Thursday, August 05, 2010

Never Ask…

“What else could happen?”

I should know this by now. Yesterday, the children were at their father’s cousins’ home. Someone thought it was a brilliant idea to allow the middle child (6 years old) to sit ON TOP OF the billiard table while the “bookends” jumped from sofa to table and back again. Unlike her siblings, the middle child is EXTREMELY cautious and obeys “the rules” to the letter of the law. So one wouldn’t think that *she* would be the one to get hurt.

No one knows quite how it happened, but she fell off the billiard table and smacked her head on the marble tile floor. With the headache, dizziness and glassy eyes, we took her to the ER to get checked out. This hospital was different from the one I was at, but also excellent. We were triaged into the ER in UNDER 1 minute and were taken to CT within FIVE minutes of our arrival. They ran the CT and had us back in the ER in under 15 minutes. Everyone was extremely kind and gracious and EFFICIENT.

Total cost of the ER visit: 128.000.000 Rupiah (+/- $130 USD)
Having a 100% OK kiddo at the end of it all: Priceless!
Now let me just say in parting that the ER bill when broken down looked something like this:
100.000.000rupiah – CT scan
27.580rupiah – CT film
270.000rupiah – ER cost including doctor, administration, etc.

If we were back in the states, the ER copay alone would have been $150 and the total bill would have been in the thousands of dollars.

To put it in a little local perspective, the minimum wage here is 120.000.000 rupiah/month, so an ER visit for a local person making minimum wage would be a hard bill to pay. But I can GAURANTEE you that an ER visit at our local hospital back home wouldn’t cost $1300 (Florida min. wage is $7.5/hr, X40 hours, X52/12 to get monthly wage) total out the door cash price. Multiply it by 10 or 20 and you’d be close to the actual “cash price” of a “simple” ER visit. A Jakarta local could possible scrape together an ER visit cost, but I don’t know anyone who can scrape together $13000+ for an ER visit.

Now if you’ve got decent insurance in the States, you don’t have to come up with the “cash price”. You pay your copay, meet your deductible etc and you’re good. But what happens if you DON’T have insurance for whatever reason? Then what? I try to stay pretty apolitical here, but the differences in medical care and cost between the States and here are pretty striking. Something’s got to give. I don’t have the answers and even if I did, no one is asking me for them.

One more thing, health insurance isn’t available to everyone here. For most workers, they alone are covered by their employer thusly: they get sick, employer pays the bills for THEM ONLY. They have to pay out of pocket for their dependents. Or, if you work for an employer that offers health insurance, if you’re male, you are covered and your dependents if your wife doesn’t work. If you’re a woman, your insurance only covers YOU. Unless you’re a single mother in which case it covers you AND your dependents. This is to prevent “double dipping”. It looks bizarre from the outside, but I think it’s one thing that possibly helps control health care costs.

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