Monitor Board of Contributors: The case of the unaffordable bellyache
All through 2012 I planned to write a calm, well-reasoned column for the Monitor about health care reform, one that cited lots of statistics (for whatever they are worth), one that didn’t reveal how much personal skin I have in this game. This is not that story.
A few weeks ago, I was slowly recovering from what I thought was bronchitis. I had experienced the usual digestive distress that comes from taking antibiotics, which was painful enough on its own, but then one night, I was seized by an excruciating, breath-stopping pain across my upper abdomen and into my chest.
I couldn’t find a position on the bed that relieved it in any way. After thrashing and moaning for half an hour, wondering what this was, thinking of all the times they tell you, “If you have unexplained chest pains with shortness of breath, or sudden-onset, severe pain, call 911,” I took the conventional medical advice.
I could barely summon the breath to talk to the operator. She promised me the paramedics were on their way and told me not to try to get downstairs to unlock the door, just to stay where I was and wait for help. Some unclear minutes later, a fire truck and ambulance were both outside my house. I suppose they got in through the window.
They called out, and I hollered, “Up here,” as loud as I could. Three strange men brought a chair-shaped stretcher into my messy bedroom, where I was on my hands and knees on the bed in my pajamas. I hadn’t been able to move enough to put on a robe, much less clothing or shoes.
As they thumped me down the stairs and across the front porch, I said, “Please get my purse; it’s in the living room by the blue chair. My insurance card is there.”
They got the purse, but they wouldn’t take the card. They just kept saying, “Don’t worry about that now. Just relax. We’re taking you to the hospital. Relax. We’ll take care of you. On a scale of 1-10, just how bad is your pain?”
I gave it a 9½, which is higher than I have ever rated any pain outside of childbirth.
Now, this insurance card they wouldn’t look at belongs to a policy I pay for out of my own pocket. After searching for over a year, the only job I’d been able to find was as a part-time Montessori preschool teacher, a position for which I have been trained at a cost of about $20,000. I’m earning $11 an hour for four hours a day – less than a Wal-mart clerk, I hear – except for the days I’m sick. This month, there were a lot of those. My paychecks barely cover the premiums for this health insurance. Without an ever-decreasing alimony income, it is not an exaggeration to say I would be homeless.
At the emergency room, I tried again to give someone my insurance card. I don’t recall whether they looked at it. They didn’t seem very interested. When you’re doubled up with pain and moaning aloud, they talk as though their sole concern is sorting out what’s wrong with you. All that money stuff can wait. Let’s go to X-ray, take some blood. Here’s an IV of something or other, and here’s a cupful of something else. It turned out that I had pneumonia, but that the pain was being caused by the antibiotics I was given when I thought it merely bronchitis.
As I swallowed my bitter medicine and my humiliation, I comforted myself by saying, “At least I have insurance.”
A $715 ride
So today I opened my mail and found that the city of Concord wants $715 for that ambulance ride. On the back of the bill is a form to fill out with insurance information, and I’d like to think that if taxes won’t pay for the rescue, the insurance company might. But I’ve learned not to expect too much from our profit-motivated insurance industry.
I got hauled off to Massachusetts General once in an ambulance, never mind why, at a time in my life when I had what was considered excellent insurance coverage. They still charged me $118 for the ambulance on top of the $150 ER co-pay, and that time there was no diagnostic work, just a morphine IV until my family arrived to get me out of their hair.
It made me wonder: Since the fire department charges to take people to the hospital, what if my house were on fire? Would I have to pay the firefighters’ wages out of my renter’s insurance? But wait. Isn’t this what taxes are for?
I was relieved at first to discover that my condition was “only” pneumonia and a drug reaction. Now I find myself perversely wishing it had been worse, because the reassuring diagnosis only adds humiliation to the insult of the bill.
All the public health people, the first aid people and the primary care doctors are always saying, “If ___ happens, call 911.” Forget that! From now on, I’ll have to know for sure I’m at death’s door before I avail myself of this supposedly taxpayer-funded emergency service. How will I know? Well, I won’t. So I won’t call.
Terrified of the cost
Worse, I find myself weeping out loud (really) at the thought of what happens to the completely uninsured. I don’t mean the mythical insurance deadbeat who chooses to gamble and loses. I’m talking about the many, many people in our country whose employers, if any, don’t give them benefits, who can’t even afford the overpriced basic coverage I’m shelling out nearly $500 a month for, but who aren’t eligible for welfare or Medicaid either. How many other Americans are sitting at home with frightening symptoms, unable to drive themselves to the ER but terrified, as I was, of incurring unpayable fees for what might turn out not to be life-threatening after all? In how many of these cases was it not antibiotic indigestion?
In how many cases did the patient die because they had no idea how they’d ever pay for the help?
According to many of my fellow Americans, I must be a lazy good-for-nothing, since I can’t find a cozy office job with benefits during a recession. Clearly I didn’t deserve to be rescued, since all I do for my meager paycheck is teach and care for other people’s kids. I must not be worth saving.
In our America, people like me deserve to gasp and whimper their way through desperate pain, hope it’s nothing serious, and sometimes die in that hope.
In what way can we call ourselves a civilized nation while we let this happen to our neighbors and then blame the victims? When will anything like sanity start to inform our health-care system?
(Cherie Konyha Greene lives in Concord.)