Stockton seeks bankruptcy; comparing the cost of a city with the cost of healthcare

Putting Numbers in Perspective

 July 27th it was announced that Stockton, California, with about 300,000 residents and a $700 million debt load, is set to become the largest U.S. city ever to seek Chapter 9 protection and file for bankrupcy. Looking at these numbers left me pondering a bit. What would it take for Stockton to pay off its debt? 700 million divided by 300 thousand is $2,333. This means that the city of Stockton is claiming each of its residents isn’t creditworthy for $2333 a head. Is America that bad off? How do any of us buy anything on credit? Most adults have credit extension from several cards for $2500-$10000, but Stockton California residents aren’t good for $2333? It seems like perhaps Stockton is pulling a fast one. Given such disingenuous claims, I would suggest their bondholders demand their money back and run. This disingenuous posturing is very similar to people saying they “can’t afford to pay for their medical service/pills” when as a nation we spend hundreds of billions (voluntarily) on hair removal, supplements, and over the counter pain tablets. I guess us doctors just do a really bad job marketing our services, as apparently lifesaving services are “unaffordable”, but dubious supplements and vitamins can be purchased without a complaint.

Since this is a physician’s blog I wanted to put this level of debt into some perspective. $2300 would buy you a Reclast infusion (one year’s treatment for osteoporosis) while still returning you approximately $1000 in change. This cost is if it done in a private office; it is 6 times more expensive if you get it at Lee Memorials outpatient infusion center (see my prior blog on Medicare price-fixing policies).  In Lee county, a stripped down health insurance policy (with a $5,000 deductible and no other frills), costs $311 x 12 months = $3732 dollars/year. So let me see…. If everyone in Stockton isn’t creditworthy for $2300, how is it we are expected to pay $1400 more than that per year for each individual purchasing health insurance? Plus, despite paying that much to your insurance company, you still have to come up with $5000 out of your pocket for the privilege of owning your policy for one year. What in the world is going on? Can we all claim bankruptcy because we “can’t afford” our premiums? How does Obamacare help this situation? Did someone say “free health care for all”?

Raymond Kordonowy, MD

Internal Medicine of Southwest Florida