Thu | Jun 4, 2020

Growth & Jobs | Mitigating the maladies of medical debt

Published:Tuesday | June 25, 2019 | 12:00 AM

While many Jamaicans can access free healthcare and prescription drugs at government hospitals and clinics, the long waiting time to get certain surgical procedures done is often a deterrent for some, leaving many to opt to have it done privately.

The astronomical costs of these private surgical procedures are a dilemma for many, especially for those without health insurance. Finding the money to proceed with life-saving operations create financial and emotional burdens for patients, forcing some to engage in fundraising events, solicit funds, or seek a loan from a financial institution.

The experience is one which Christine Barnaby, a Kingston-based pharmacist, who was diagnosed with a skull-based Glomus jugulare tumour in February of this year, can relate to. The diagnosis has been unnerving for her. Equally unnerving were the various estimated costs which she received for the treatment.

“Four of the five nerves in that region of my skull have been damaged by the tumour,” Barnaby disclosed. “I’m having a lot of complications, such as excruciating pain in my head and shoulders, spasms, numbness to my face, palpitations, and I’m gradually losing my speech,” she added.

Due to the rarity of the tumour and the location of the growth, local and overseas specialists have recommended that she does treatment abroad. The tumour occurs in three of every one million persons.

In order to initiate the various recommended procedures, Barnaby has embarked on a GoFundMe account to assist in raising some of the urgently needed funds. To date, she has only achieved approximately 10 per cent of the targeted sum of US$80,000, which is only a portion of the estimated expenses.

She has her first appointment at the Mayo Clinic in Jacksonville, Florida, on July 16.

“Being in the healthcare industry, I knew that the treatment would be expensive; however, I never imagined it would be so high. I am, therefore, grateful to the persons who contributed to my GoFundMe tumour treatment fund. Even strangers have contributed,” she said.

Similarly, Marcia Sewell (not her real name), a retired schoolteacher, was faced with a predicament when she was required to come up with J$5.2 million to correct her lumbar spinal stenosis.

“The condition started in 2011, and it was getting progressively worse. I couldn’t stand for more than five minutes, and I was hunching. It was affecting by bladder and bowel functions,” she disclosed.

With the knowledge that her condition would continue to deteriorate, rendering her physically challenged, she chose to proceed with the corrective procedure.

Taking out a five-year loan against her shares and deposit at her credit union, along with her savings and financial assistance from her children, she did a successful surgery in May of this year.

“I’m 80 per cent better now. The surgery was worth doing,” she declared.

Reasons for high cost

Dr Clive Lai, president of the Medical Association of Jamaica, explains that the high cost of surgical procedures is dependent on several factors.

“When a patient is going for surgery, there are fees incurred from the doctors and the hospital,” Dr Lai explained. “The doctors would include the main surgeon, one or two assistant surgeons and an anaesthetist. Depending on the type of surgery, certain specialists like the neurosurgeons and cardiothoracic surgeons will definitely charge more. A specialist anaesthetist will be required and that adds to the cost. Also, depending on the complexity of the case, such as brain and open-heart surgery, special equipment is required; and a longer time is spent in the operating theatre. This again adds to the cost.”

Dr Lai further outlined that other costs, such as medical implants and the use of the hospital, including room, operating theatre, labs, drugs, and X-ray equipment, are all added to the overall expenses.

“It is good when persons have health insurance to defray the costs. It is also advisable to get a second opinion when it comes to the prices charged by some doctors and hospitals.”

Steve Distant, chief of sales at JN Bank, posits that good health is one of the most valuable possessions someone could have.

“It is said that ‘good health is wealth’. Many times we spend a lot of money to get back our health. Medical bills are one of the main reasons why some people fall into debt.”

Like Dr Lai, he stressed that it is important for people to invest in a health insurance policy, which they can draw on to support the financing of their medical costs. In addition, he encouraged people to also maintain an emergency fund.

“Keep funds in an account to which you have very limited access, so that it becomes inconvenient for you to touch those funds. You may want to consider placing it in a fixed, long-term savings account, where it can grow interest and not be chipped away by fees and charges,” Distant advised.

“And instead of dipping into your savings, you could also easily borrow against what you have saved at a much lower interest than an unsecured loan,” he said.

However, Distant stressed that beyond insurance and savings, perhaps the best policy to mitigate debilitating medical debt is to practise good health and wellness.

“Simply take care of yourself. Consume healthy foods, be temperate, exercise and visit your doctor regularly for check-ups to guard against diseases that will only reduce your quality of life and dig large holes in your pocket,” he said.

“Make healthy living a habit and you’ll spend less on medical bills and avoid debt,” he maintained.