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How High Medical Bills Can Take A Toll On Both Patients And The Nurses Who Care For Them


NPR's recently run stories about high medical bills and people who struggle to pay them in our Bill of the Month series in collaboration with Kaiser Health News. After our most recent story, we heard from a nurse who says high bills affect her relationship with patients, and perhaps their care.

Hilary Valdez is a cardiac nurse at a hospital in Colorado Springs, Colo. She joins us now. Ms. Valdez, thanks so much for being with us.

HILARY VALDEZ: Thank you for having me.

SIMON: As you see it, what are the effect of high bills on some of your patients as you deal with them?

VALDEZ: Well, initially, I wrote in because I was frustrated. These stories aren't sensationalized. And because of these crushing bills, the public has become, I think, less trusting of health care providers. And so I wanted to speak from the perspective of nurses and other clinicians who work directly with the patients because we hear their frustrations the loudest.

I had a patient who had a heart attack. And he called me from the hall. He was sweating and short of breath, and his chest pain had returned. And protocol dictated that I get the 12-lead EKG machine. And as I was placing the leads on his chest, he looked at me almost suspiciously and asked me what that was going to cost.

And that was a teaching moment for me because I think of that machine the same way I think of a blood pressure cuff or a stethoscope. It's a way for us to assess our patients. And it shocked me that in this situation that could have been life-threatening, he was mostly concerned about his bill.

SIMON: Has it happened that your - I don't know - you're about to take care of someone, doing one of the amazing things that nurses do, and a patient looks up and says, wait; I don't know if I can pay for that?

VALDEZ: It has. And patients have the right to autonomy and transparency. And it's important that we help them navigate the system so they can be more comfortable making their health care decisions. And nurses - you know, patients need to utilize us. And we advocate so much for them. They need to think of nurses as multitools. We have the doctors' ears and the social workers, case managers, pharmacists. And patients, I think, need to be aware that we can help get them resources that they might not know exist.

SIMON: From your perspective, what worries you the most about health care in this country?

VALDEZ: Oh, I don't quite have the answer to that. My concern, though, is that patients become fearful of seeking health care. And not all situations require hospitalization, but when someone puts off a nagging pain for years and years because they think they might lose their home, they end up in a lot worse of a situation than if they had sought help earlier.

SIMON: Yeah. I have been told that you have to struggle with some of these questions in your own personal life, too.

VALDEZ: Yes, I have a chronic illness, actually - epilepsy. And since I was a child, I have dealt with hospitalizations and diagnostic tests and, more recently, even surgery. And the medications that I have to keep me seizure-free so I can work - they're expensive and have become more so. If I wasn't in a dual-income household, I don't think I would be able to make those payments.

SIMON: So you're a nurse with a chronic condition, and you're not certain you can afford the medication you need to keep you going.

VALDEZ: No. And I have great health benefits, too. But, in fact, benefits change, sometimes from year to year, and a medication that I would get at a certain price from a certain pharmacy might change with next year's benefits. So it's hard for me to navigate, even as someone who, I think, does have health care literacy.

SIMON: Hilary Valdez is a cardiac nurse at a hospital in Colorado Springs. Thank you so much for being with us.

VALDEZ: Well, thank you for having me. Transcript provided by NPR, Copyright NPR.