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The saga of the boot illustrates the problem of health care costs

Hannah Hayes
Patient
June 15, 2015
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While there are worse times to sprain an ankle and chip a bone than just one week before a long­awaited trip to Venice, I couldn’t think of one as I sat in the emergency room for eight hours last fall.

Venice, the place of canals and not cars; ancient bridges sans escalators. How ironic that just a few days before I was crowing to my husband over my hotel coup. A quaint, 18th-century hotel in the heart of Venice, right off the Rialto Bridge for less than 100 euros a night! Just because people did not like to climb stairs! Two ­hundred and seventy-eight to be exact!

My husband and I are self-­employed, and we pay for our own health care. Beyond the fact that this ill-­timed tumble down the stairs in the dark cast a cloud over our vacation and had me in incredible pain for several days, it meant thousands of dollars in hospital bills. We have a high deductible, but we are thankfully healthy (albeit clumsy) so it was a decision we weighed carefully.

Unfortunately, I was not on my game when I went for my follow­up a few days after leaving the ER with a wrapped foot, crutches, and prescription for Vicodin. Perhaps it was the pain or the anxiety of being able to make this trip, but when the doctor fitted me for a boot I didn’t much question him.

“This may or may not help,” he explained to me. “Some people find it’s easier to walk with a boot. But if it doesn’t feel comfortable, then don’t bother with it.” In other words, it wouldn’t interfere with my foot healing if I chose not to wear it.

So I wore the boot on the plane, but once arriving I found immediately that it caused more pain than not wearing it. So I hopped around Venice on crutches and rid the Venetian pharmacies of every ice pack in their stockrooms.

When we left Venice after three days, I left the boot in my room. We had rented a car for the rest of our Italian vacation, and life got easier.

A few weeks after returning, the hospital bill arrived. Wincing, I opened it and let out a shriek. The boot? Nine hundred and sixty-two dollars, more than three times the cost of our hotel in Venice. When I looked up the boot on Amazon, it was listed for $69.

I called the hospital to complain, but they pointed out that I didn’t have to accept the boot. “But he never gave me a choice!” I sputtered. “He never said ‘here’s a thousand dollar shoe that may or may not work’ or ‘you could pay $1,000 for this one or get a $69 boot on Amazon.’ He said ‘here, try this …’ He’s a doctor, so I said OK.”

“Well, doctors are not allowed to discuss what things cost,” she explained. She then suggested I put my case in writing and apply for financial aid.

When I got the financial aid form, it looked like I would have to give up my house before they would even consider waiving the cost of the boot.

I called a lawyer friend who advocates for people who like me, trying to negotiate the health care system. She suggested I write up the details and send it to the billing department, and cc her on it.

In addition to my lengthy explanation, I enclosed a printout of the boot for $69 on Amazon, as well as the check for the rest of the ER visit, deducting the boot. I waited for another bill, and when none arrived, I decided I had scored a victory over the boot.

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Several months later, however, I called to get a copy of a different bill (my husband cut his hand when a window shattered as he was trying to close it). I was told my account was in collections. I assumed the boot had come across their radar once again.

I spent yet another hour writing up an explanation; but when I called to get a copy of the outstanding bill, there was no record of it.

Following a concussion my son suffered in basketball, I decided we were far too clumsy for a high deductible. And while I always ask questions now about what we’re paying, I do hope Obamacare will deep six issues like this while fervently hoping the boot will never resurface again.

Hannah Hayes is a freelance writer.

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This post originally appeared on the Costs of Care Blog. Costs of Care is a 501c3 nonprofit that is transforming American health care delivery by empowering patients and their caregivers to deflate medical bills. Follow us on Twitter @costsofcare.

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