The Awful Choices in America’s Health Care System
There are millions of us. We cling to the windowsill by our fingernails, twenty stories above the busy street, our faces desperate for hope and salvation. In pain. And slipping…
Today, because I desperately need health care I cannot afford, I am considering choosing a $1000 x-ray instead of a $120 x-ray.
Here’s how that works: My spine collapsed a couple of years ago. What I mean by that is unclear even to me; it has never been evaluated by a physician. I’ve had back problems for years. The offered solutions are always so outrageously expensive that I don’t even bother going to the ER anymore. Ice and pills. And pills and pills and pills.
“Left untreated,” says a website, “the disc can deteriorate rapidly.” Does the disc know that the Affordable Care Act will kick in, maybe, in 2014, and to just hold on awhile longer?
An ad in the local paper promises to relieve the pain, through a procedure called Spinal Decompression. For a limited time, it is only $37. $37! At this point, if someone offered to hit me with a brick and call it health care – for only $37! – I’d consider it.
I carefully removed 37% of my net worth from the bank one sunny morning and headed to San Luis Obispo for the appointment. The doctor was very nice. The explanation is encouraging. I am excited.
“We will need an x-ray first,” she says. She writes me a prescription for an x-ray. I put it with the other prescription for an x-ray I received from the SLONoor Foundation: I file it under ‘never’.
The x-ray is $120. It is not an impossible sum. But having the pacemaker battery ‘interrogated’ to find out how much juice is left is going to cost $400. The pacer is seven years old, at the end of its life expectancy. Mine, too, if I don’t get a new one.
Towards what should I be saving money: The prevention of death, or the prevention of disability? The new pacemaker is going to cost $14,000 – $100,000. Who needs a spine, when you don’t have a heart? The Tin Man beats the Cowardly Lion every time.
Still, it’s going to suck if the ‘disc deteriorates rapidly’.
I could have gotten on disability back when my heart went kaput, but I didn’t want to. Contrary to popular conservative belief, there aren’t millions of us excitedly hoping to be sitting around eating chips and playing video games while collecting government checks.
You cannot get access to healthcare without being declared disabled.
But now, here’s a choice: I could try to be declared disabled before I am actually disabled. I don’t have to fake anything. Sure enough, I can barely walk.
The other option is the ER. The ER, if I go in today – and I would have to fake a recent injury – would take an x-ray of my back. Then I could put the $120 towards the pacemaker. The ER would send me a bill for maybe a thousand, and, since I can’t pay that, the debt would be absorbed into the state and national catastrophe that is our for-profit/in debt health care madness. Then I could rush back to the spine people with the x-ray before the $37 special is over.
There is a fringe benefit to this plan, as well: It is a chance to meet the people at the ER.
I need to get to know them. If my pacemaker is near dead, it is likely that I’ll need to spend the next six months in the ER waiting room. They won’t treat you unless you are actually having a life-threatening emergency. I’ll need to collapse, face-down, flat lined, before they can do anything. And then it will cost $100,000, for sure.
Somewhere in Norway, a man of modest means with a pacemaker and a formerly bulging disc is going to work today, or starting a business, or sleeping through the night. This is because Norway is a society, based upon the cooperative good of the whole. They have figured out that it is cheaper for society to take care of health problems early, at the outset, rather than waiting until the citizen is permanently disabled and cannot work or pay taxes.
We, on the other hand, are a collection of private-profit/public debt generators who exist for the benefit of enriching a few insurance corporations at the expense of the pain and suffering of millions and the debt of the whole.
Obamacare won’t fix that. But for those of us who can manage to live long enough, it might buy us an extra few years to work on changing that system.
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