The question is, are high US medical costs simply out of control or are they justifiable?

A friend who recently visited us from South Africa (i.e. no US health insurance) got sick on a Saturday evening. All of the symptoms pointed to the possibility of meningitis.

After a quick call to our family physician, we took off to the ER of a newly-built hospital not too far from where we live.

Upon arrival at 8 p.m., the ER staff immediately tended to our guest and provided all of us with masks just in case it was meningitis. Our guest was put in a room in the ER. Some blood tests and a CT scan were done. Our guest was also put on a drip to provide liquids and given some pain medication.

In total, the attending physician spent maybe 20 minutes with the patient, and the nurse spent maybe an hour, if that long. In the end, with long periods of waiting alone in the room, we were sent home at about 1 a.m. with a prescription for some medication. Luckily, no meningitis.

The service was excellent, but then came the bills. The cost of this little excursion to the ER… a little over $8,000.

A Comparison of Medical Costs

Earlier this week, a family member of ours fainted and was taken to the ER of a private hospital in Port Elizabeth, South Africa. Some blood tests, an EKG and a CT scan were done. Everything was found to be in good order, but to be safe, it was decided to take our family member up into the High Care unit of the hospital for the night.

All went well and the patient was sent home the next morning.

By all accounts, this hospital also provided excellent care. The cost for the ER care and a night in High Care? R14,000 or a little over $1,500 at the current exchange rate.

That is less than 20% of the cost of our trip to the ER here in the US!

US Medical Costs: Outrageous or Justifiable?

Before this second ER incident with our family member took place, I looked at the $8,000 bill for the first ER incident and simply could not see where $8,000 in value comes from.

$8,000 provides housing for a family for many months. It can buy a used vehicle that can be driven for a few years. It can buy food for a family of four for at least a year. How is it possible that 5 hours in an ER, with not much more than basic care provided, can cost $8,000?

After the second ER incident took place, it confirmed in my mind exactly how outrageous the cost of medical care in the US can be.

As our politicians like to remind us prior to each election, our medical care system is broken. It is not that the service is bad, but rather that the medical costs to patients are out of control.

I am not convinced that simply forcing everybody to have medical insurance is the solution. The crazy high medical costs will simply find its way back into the pockets of the American people in the form of high insurance premiums.

What Do You Think?

So what do you think about medical costs in the US? Is it outrageously high or can it be justified? Take our poll below and leave a comment…

Some might say, “So what? People have migrated for thousands of years and will continue to do so in the future!”

The thing is, South Africa’s emigration rate has been higher than what can be described as “normal migration” and there has been significant concern over the so-called “brain drain” – skilled people leaving.

Given the audience of this website, many of the readers of this blog fall into the category of people who have left South Africa in recent years to build a new life in another country, including the United States.

Ever wondered why? What are expats’ main reasons for leaving South Africa?

To all of you South African expats who have permanently settled elsewhere, I ask this… (Pick up to 2 answers, but if you have only one reason, pick only one.)

Vote in the poll and leave your comments below…

Once you reach that point, the question becomes, “Do I give up my South African citizenship, or do I go for dual-citizenship?”

There are some issues with both options…

Giving Up SA Citizenship and having US Citizenship Only

• You will be regarded as a foreigner in South Africa and will need to get a visa when you visit SA. (This is not a problem for the usual short-term tourist visas. You get those at the airport.)
• If you ever decide to move back to South Africa, you will need to apply with the SA govt for residence status and to regain your citizenship, i.e. you won’t simply be able to show up and settle.
• You will not have to go through the whole process of renewing your SA passport every few years, a process that can at times be frustrating.
• When visiting South Africa, since you will be there as an American, you will able to get assistance from the US embassy in the case of an emergency.
• You will no longer be subject to South African laws, e.g. possible military conscription obligations, or not being able to take your US-bought firearm into South Africa.

Keeping your South African Citizenship (Dual Citizenship)

• You have to renew your SA passport every few years. (As I said, sometimes the process can at times be frustrating.)
• You can go back to South Africa at any time you choose, whether to visit or live.
• When visiting South Africa, you have to enter South Africa as a South African (i.e. on your SA passport). This means you can’t take your US-bought firearm with you on a hunting trip because you won’t have a South African firearm license for it. You also won’t be able to get assistance from the US embassy in the case of an emergency.

There are probably more issues to consider, but these are the general ones.

So my question to you is this:

Tell us what you think, and feel free to add your thoughts as a comment below!