Life as a Spectator Sport

Just one of many examples of ordinary hardworking citizens caught up in a health care system that, like higher education, is essentially available only to the wealthy.

In December, my grandson was a backseat passenger in a driver's education car that was rear-ended by another vehicle. The others in the car weren't injured, but Nick was taken to the emergency room complaining of pain and stiffness. The ER diagnosed whiplash, not unexpected, and sent him home with a prescription for pain medication. The other driver's insurance company said they'd pay the hospital bill.

But over the next week, instead of fading away, the pain became worse, and he began to have headaches and brief blackouts. He had no strength in his arms, and couldn't move his head from side to side without severe pain. Shelley, driving a load somewhere in Texas, told him to go back to the ER.

He needed an MRI, they said. Who was his insurance carrier? He said the insurance company whose driver had hit him was going to pay for his medical costs. Sorry, said the hospital, we don't do third party billing. Nick called Shelley and she called the hospital, but they were adamant. Without insurance, the only option was to pay up front, a minimum of $1300. It might be more, said the clerk, depending on how many images they had to make.

Shelley called me, unbelieving. "What am I supposed to do?" she asked. "The insurance company won't pay anything until we give them all the bills, and the hospital won't even see what's wrong with him unless we pay them up front! Where is someone supposed to come up with that kind of money?"

I suggested that she call a different hospital, something she had already thought of doing, and she did eventually find one in Roanoke that would bill the automotive insurance company. I drove Nick up there, he had his MRI, the ER doctor gave him a referral to a local neurologist for a herniated disk, and we thought everything was under control. But no. After a month's wait to see the neurologist, they were turned away on Monday because the doctor had allegedly called in sick. She didn't know, the clerk said, when she could give them another appointment. Shelley suspects that the hospital told them Nick didn't have insurance. That sounds paranoid, granted, but the clerk claimed to have called Nick's cell phone to leave a message about the canceled appointment. "They didn't have Nick's number," Shelley told me. "I gave them my number, to make sure I knew what was going on." And there was no message on Nick's voice mail anyway, even if they had somehow managed to get the number, nor on Shelley's phone.

Yesterday, Shelley took him back to the ER, they diagnosed "post-concussion syndrome" and gave her a referral to another neurologist. As it turns out, even though he's over eighteen, Nick was still eligible for the Medicaid insurance he had as a child, since he was a full-time student living at home with a parent. So Shelley called to see whether the doctor's office took Medicaid. No such luck, but she said she'd come up with the money for the first visit somehow. Fine, the clerk said, but we can't make an appointment over the phone; you'll have to come into the office. So Shelley took another day off work. In the doctor's office, the clerk asked what insurance Nick had. "He only has Medicaid," Shelley began, "but--" She was going to say that she knew they didn't take Medicaid and was prepared to pay their $250 office visit herself. Before she could get the words out, the clerk exploded. "Are you the one who called this morning? I told you we don't take Medicaid!"

Shelley said she felt like screaming back, "And I told you I was going to pay for it!" But she kept her temper and managed to get an appointment for next week, after more intrusive questions from the clerk about why they had waited so long to do anything about his injury, and why he still had Medicaid when he was over eighteen. By next week, six weeks will have gone by since the accident, with the symptoms growing more severe all the time.

The month's wait for the first appointment was the major part of the delay, of course, plus the couple of days it took to get the MRI. If he'd had the MRI right away and been seen promptly by a neurologist, he might well be fine by now. At the very least, he'd be under definitive care.

Contrast this with Clarence, who still has his federal Blue Cross insurance. When he began having mini-strokes last fall, the local ER immediately transferred him to a hospital with more extensive resources. It was only hours after that before he was surrounded with specialists, and scheduled for one test after another. By the time I took him home two days later, the hospital charges alone were over $40,000. But no problem--the insurance company paid all but $100. Blue Cross also paid nearly all the doctors' bills, leaving Clarence with a manageable co-payment.

Is Clarence more worthy than Nick? A better citizen? A more productive member of society? Wealthy, even? In fact, those questions are irrelevant and worthless. The only difference between them is that Clarence had a good insurance policy when he was working, and was lucky enough to be able to take it with him into retirement. Shelley, who has worked her entire adult life, worked just as hard as Clarence, hasn't been able to get jobs with that kind of insurance. So Nick has gone nearly six weeks without care for what will probably be diagnosed as a traumatic brain injury, and if this delay in care results in permanent disability, they will have no recourse to anyone. Shelley did engage a lawyer, but that's only to deal with the automobile insurance company. The neurology practice that refused to see them right away gets off scot-free, as well as anyone in the hospital who may have talked to the office about Nick's insurance status.

That's why we need healthcare reform. I'm not able to talk coherently about my personal feelings about this.

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RSS Feed PERSONAL Send email to liz at life-as-a-spectator-sport.com Home I'm a mother, grandmother, a computer professional, Democrat, Christian. I welcome politely worded comments and email, my spam filter throws the rest away, so don't bother to flame me WHY 'LIFE AS A SPECTATOR SPORT' "If you're lucky not to live in the gutters of a slum, but still can't afford to take vacations in the Alps, you're part of that enormous middle class who lives life through the medium of the television, further separated from "real" life by air conditioner, by automobile, by dishwasher, microwave and ice-in-the-door refrigerator, by automatic washer and dryer, and all the other appliances and conveniences that make it possible for America to live life at second hand. I'm not sure why Americans decided that televised drama was better than the real thing, that cardboard microwave food containers were an adequate substitute for real dishes, and their contents for real food, or that cooking, dishwashing and face-to-face conversation wasn't worth the effort and time it required. Someone fed this nation a plastic crate of out-of-season tomatoes and told us it was life and we took them at their word, and we're so much the poorer for it that it's hard to know where to start to list the shortcomings." I wrote this a couple of years ago, but I have to admit it's much less amusing than I thought it would be to see the artifical construct falling apart. THE NON-ELECTRIC HOME Cleaning, 1 Cleaning, 2 Cleaning, 3 KNITTING BLOGS Extravayarnza Knitting Heretic Mind of Winter Pie Knits Persistent Illusion See Eunny Knit The Keyboard Biologist Taleweaver's Ramblings TECHnitting Wendy Knits FINISHED PROJECTS -------FINISHED IN 2006------- Peruvian Cap Tutti-Frutti Socks Shelley's Socks Carol's Socks -------FINISHED IN 2007------- Chain Link Socks Baby Surprise Jacket Valerie & Friend Baby Bonnet Rainbow Baby Socks Girls Pixie Hood Mitred Square Heart Red & White Socks Coffee Cup Pot Holder Nubbins Dishcloth Garterlac Dishcloth Suede Booties Kate's Socks Norwegian Sweet Baby Cap Half Thumbless Mittens Red Mittens for Akkol -------FINISHED IN 2008------- SELF-RELIANCE AND THE FUTURE -- Blogs and websites -- Causubon's Book Club Orlov Food Storage Made Easy From the Wilderness In the Wake Listening to Katrina Survival Topics The Modern Homestead The Oil Drum Notes from a Hillside Farm -- Mailing Lists -- 12vdc Power Living on the Land Rainwater Refrigeration Alternatives Old Ways of Living POLITICAL BLOGS and SITES The political sites have moved BOOKS I'M READING How to Grow More Vegetables, etc. Small Scale Grain Raising ARCHIVES February 2009 January 2009 December 2008 November 2008 October 2008 August 2008 July 2008 May 2008 April 2008 March 2008 February 2008 January 2008 December 2007 November 2007 October 2007 September 2007 August 2007 July 2007 June 2007 May 2007 April 2007 March 2007 February 2007 January 2007 December 2006 November 2006 October 2006 September 2006 August 2006 July 2006 June 2006 May 2006 April 2006 March 2006 February 2006 January 2006 December 2005 November 2005 October 2005 September 2005 August 2005 July 2005 June 2005 May 2005 April 2005 March 2005 February 2005 January 2005 December 2004 November 2004 October 2004 September 2004 August 2004 July 2004 June 2004 May 2004 April 2004 March 2004 February 2004 January 2004 December 2003 November 2003 October 2003 September 2003 August 2003 July 2003 June 2003 May 2003 April 2003 March 2003 February 2003 January 2003 December 2002 November 2002 October 2002 September 2002 August 2002 July 2002 June 2002 May 2002 April 2002 March 2002 February 2002