Bodily and Financial Ailments

I've talked about Ryan Estrada here before. It seems like he's always doing something interesting, even if that occasionally means it puts his life in peril. He's recently noted, though, that his closest brush with death came from sitting on a couch in Florida. Estrada has just posted on his site a 10-page story about how he had to undergo surgery for testicular torsion. Go over there and read about it. (Don't worry -- it's a family-friendly comics and no naughty bits are shown at any point!) Of the ten pages, the first page is basically the set-up, then there's seven pages of the story itself with a resolution on page nine. But then he has something of an epilogue on the last page, and that aspect of the story is what I want to focus on.

Estrada had been living in South Korea at the time, and he was only in Florida on visit. I mention that to explain A) why he didn't have health insurance, and B) why he "hid" in Korea after the events of the story; he simply returned home. The story was originally done for CORPUS: A Comic Anthology of Bodily Ailments, which came out last year. The anthology, and certainly Estrada's story in it, tie in to the growing trend of graphic medicine stories -- comics that are expressly related to medicine or illness. But while the crux of Estrada's story is indeed focused on the torsion incident itself, that last page -- the pseudo-epilogue I mentioned -- is about getting flooded with bills afterwards.

Estrada works as a freelance cartoonist. He doesn't make tons of money -- enough to live comfortably in South Korea, but he's not what you'd call wealthy. Estrada has been very open about his finances over the years. I don't know exactly when this story took place, but I think he was making about $20,000 annually around that time. Technically above the poverty line here in the US, but not by much. He noted to me that the bill for a one day stay in the hospital -- not counting any of the doctor visits, examination fees, etc. Just the hospital stay itself -- was more than that. He says he could have bought a house with the money that got racked up in bills.

And I don't think anyone familiar with the US medical system would question any of that. "Yup, sounds about right!"

The leading cause for bankruptcy in the United States is medical expenses. Roughly 2/3 of all bankruptcies in the US are because of medical bills that people can't afford. And nearly 80% of those people HAD health insurance!!

Go back and read Estrada's comic again. Out of a ten page story, discussion of medical costs/bills occur on literally half the pages. As he's lying there in a fetal position, experiencing the worst pain in his life, he's actively talking about skipping parts of health care because of the cost. His very first line of dialogue is: "Does anyone know how much it costs to go to an emergency room if you don't have insurance?" My point is that the health care system here in the US is so fucked up that there are literally no walls between discussions of actual health care and how life-shatteringly expensive it is. Estrada was asked to write a story about "bodily ailments" and half of his story is about the financial impact of it. The two are so intertwined as to be inseparable.

Estrada is certainly not unique in being in this position. But his story highlights for me two conclusions:

1. Graphic medicine as a genre of comics will continue to expand, but will also increasingly incorporate a great deal of financial issues/concerns as well. This will require two sets of storytelling skills from artists -- the ability to relay medical information and the ability to relay financial information -- and those who are talented at both will be the stand-out artists that are celebrated. This could have the potential effect of talented graphic medicine artists (unfortunately) not getting enough credit and/or accolades because they're not as adept at relaying the fiscal side of the story.
2. As a society, we're going to see more and more people emigrate to other countries specifically to escape medical bills. Estrada, as I said, already had made a home in South Korea, so he wasn't trying to escape the bills specifically, but he did discover something of a loophole that worked to his advantage. It will only be a matter of time before this becomes more widely practiced as an intentional means of fleeing impossible medical debts.

Both of these, for different reason, give me cause for concern. Estrada has more than once proven he's generally ahead of the curve compared to everybody else (he literally invented "normcore") and while I generally like to celebrate that about him, this is one time I hope he doesn't become a trend-setter.

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