Bend Over and Cough

August 3, 2018

Sharlene was in the dumps. She gets that way every so often. When the Gloomies take root, she heads in to see her doctor friend at the local emergency room. At the front desk, Sharlene—who is unemployed and has no health insurance – vaguely describe her symptoms, takes a number and waits patiently. When it’s her turn, the doctor greets her like the old friend she has become. They talk. He checks her vitals. He squeezes her hand which is likely the only human contact she’s had in a while. She feels better immediately.

She wasn’t really sick. She just needed someone to talk to.

Blessed are the poor in spirit so they may inherit the world. And probably a piece of my inheritance too. Though she did not pay for her visit—good luck trying to find data on the price of a trip to the ER—those costs are necessarily absorbed somewhere. Most likely by people like me who actually pay for our healthcare needs.

Perhaps our family is an anomaly. We are healthy, we are employed. We have insurance. We have the ability to pay our fair share, which we do happily. In fact, we consider it an honor and responsibility of a blessed life to help the least of these.

But that obligation is finite. Like a family, we’re happy to pay for our kids but at some point, we demand they have some skin in the game too. I was reminded of this recently when I was felled by a whopper of a tissue-tearing cough. After eight days of ignoring my worsening symptoms, I did something I haven’t done in six years: I went to the doctor. Or at least I tried. That journey revealed a system that punishes the healthy and gouges those that can pay for services.

The first trick was getting an appointment. Despite the fact I was an established patient at the “patient-centered” clinic, my request to see my preferred physician was denied and I was relegated to the walk-in clinic. What’s the point of being an established patient when I was ultimately treated by a nurse practitioner whom I did not know nor did I choose? So much for patients’ rights.

The nurse diagnosed me, handed me the coveted prescription and stuck me with a bill for $188. Payment due at the time of service. Large caps. I left the clinic feeling broke, puny and if I could have mustered the energy, frothing mad.

Welcome to the dumpster fire we call healthcare in America. Navigating the system is like being an unwilling contestant on a Hunger Games show where pulling the wrong lever looney tunes you to a gauzy netherworld of impossible and ever-changing cruel challenges.

Why was Sharlene’s access to healthcare, which was wildly more expensive and ill-suited to her needs — she needed a mental health professional — more readily available than my quest for treatment?

Before you suggest I call the Waaa-mbulance, consider this: The amount Tim and I have paid in coverage just in the last five years could have paid for our children’s entire college education. Twice. Yet it did not cover my visit last week. Indeed, the Kaiser Family Foundation estimates that 43 percent of uninsured choose not to purchase insurance because it’s too expensive and ultimately never pays for the services you need.

Ironically, while I was busy convalescing, my sister was busy breaking her arm while backpacking in Yellowstone. Rather than go to an out-of-network provider and deal with the cluster of anticipated insurance denials, she cowboy’d up, self-splinted her arm and drove ten hours to her home state to seek medical care.

Healthcare system, you have failed us.

I’m not advocating for special treatment based on ability to pay. Nor am I suggesting anyone should be denied access to healthcare. I don’t pretend to understand the complexities of the system nor am I particularly interested in travelling the gummy spiderweb of factors that got us to where we are today. I’ll leave that to our elected leaders and the health care intelligentsia. I am, however, suggesting we come up with a solution that doesn’t involve a complicated schema of high-level negotiations in order to see the whites of a doc’s eyes for treatment of a common cold.

What I know is this: with a sustained three-digit temperature and summer whiling away outside my window, all I wanted was to get better. I did, no thanks to the surplus of inaccessible physicians and specialists in my town nor to any of the many granite-countered “boutique” health care facilities.

Maybe that’s why Sharlene was so sad.