Sad and disturbing case of a young, relatively healthy heart transplant patient who ended up costing Medicare $2.1 million in the year he died -- of a cause other than heart failure! Everyone knows that a tiny fraction of patients end up accounting for a giant share of the entire healthcare pie in the months before they die... but this story shows exactly how that happens. (If you can't breach the firewall through the link, Google "Scott Crawford Medicare".)

One of the most amazing factoids: the heart transplant itself, which was done at Johns Hopkins, cost just over $375K. My craniotomy cost roughly $300K, which Stanford ended up writing off because I was unemployed and uninsured. Does that mean I was part of the "tiny fraction" of patients who end up sucking up all the healthcare dollars? That is a disturbing thought.

If Medicare were available for everyone, those costs would be shared by a very big pool of people.

To be fair, I had health insurance continuously from age 16 to age 40 -- for which I not-infrequently paid cash via COBRA or super-small-business coverage. I think I never cost the insurer more than $500/year, because I enjoyed a level of perfect health that I did not appreciate at the time. But within SIX WEEKS of losing my coverage for the first time in my adult life -- because companies that go out of business do not offer COBRA, entrepreneurs! -- I had this extremely expensive catastrophic event.

yikes

Joyce, it's awful to hear you had this event. I hope you are on the recovery path now.

Based on the amazing progress of pandawhale, it looks like you are doing very well.

Struggling with the decease is extremely hard, but struggling with insurance and payments while recovering is catastrophic. I do not think you should be disturbed about the costs assigned by the system to your procedure.

There is no way this cost is justified. The healthcare system is in downward spiral. Any enterprise will be in such situation, if people working there are not allowed to work. Medical professionals are in chains of patches of regulations, politics, poor management, unclear priorities and processes established just to be legally protected.

Once active and creative people either leave or turn off their creativity, the system becomes extremely inefficient. It's literally rotting from the inside. Thus the costs to run extremely ineffective machine are piling up.

I do not think patients are responsible fo inefficiencies of the system, which is, by no means, has anything resembling free market driven enterprise.

US medical system needs to change. I hope Obamacare is the first step towards recovery.