Top Doctors: My Daughter’s $29,000 Appendectomy

When the bills and insurance forms for my five-year-old’s surgery started rolling in, I was the one who needed a doctor. So I set out on a quest to understand them — and learned just how screwed up our health-care system really is

Any Philadelphian who’s been inside Children’s Hospital will tell you it’s an institution at once breathtaking and heartbreaking. On the breathtaking side, the only thing I can compare it to is Disney World, which — no matter where you stand on it philosophically — is without question the cleanest, friendliest, most competently run operation in the entire history of humankind. CHOP, I can say confidently, runs a close second.

As for the heartbreak? Well, it strikes you the minute you walk through CHOP’s sparkling glass facade and start striding its sunny, brightly painted corridors. There are kids here who will spend years as patients in this place, and some of them will never go home. If there’s a deeper level of hell than being the parent of a gravely ill child, I can’t fathom what it might be.

Deirdra Young oversees billing and payment for all those patients. She’s a soft-spoken middle-aged woman, and she works, not in CHOP’s main building on 34th Street, but in space CHOP rents in the Wanamaker Building near City Hall, in an office adjacent to a sea of cubicles so large it’s almost comical. I went to see Deirdra one day with a sheaf of papers under my arm and a simple plea: Help me, Deirdra, feel less like a dunce.

The first paperwork related to Sarah’s surgery arrived a couple of weeks after she came home. Since the health coverage I get as a staffer at this magazine is what’s known as a high-deductible/health savings account plan — that is, I’m responsible for the first $4,000 of annual costs, which I pay out of a health savings account to which I make monthly contributions — I braced myself, expecting to see a vast total cost of which, hopefully, I’d only have to pay a petite proportion. I saw neither. The paper, from my insurance company, United Healthcare, read:

Radiology Services $71.00
Network Discount $14.20
Amount Allowed $56.80

I was baffled at first, but then secretly gleeful, the way you feel when you’re speeding and you pass a cop but for some reason he doesn’t pull out and come after you. Could it be this was it — the only bill I was going to get? That somehow everything Sarah had gone through — the ultrasound, the surgery, the IVs, the three nights in the hospital — had slipped through the billing cracks? She was small. It was possible.

Over the next few weeks, unfortunately, I started seeing and hearing the lights and sirens that haunt a wanted man. Every day when I came home from work, a new bill or statement from my insurance company was waiting for me — most of them either indecipherable or contradictory. There was a bill for “anesthesia services” of $1,326, yet the amount due was only $1,060, though neither I nor my insurance company had paid anything so far. There was a bill for “radiology services” that seemed to indicate the $209 charge was covered by insurance, but another identical one that indicated it wasn’t. My favorite showed up in December: It listed a charge for room and board of $3,100, then another for “IH miscellaneous services” of — drumroll, please — $19,742.16. I wondered whether my five-year-old daughter had been force-fed Kobe beef throughout her hospital stay, or maybe had been ordering up porn on pay-per-view.