Two weeks ago, Joycelyn Elders spoke at a conference I was attending in Little Rock, and among the bits of wisdom she shared was this: We don't have a health care system. We have a sick care system, because the system doesn't care, until you're sick, and even then they don't care unless you can pay. (That's as close to word-for-word quote as memory allows.) Her words resonated with me, because I'd just had the experience of accompanying my daughter to the emergency room, after a car accident. It was my first opportunity to see just how sick this system really is.
My daughter was lucky, and only had minor injuries to her hand and ankle, requiring just a few stitches (9) and the usual array of x-rays and pain medicine. She was "luckier" because she had insurance.
In the adjacent room her friend had similar injuries but no insurance. The girls had collided when the car overturned, knocking their heads together. My daughter got a neck x-ray. The other girl didn't. My daughter got pain medicine. The other girl didn't. To be fair, she didn't require stitches (in my expert, non-medical opinion) but it would have been nice if she had at least gotten pain medication, since to my untrained eye, pain would be a better criteria for distributing them than insurance. But of course, I am not a doctor.
Fast forward to last Friday, when we went in for follow up care. First, we had to deal with the insurance nightmare that is an automobile accident. Our insurance doesn't want to pay because it should be covered by the accident policy of the driver. (The driver, another young person, carried liability insurance but not collision, so this accident cost him the family's only car.) Luckily, our family doctor agreed to file his charges anyway. Not so for the provider of the x-rays that were required to check the healing of the ankle. They said that because the insurance company might decline payment, they would have to treat us as a "self pay" which means payment in cash, even though we have not one but two health care policies (Blue Cross/Blue Shield, + Champus, because my spouse is retired military.) To clarify, we have two healthcare policies, but were treated as "self-pay" because the health care provider anticipates the insurance companies battling over who has to pay.
The bill for the x-rays was over $300, but the helpful cashier informed me that if I paid in full immediately, they give a 20% discount. So because I could pay (which was a lucky circumstance) I got to pay less. Had I been strapped (as often happens) I would have paid more. Had I been completely unable to make a payment, she wouldn't have gotten the x-rays, as far as I could determine.
One last note: while I was at the doctor, I inquired about the HPV vaccine (that prevents cervical cancer.) I was advised to check to see if my insurance (Blue Cross/Blue Sheild) would cover it. The answer: No. Had my daughter been under 18 (she's 19) they would cover it. After 18, you're on your own. When we related this to the doctor, he told us that not even his insurance covers the vaccine, despite the clear evidence that it saves lives. He's paying for his daughter's shot out of his own pocket, as I will do, just as soon as we're done with the fallout of the accident.
Healthcare indeed.