and it's not about me.

I'm not even sure it's about medical insurance -- but it's sure about the D.

I've recently learned that a recent infection has cost a close real-life friend (and fellow PWD) another one of his toes, and a sizeable chunk of uncovered medical expenses. Until this weekend, a number of his close friends (including me) had known he'd been hospitalized, and that there was talk about a skin graft after everything healed -- but we didn't know the extent of the damage (both physical and fiscal).

The kicker of it all is that this friend has medical insurance. It's a ridiculously high deductible, but in this world, even high-deductible insurance is insurance. And a job is a job. Most insurance I'm familiar with caps out-of-pocket cost at something approaching three months' gross wages -- six months' at the most. Unless, of course, you blow out the top-end, lifetime coverage limit -- which used to be fairly high. Without the skin graft, and without rehabilitation, we've been told that this friend is looking at uncovered costs equal to a year's gross salary for the average "breadwinner" in a two-income working-class household.

This is above and beyond the cost of insurance premiums, the annual deductible, doctor-visit co-pays, and the cost of insulin, oral medications, and supplies (which, I am told by other friends familiar with the costs of insulin-dependent diabetes, runs about twice as much as the gross salary of someone working full-time at minimum wage above and beyond what "excellent" insurance covers).

Needless to say, we're quite concerned.

While my RL friends and I work at leveraging various connections to help our friend, I have to wonder about all of the other diabetics who encounter this sort of issue -- many of whom do not have a job that pays as well, or even the barest "major medical" coverage. Those of us PWD here on dLife, or active in other diabetes-oriented communities, understand that even with the strictest of attention, blood glucose excursions happen, infections happen, and sometimes worse things happen.

While the magnitude of this friend's uncovered costs are staggering, I have to figure that between the time he's been in the hospital, the costs of the surgery, and the various levels of care before, during, and after, there's not likely all that much -- if any -- padding. Between the costs of real estate (and the highest property taxes in the nation), equipment, personnel, and supplies; the costs of liability insurance and malpractice insurance; the costs of diagnostic tests to confirm for the insurance companies that further care is required; the costs of filling paperwork in multiplicate and managing all aspects of the paperwork trail; and the cost of covering those who are not covered by insurance (and whom the state demands facilities treat, regardless of their ability to pay)... it all mounts up.

It has been often publicized that most personal bankruptcies in the United States are medical bankruptcies -- that is to say, people are forced into bankruptcy because their medical bills are so astronomically high that they cannot begin to acquire enough money to pay them. This results in more uncollectible charges, resulting in more costs being passed on to patients in an ongoing spiral which has led a number of hospitals being forced to declare bankruptcy and to close up shop.

Near as I can tell, there is no option -- public, private, insured, pay for service -- that will end either the price escalation, or the decline in available services. While the oft-dreamed-of "cure" will not reverse the damage that has already occurred, perhaps it will save others the pain and anxiety that my friend and his family are going through.