Huge bills begin arriving in the mail, a frightening deja vu for Tony Andrade. The shoe box in his bedroom already is stacked with overdue notices from hospitals and doctors.
Andrade's cancer surgery was a success. Only part of his bladder had to be removed, and he headed home from the hospital after two nights to recover in his mother's guest room. His burdens are lighter now that surgery is behind him.
But a new statement from Kaiser Permanente dated Sept. 20 is particularly jolting. It gives Andrade two weeks to pay $11,309.10, most of it for the June 17 visit to the Kaiser emergency room, where the cancerous growth in his bladder was discovered. The body scans alone cost $7,600.
Two other bills arrive at the house he shares with his father near Franklin Boulevard and 17th Avenue. These are for another visit to the emergency room, on Sept. 19 at Mercy General Hospital, for pain that turned out to come from his pancreas, unrelated to the bladder cancer. The hospital wants $420, while the ER doctor is separately owed $637.20.
The statements from Mercy were a surprise. Andrade, 47 and uninsured, thought the bills would go directly to Sacramento County, which had agreed to pay for his care back in July, when it deemed him medically indigent.
"They told me I wouldn't be paying anything," he says, his voice soft, but strained. "The bills keep coming."
Andrade hopes these will be the last of the bills added to his collection, now that the county is covering the $62,000-plus that Sutter General Hospital will charge for his surgery.
It would seem a cruel twist that those with the least have to pay the most for medical care. But lacking health insurance means forgoing the bargaining power of insurance companies. Andrade's bills likely are thousands of dollars higher than they would be if he were insured.
Andrade doesn't know much about the ins and outs of the current national health care policy debate, but he does realize he's the little guy in the big-money world of medical care.
"If I could pay for any of it, I would," he says. When a bill collector calls, he assures the caller that he isn't trying to shirk his financial obligations. He asks for more time, even though he knows that all the time in the world won't allow him to pay off all those medical bills.
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