey Selix, Dec. 24, 2008

Comments (9)

  1. Submitted by Melissa Hansen on 11/02/2009 - 11:45 am.

    Thank you for sharing your experience and congratulations on thriving through the year despite all of the burdens brought into your life. Your article resonates with me because in the last year my partner has had an unexpected onslaught of chronic conditions normally expected of people 25-30 years older than him. He has had 3 hospital stays, so much fantastic follow-up care, and is on 13 medications now, some for life. Despite the mental stress and lifestyle shift, the health insurance piece of our story has been unbearable at times- and we have awesome insurance! The cost of care is amazing, we have so many statements of benefits coming in the mail everyday that I may feel slighted when they stop arriving. I do not know where would would be without my awesome health care coverage from my large employer. My husband is self-employed, where would he be without me? Broke and ill, with bills to worry about on top of daily care and basic chronic disease care stress. We are so grateful that we have not had to worry about the bulk of his care bills; I am so livid that others are not so lucky. I try to explain our story to people in terms like you have above whenever I can and I am glad that you have done the same.

  2. Submitted by Bernice Vetsch on 11/02/2009 - 12:57 pm.

    A few weeks ago I met a young man who teaches at a local private college. He and his wife have two small children and a mortgage. She was recently laid off, but with his salary and his employer-paid health insurance they can get by.

    EXCEPT for the $20,000 in health care bills he ran up because he was attacked and beaten by a couple of bad guys before he found his current job with its excellent insurance.

    Within a few months, they’ll have to start choosing between making their mortgage payments or making payments against the $20,000 in medical bills, a pretty scary prospect. Do you suppose the police (or his doctor(s) or ?) failed to mention the Crime Victims Reparations fund?

  3. Submitted by Casey Selix on 11/02/2009 - 01:22 pm.

    Thanks to Melissa for sharing the story of her husband.

    To Bernice: I did not find out about the reparations fund through the police or my health-care providers. I remembered reading about it several years ago, and that’s when I Googled it.

    I hope you’ll suggest to your acquaintance to check it out — it may not be too late for him to file a claim.

  4. Submitted by Jeff Kline on 11/02/2009 - 03:43 pm.

    Casey; I’m a bit concerned that you shared a bit more information there than you needed to. You left in your “Patient control number” which among other things could be used to commit fraud or ID theft. I would encourage you to not provide that information as it is not needed for this topic of discussion.

    Now I also ask something else. Supposing they do find the perpetrator. Now what? The typical liberal mindset is that “he was forced into this by circumstances outside of his control” or any number of other nonsensical associations they typically give these perps. What kind of retribution would you expect to see, What kind of retribution do you think you will really see?

  5. Submitted by Casey Selix on 11/02/2009 - 04:27 pm.

    Jeff,

    Jeff,
    Thanks for the tip on the control number. It has been stricken.

    If the perpetrator(s) were to be caught, I would want to see appropriate sentencing. I know that my family and friends (some of whom work in the judicial system here and out of state) would like to see the maximum sentence.

    I’m just not holding out a lot of hope that this crime will be solved. In the meantime, I need to get on with my life, and part of that, unfortunately, involves acceptance that the case won’t be solved.

    Thanks for asking.

  6. Submitted by Jay Wilkinson on 11/02/2009 - 06:58 pm.

    I had a recent experience with the French medical system. Their system is Rated #1 in world for quality at 60% of what we pay in the U.S. Something to do with a single payer system and elimination of frills….

    A cycle accident resulted in abdominal injury in rural France. After 4 days of pain, I went to tourist office in Beaune, a small city in Burgundy region at 10 a.m. for a referral.

    At 12:20 I saw a GP in his office and was examined, questions, reassured and given prescriptions and referral to a radiology office “just to be sure.” 25 euros or $37.

    At 3 p.m. I have 4 prescriptions. 18 euros or $25.

    And 2 xrays and a full abdominal ultrasound exam and reading. 102 euros or $140.

    Bad bruises and slow healing.

    It would cost my insurance co. more to process the bills than what it cost me to get the medical care.

    And then there was the time when a family member had a month in neuro-vascular intensive care in France with a total bill of just over $21,000….

    France will probably not readmit us, but the insurance co. will likely smuggle us in as a cost-savings measure.

  7. Submitted by Martha Mason Miller on 11/02/2009 - 08:21 pm.

    About 15 years ago I had the same diagnosis as a result of being hit by a car while riding my bicycle. In spite of my helmet, I was unconscious for about 10 minutes. They checked me out at my local (Canadian) hospital and sent me home, a Friday evening. Monday morning my GP sent me in for a CAT scan and other tests (all covered by Canadian health care: NO CHARGE) but they did not find anything.

    Fast-forward 3 years, and I began to have seizures. After a multitude of case histories, and visits with neurologists and psychologists (batteries of tests to gauge my abilities), the only cause they could find was the head injury.

    Unfortunately, you don’t know what will crop up in the future. Fifteen years later I am doing fine, but it took a long time to get here. I will take anti-seizure medication for the rest of my life, live with the knowledge that other conditions could occur, and look back with regret at the havoc wreaked on my young family and my marriage.

    Head injuries are serious. You have no control over what a mugger does to you, but I get angry every time I see a motorcyclist, moped or bicyclist without a helmet (or almost as bad, an inadequate one). My injuries occurred even with a good helmet on. People in the U.S. seem to have become so obsessed with personal freedoms that they don’t think about the costs to society whether injuries, health care, or insurance.

    Good luck with your head and health! Thanks for sharing the story with us.

  8. Submitted by Bernice Vetsch on 11/03/2009 - 12:18 pm.

    Thanks very much, Casey. I too, have now googled and found the following information that may, because of your personal story and article, help even more people.

    Several states have such programs. In Minnesota, the Crime Victims Reparation unit is part of the state’s Dept. of Public Safety, Office of Justice Programs.

    Victims can apply for help at the Crime Victims Services Office, Bremer Tower, Ste 2700, St Paul 55101, and/or by calling 651 201 7300.

    Application forms can be printed out at their web site.

  9. Submitted by Casey Selix on 11/04/2009 - 09:20 am.

    Here is a link to the Crime Victims Reparations Fund’s downloadable applications and eligibility information.

    http://www.ojp.state.mn.us/MCCVS/FinancialHelp/index.htm

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