the emergency room series, cc by-nc-nd image from Jillian Corinne on Flickr
What follows is a deidentified and slightly dramatized (but only slightly) version of a recent encounter I was privy to:
Setting – The emergency room of a large hospital somewhere on the east coast of the United States, 4:30am.
An employee of said hospital has just brought his wife in from home after she developed excruciating abdominal pain that medications didn’t help. In an examination room, she lies on a gurney, writhing in pain and unable to get comfortable. He looks on, tense with worry; he knows enough to be concerned about several possible things that might be wrong, but is unable to do more than wait for test results to return and pain medication to arrive. He’s also exhausted, both from the stress of the moment and the suddenly truncated sleep.
A slim man, bearing a clipboard, enters the room. He is pleasant, but slightly awkward.
Warren: “Hello, my name is Warren. Are you Anne Turner?”
The woman nods assent before twisting to a new position.
Warren: “And so that makes you Jack Turner?”
The man blinks bleary eyes, and straightens up in his seat.
Jack: “Yeah, that’s me.”
Warren: “Alright, I just need to deal with one small thing about your insurance.”
Jack: “Okay… I work here, and you already know that I have my insurance through this hospital.”
Warren: “Yes! We just need to resolve the matter of the $25 copay. Would you like a payroll deduction, to pay it out of pocket, or be sent a bill?”
The man and the woman exchange a beleaguered look.
Jack: “So, I work at this hospital, I have my medical insurance through this hospital… and I have to pay a copay for this ER visit?”
Warren: “Yes, sir.”
Jack: “And I can do this through a PAYROLL DEDUCTION?! Is that supposed to be a perk?”
Warren: “Um… yes, sir.”
The man and the woman gaze at each other with incredulity.
Jack: “Fine, I’ll just pay it now, then.”
He pulls two $20 bills from his wallet and hands them to the slim man, who quickly exits. The slim man returns about ten minutes later, money still in hand.
Warren: “I’m sorry, Mr. Turner, but do you have change?”
Jack: “Change? Change? The hospital… doesn’t have change?”
Warren: “No, sir.”
The man and the woman share yet another bemused glace. He checks his wallet again.
Jack: “Since I work for this hospital, neither do I, it seems.”
Warren: “Well, would you like me to do a payroll deduction?”
Jack: “You know what? Just send me the bill.”
“Sir, the nurse and the doctor are waiting outside to treat your wife, so if you’d just sign this paper for a loan to cover your copay, I can let them in. Thank you. Now naturally, all of this is just for the hospital. Everyone who will treat your wife is an independent contractor who will bill you separately over the next four to six months because the hospital won’t release your insurance information to their own contractors in order to protect your privacy.”
21st century medicine, controlled by a 17th century business infrastructure.
Don’t ask me how I know…