Fact checked by Derick Wilder
If there’s one thing we can all agree on, it’s that healthcare costs too much, and something must be done about it. Okay, not all of us. Insurance companies would disagree, despite what their marketing campaigns tell us.
Out-of-pocket healthcare spending per person reached $1,514 in 2023, according to health policy research organization KFF. That doesn’t include premiums. As costs pile up with every doctor’s visit, test, and procedure — minor or major — they chip away at our budgets and at our hopes of retiring or leaving something behind for our kids.
As of this writing, I owe $2,598.12 to three different medical organizations. A minor emergency in Las Vegas a few months ago earned me an ambulance ride and a night’s stay at University Medical Center. I owe the hospital $219.68 and the ambulance company, American Medical Response, $1,423.70. My hometown provider of choice, Northwestern Medicine, has me for $954.74.
I’m paying all of these off with interest-free payment plans. University Medical Center gets $25 a month, which will be zeroed out in August. The ambulance company gets $60 a month through November 2027. Northwestern gets $50 a month, but I don’t think that balance will ever disappear.
I can’t say how long I’ve carried a balance with Northwestern. It may have started in 2014 after skin cancer removal and reconstructive surgery. Since then, other than routine preventative care, I’ve had two cysts removed, an MRI, a colonoscopy, follow-up tests, and a couple of trips to immediate care for foolish injuries earned through impatience with home projects. Nothing major. Nothing catastrophic. But health issues happen. A hundred dollars here, two hundred there, adds up.
Could I pay it all off right now? Yeah. Should I? Probably not. Like many people, my budget is pretty tight. Is it worth sacrificing a modest vacation or cutting back on what I spend on my kids at Christmas? I’ll need a new car soon. Houses always need repairs. So no, it’s not worth it to me. I’ve made this debt part of my budget, and I plan to keep it there.
If my grandfather were alive today, he would be livid. To him, debt — any debt — was unacceptable. He paid cash for his house and his cars. Had I followed his path and become a successful businessman instead of embracing the endless hustle of a writer’s life, maybe I’d have the liquidity to avoid debt entirely. But things cost less in his day, even when adjusted for inflation. And he didn’t face the stack of modern expenses we accept as normal: cell phones and data plans, computers, internet service, streaming subscriptions, childcare, cloud storage, LinkedIn Premium…. Compared to his ledger, ours looks less like a balance sheet and more like a balance area rug.
Sure, I could live with fewer streaming services. I don’t need an iPad — though my eldest son would strongly disagree. I’m not jetting off to exotic destinations, but what’s wrong with a little adventure now and then? These are the costs of living, not just surviving. And that price includes what I owe Northwestern.
I’ve come to accept this perpetual healthcare debt as essential to my budget as groceries, the mortgage, insurance premiums, and retirement contributions. It’s a nonnegotiable expense. I can’t do much about it. But my HBO Max subscription? That I can cancel. Why am I paying for commercials anyway?
